Two patients presenting with lower extremity paralysis and abnormal electrocardiogram.

Michael D Morgan, Adam Ligler, Michael D Boswell, Laszlo Littmann

Department of Internal Medicine, Carolinas Medical Center, Charlotte, NC 28232, USA.

The American journal of emergency medicine 2013 Jan

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Acute bilateral lower extremity paralysis is a medical emergency frequently caused by spinal cord pathology. A few systemic diseases including metabolic and endocrine abnormalities, however, can also present with lower extremity paralysis. In such cases, an abnormal electrocardiogram can immediately point to a likely systemic etiology. In this report, we present 2 patients with a near carbon-copy presentation where previously healthy Hispanic men woke up in the morning not being able to get out of bed because of severe lower extremity weakness. In both cases, abnormal electrocardiograms on presentation pointed to the most likely diagnosis, which was quickly confirmed by simple laboratory testing. The appropriate evaluation and management of such patients are discussed.

Citation

Michael D Morgan, Adam Ligler, Michael D Boswell, Laszlo Littmann. Two patients presenting with lower extremity paralysis and abnormal electrocardiogram. The American journal of emergency medicine. 2013 Jan;31(1):268.e1-4