Peripheric neuropathy

chauretd at ere.UMontreal.ca chauretd at ere.UMontreal.ca
Thu Mar 20 23:01:55 EST 1997


  This is a 50 y. old patient who consulted me last november when he
was really sick. At that time, he presented with a sharp neuropathic
pain in both legs associated with fever. He also presented dyspnea and
the CXR showed an alveolar hemorrage. He also presented an acute renal
insufficiency with 1 red cast. He was put on cefuroxime. A screening for
vasculitis was done and was negative. No cultures were obtained from the
lungs. ANA, Anti-GBM, ANCA , CRYO were all negative. He improved drama-
tically in only 48 hours with cefuroxime except for this burning pain
still present in one leg. We thought about a para-infectious syndrome
which will resolve in few days. The pain persisted, we did an EMG which
was normal. We tried Elavil and Tegretol, no recovery. This burning pain
and this numbness in the right inferior was still present. We rehospita-
lized the patient, we did a lumbar puncture, CT-SCAN of the lumbar region,
a complete metabolic work-uo... everything was normal. The only thing
which was not done was a CT-SCAN of the brain. Except for fatigue and
this neuropathy, the patient has no other complaints. He wants to know
what is the problem.. Could this be multiple sclerosis?? Or an atypic
para-infectious neuropathy..

   If you had a patient like this one or if yoou can help me with the
diagnosis, this will be very appreciated..

Denis Chauret m.d.    chauretd at ere.UMontreal.ca

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