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EMin5

EM in 5: Rapid Neuro Hand Exam

Welcome to this week’s edition of EMin5 by Dr. Anna Pickens.  Today we’ll review a few tips on how to do a rapid neurology exam of the hand, and the great thing is you can complete the whole thing with one swift motion!

em@3am

EM@3AM: Myasthenia Gravis and Crisis

A 29-year-old female presents with generalized weakness and vision problems. The weakness is worse at the end of the day, and she has noted double vision. The symptoms worsen with heat. She denies any other neurologic deficits, including paresthesias. What is the likely diagnosis, and what is your next step in evaluation?

em@3am

EM@3AM: Multiple Sclerosis

A 33-year-old female presents with blurry vision. She has also experienced intermittent paresthesias in her extremities and weakness. Your motor and sensory exam is normal, but you find internuclear ophthalmoplegia and an afferent pupillary defect. With these intermittent neurologic symptoms and ocular findings, what is the likely diagnosis, and what is your next step in evaluation?