Dr. Ashutosh Chandan Dubey (Internal Medicine) needs a second opinion on this medical case.
Recurrent Ataxia with slurring of speech under Ix.. Can it be MS Or any other cerebellar cause??.. Why there is slurring of speech while cranial Nv examination is normal.. *Chief Complaints* A 50 yr old male has come with unable to walk properly and slurring of speech since 4-5 months. Pt had similar history back a couple of times, for which he was taking treatment from outside. He was diagnosed as SACD and was taking Hydroxycobalamine without any improvement. I did complete neurological examination. Mental function, cranium, spine, Meninges, motor system, sensory function and cranial nv are normal. Pt had ataxia, with dysdidochokinesia and difficulty with past pointing, incordination, ataxia etc. No nystgmus, titubation or INO. No H/O HTN, T2DM, Thyroid disorder, substance abuse, Trauma, high risk behaviour etc. His previous report shows both cerebellar and cerebral atrophy, normal Sr Vit B12 level, normal Thyroid profile. Now we are planning MRI Brain, MRI spine, Spinal fluid for oligoclonal band etc. Ur opinion plz.. What else need to be done.. I have attached the link of neurological examination. Kindly take a look. *Investigations*
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