55 year old male with tingling sensation in the arms and legs

This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent. Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs. This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box.

55 year old male presented to opd with complaints of
1.tingling sensation in the upper and          lower limbs since 1 year
2. Burning sensation in the palms and        soles since 1 year 
3. Constipation since 10 years 
4. Bilateral knee pains



HOPI
patient has a history of neck injury following a bika accident 10 years ago .
He developed constipation subsequently.
He a history of tingling sensation in the upper and lower limbs since the last ten years

PAST HISTORY 
no significant history 
Patient has no history of DM/HTN/THYROID /EPILEPSY/TUBERCULOSIS 
 
PERSONAL HISTORY 
Diet: mixed 
Sleep: ADEQUATE 
Bowel and bladder movement: regular 
Addictions: none 

General examination: 

Patient is conscious, coherent and cooperative. 
She is oriented to place and person but not to time. 
No pallor, icterus, cyanosis, clubbing, lymphadenopathy ,edema

Vitals on admission: 
Temp: 98.6
PR: 90/min
BP: 120/70 mmHg

RS: BAE +
      No abnormal breath sounds

CVS: S1 S2 present 
          No murmurs

CNS: patient is conscious
         Speech is normal
         No neck stiffness
         Rombergs sign positive
        Reflexes



        
P/A: soft, non tender 

Reflexes

Gait
  
Investigation:

Provisional diagnosis
Patient may diagnosed with lesion or compression  at C3 - C4 level

Follow up
Patient has been discharges and yet be reveiwed following an MRI scan to localise the lesion

Literature

1.Constipation and spinal cord injury
    One study found that 40% of people with spinal cord injury experience constipation. Why is something like constipation so common among people with spinal cord injury? Because the SCI itself changes how the intestines work. Lab and special X-ray studies show that SCI makes your food take longer to travel through your colon. The longer it takes to go through your digestive tract, the more fluid gets absorbed there. This makes a drier stool which can increase constipation. And, along with working more slowly, your digestive tract just may not empty right or get stopped up.

2. UMN VS LMN
    

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