Dr. Manorama Rajan (Neurology) needs a second opinion on this medical case.
47 yr ,F, Todays 1st OPD case.
Presented with low back pain 7 yrs ,progressive parasthesia both lower limbs 2 months,buckling of the knees while walking occasionally for 2 weeks.
Insedous onset and progressive low back pain for 7 yrs . Look lot of treatment. Pain aggravated since 4 months and took ayurvedic treatment including back and leg message for 2 months. After that developed parasthesia both legs and since 2 weeks whole walking there is tendency to fall due to buckling of left knee. Denied having any blower or bladder dysfunction.
MRI done before reported to have disc lesion.
Past history - No trauma to the back. No known medical illness.
On exam vitals stable. BP 130/ 80 mmhg.Intact cranial nerves and upper limbs.Mormal abdominal muscles Mid adductor spasticity left side. Lower limbs gr5/5 power. DTRs bilsteral hyperactive kneejerks,ankle jerks normal with O plantars bilaterally.Dulling of sensations below D12 Rt side.( Pt is from the neighboring state making mistake for sensory exam in the OPD).
An urgent MRI Dorsal spine done.
What is the diagnosis?
After seeing the MRI ,she is ref to Neurosurgeon and waiting to see the Neurosurgeon