A 44-Year-Old Man With Progressive Weakness and Back Pain

Benjamin O. Cornwell, DO; Jignesh Modi, MD

Disclosures

November 26, 2018

Editor's Note:
The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to recognize accurately. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a future Case Challenge, please contact us.

Background

A 44-year-old man is referred for neurosurgical evaluation secondary to a 6-month history of progressive bilateral lower extremity numbness and weakness. Additionally, he reports a history of back pain over the past 4 years that he describes as an occasional sharp shooting pain down his right thigh.

The only medication that he has taken is ibuprofen for pain relief. His surgical history only includes an appendectomy at age 14 years. He denies tobacco, alcohol, or illicit drug use.

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