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Distinguishing Motor Weakness From Impaired Spatial Awareness: A Helping Hand!

Our patient, aged 73 years, had background peripheral neuropathy of unknown cause, stable for several years, which caused some difficulty in walking on uneven ground. He attended for a teaching session but now staggered in, a new development. He had apparent weakness of his right arm, but there was...

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Detalles Bibliográficos
Autores principales: Raju, Suneil A, Swift, Charles R, Bardhan, Karna Dev
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5436835/
https://www.ncbi.nlm.nih.gov/pubmed/28579860
http://dx.doi.org/10.1177/1179547617709462
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author Raju, Suneil A
Swift, Charles R
Bardhan, Karna Dev
author_facet Raju, Suneil A
Swift, Charles R
Bardhan, Karna Dev
author_sort Raju, Suneil A
collection PubMed
description Our patient, aged 73 years, had background peripheral neuropathy of unknown cause, stable for several years, which caused some difficulty in walking on uneven ground. He attended for a teaching session but now staggered in, a new development. He had apparent weakness of his right arm, but there was difficulty in distinguishing motor weakness from impaired spatial awareness suggestive of parietal lobe dysfunction. With the patient seated, eyes closed, and left arm outstretched, S.A.R. lifted the patient’s right arm and asked him to indicate when both were level. This confirmed motor weakness. Urgent computed tomographic scan confirmed left subdural haematoma and its urgent evacuation rapidly resolved the patient’s symptoms. Intrigued by our patient’s case, we explored further and learnt that in rehabilitation medicine, the awareness of limb position is commonly viewed in terms of joint position sense. We present recent literature evidence indicating that the underlying mechanisms are more subtle.
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spelling pubmed-54368352017-06-02 Distinguishing Motor Weakness From Impaired Spatial Awareness: A Helping Hand! Raju, Suneil A Swift, Charles R Bardhan, Karna Dev Clin Med Insights Case Rep Case Report Our patient, aged 73 years, had background peripheral neuropathy of unknown cause, stable for several years, which caused some difficulty in walking on uneven ground. He attended for a teaching session but now staggered in, a new development. He had apparent weakness of his right arm, but there was difficulty in distinguishing motor weakness from impaired spatial awareness suggestive of parietal lobe dysfunction. With the patient seated, eyes closed, and left arm outstretched, S.A.R. lifted the patient’s right arm and asked him to indicate when both were level. This confirmed motor weakness. Urgent computed tomographic scan confirmed left subdural haematoma and its urgent evacuation rapidly resolved the patient’s symptoms. Intrigued by our patient’s case, we explored further and learnt that in rehabilitation medicine, the awareness of limb position is commonly viewed in terms of joint position sense. We present recent literature evidence indicating that the underlying mechanisms are more subtle. SAGE Publications 2017-05-15 /pmc/articles/PMC5436835/ /pubmed/28579860 http://dx.doi.org/10.1177/1179547617709462 Text en © The Author(s) 2017 This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page(https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Case Report
Raju, Suneil A
Swift, Charles R
Bardhan, Karna Dev
Distinguishing Motor Weakness From Impaired Spatial Awareness: A Helping Hand!
title Distinguishing Motor Weakness From Impaired Spatial Awareness: A Helping Hand!
title_full Distinguishing Motor Weakness From Impaired Spatial Awareness: A Helping Hand!
title_fullStr Distinguishing Motor Weakness From Impaired Spatial Awareness: A Helping Hand!
title_full_unstemmed Distinguishing Motor Weakness From Impaired Spatial Awareness: A Helping Hand!
title_short Distinguishing Motor Weakness From Impaired Spatial Awareness: A Helping Hand!
title_sort distinguishing motor weakness from impaired spatial awareness: a helping hand!
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5436835/
https://www.ncbi.nlm.nih.gov/pubmed/28579860
http://dx.doi.org/10.1177/1179547617709462
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