17-12-2024
This is an Online ELog Book to discuss our patient's de-identified health data shared after taking his signed informed consent. Here we discuss our patient's problems through series of inputs from available global online community experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs.
In this case the patient is a 70yr old male who suffered a stroke in 2013 and was treated in Nalgonda. He was a k/c/o CKD since 2014. He was under dialysis for a short period and was prescribed Nodosis later. He is a k/c/o of HTN since 10 yrs with medication Cynod and Ecosprin. Since 2020 he experienced tremors in his hands and limbs.
70M was waiting in OPD while the Doctor was passing by and couldn't help but notice his peculiar movement disorder (and didn't notice the Harry Potter snake sign in his left arm as the sleeves were concealing it)! He was seated near the psychiatry OPD and making circles with his fingers in the air and from time to time his left shoulder was shrugging and his arms were moving along with his feet tapping on the ground as if he was dancing on the chair. In 2013 he had suffered a stroke from which he recovered soon only to be diagnosed CKD in 2014 and was given this sign in his arm toward life long dialysis but after a few sessions they were stopped and he never required dialysis later till date and his last creatinine a week ago was 2.5
So is his current chorea a result of his cerebral vasculopathy or CKD associated toxins? Perhaps likely to be the former?
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