A 47-Year-Old With Diplopia, Limb Tingling, and Imbalance

Sujatha R. Borra, MD; Rahul R. Borra; Darshan Rola; Neal T. Patel


August 03, 2021

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A 47-year-old man presents with diplopia, mild bilateral lower-extremity tingling, and moderately impaired gait. He also reports problems with balance that have led to some falls. He first noticed these symptoms approximately 1 week ago and describes them as constant, with only mild progression since their onset. He has no pain, including headache, and does not have fatigue or fever.

The patient has no significant medical history, aside from a mild upper respiratory tract infection that resolved with a course of antibiotics 2 weeks ago. His surgical history and his family history are unremarkable. He does not use alcohol, tobacco, or illicit substances. He is not currently taking any medications or vitamin supplements. The patient is concerned that normal daily activities have become difficult to perform, and he now requires assistance.


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