38 year-old female with a history of DM2, hyperlipidemia, hypothyroidism and migraines who presented with a chief complaint of bilateral upper extremity weakness. On the day prior to presentation, around 10:30 pm she noticed pain in the back of her neck and she denied any associated trauma. She used the bathroom, and went to bed. Around 3:00 am she awoke to use the bathroom again and noticed she couldn’t bend her fingers, and developed numbness and paresthesias in her bilateral upper and lower extremities. Her legs felt unsteady and she had to balance herself against the walls, and denied any dizziness or light-headedness. She returned to bed hoping the symptoms would go away. When she awoke around 7:30 am she had difficulty rising from a seated position, and that morning appreciated a tightness around her abdomen, and was having difficulty urinating that morning.
On exam the patient had bilateral UE weaknes distal > proximal and mild LE weakness, C8 sensory level with decreased pain and temperature, with sparing of vibration and proprioception, and, and urinary retention.
Awesome!!
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