65M With Chronic Paraparesis Since 10yrs

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65M with chronic progressive paraparesis since 10 years. Fell from a toddy tree 20 years back and was bedridden for 6 months and then recovered well enough to resume his toddy tree climbing for next 10 years!

10 years back he again developed weakness in his lower limbs, right more than left with equine gait and walked with a stick also had urinary retention and bowel constipation. 

Was operated with a laminectomy and his bowel bladder symptoms improved but his paralysis progressed even more and required two sticks to walk over last ten years and last year he was gradually getting bed ridden and having to sit for a long time because of which he's now admitted with these gluteal ulcerations and fournier's gangrene that was debrided and transferred to our ICU in view of his AF and hypotension.

On examination by @PPM3 his lower limb reflexes are absent, tone reduced and power couldn't be tested.

PPM 3 -

PPM 3 - ICU bed 2.

BP charting with requirement of inotropes coming down.

PPM 1 - Thanks.

Nice to see some positive outcomes in this patient of chronic quadriparesis and cauda equina syn due to his toddy climbing occupation that happened 20 years back and climaxed recently with saddle anesthesia sores causing sepsis and hypotension and we hope he shall be coming out of this soon.

PPM 1 - 

PPM 1 -Nice afternoon session today around this 70 year old man with cauda equina in the sense he made a remarkable recovery from what he was yesterday afternoon when @~K Shiva Sai Nagendra said he was worried that his urine output was progressively reducing but today he made a dramatic recovery in his hypotension and hourly urine output with his atrial fibrillation spontaneously reverting to sinus rhythm!

PPM 1 - @PPM4 can you share the complete neurological findings from what couldn't be shared earlier as he was drowsy and very ill but can be done now as he appears much better today?

PPM 1- His saddle anesthesia ulcerations and Fourier gangrene debridement.