warm-up time after exposure to cold ( 5 ), controls rest pain, shortens and reduces frequency and severity attacks ( 6 ) including stiffness, numbness, acute pain, color change, and swelling ( 7 ), prevents impending infarction of digits and successfully heals ischemic ulcerations caused by profound vasospasm in the majority of patients ( 1 ). These favorable changes of improved perfusion are q...

Methods An 83-year-old male with history of AF, DM, cardiomyopathy presented with acute weakness and numbness of the left upper extremity. Two weeks prior to his presentation his INR reportedly ranged from 1.1 to 1.6. However, his INR level was 2.3 at the time of presentation. Upon examination, he was alert and vital signs were stable. Cardiovascular examination revealed irregularly irregular r...

Necrotizing Autoimmune Myositis (NAM) is an Acute autoimmune disease of the proximal skeletal muscle. The increased rate of morbidity and mortality in NAM is related to the severety and extant of muscle weakness. Patients with NAM develop antibodies to a specific signal recognition particle (anti-SRP ab). Peripheral neuropathy is extremely rare during the course of the disease. We report the ca...

Thyrotoxic periodic paralysis is a rare endocrine disorder seen predominantly in men of Asian origin. The case is reported of a patient who presented to the accident and emergency department with sudden onset of weakness of his lower limbs. Hypokalaemia was identified and treated with resolution of symptoms. Additional tests identified the patient as being thyrotoxic. He was treated with oral a...

A 68-year-old woman visited the emergency department twice with symptoms of acute heart failure including shortness of breath, general weakness, and abdominal distension. Laboratory findings showed extremely low level of serum hemoglobin at 1.4 g/dL. Echocardiographic examination demonstrated dilated left ventricular cavity with systolic dysfunction and moderate amount of pericardial effusion. ...

Although acute onset hypokalaemic paralysis is an uncommon cause of acute weakness, morbidity and mortality may occur due to respiratory failure and cardiac arrhythmias. Therefore it is important for a physician to have an idea regarding the underlying causes and its prompt management. To the best of our knowledge, this is the first case of congenital adrenal hyperplasia (11 beta hydroxylase de...

We report a 51-year-old woman with polymyositis accompanied by a high titer of antiacetylcholine receptor antibody. The patient presented with weakness of grip strength followed by rapidly progressive dyspnea, which required mechanical ventilation. She was treated with a glucocorticoid and came off the respirator one week later. Antiacetylcholine receptor antibody activity was elevated in the a...

The signs associated with an upper motor neurone syndrome vary considerably between text books. Often included are loss of dexterous, rapid and fractionated voluntary movements, variation of movement with mode of activation (prime mover, synergist, antagonist), weakness, various postural signs (eg, pronator drift), time-dependent tonal and tendon reflex changes and the extensor plantar response...