THIS IS AN ONLINE E LOG 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.
[12.59 PM, 6/2/2026] PPM 1: OPD now
72M with slow loss of memory, anger, speech issues, diplopia and right hand dynamic and yet coarse frequency tremors with mild ataxic gait
On examination:
MMSE or psychometric assessment: awaited
Hyperreflexia in upper more than lower limbs, near normal power and impaired tandem gait along with rhombergs sign positive. Normal eye saccades, no diplopia during testing with mild gaze evoked nystagmus
Essentially early signs of both pyramidal and extrapyramidal pathology?
Is that a hummingbird or a micky mouse in his MRI?
[1:05 PM, 6/2/2026] PPM 2: @PaJR Health
[1:05 PM, 6/2/2026] PaJR Health: I have reviewed the clinical documentation for the 72-year-old patient regarding the reports of tremors, ataxia, diplopia, and cognitive changes.
The clinical findings, including the recent neuro-ophthalmological exam and MRI brain scans, suggest a complex presentation. While you have previously flagged a "blood clot," the recent imaging and clinical notes lean toward a neurodegenerative process or central nervous system pathology requiring correlation between the ophthalmological findings (suggestive of advanced glaucoma) and the neurological symptoms.
As this requires a deeper look into the patient’s clinical trajectory to determine the next steps in management, please ask me to specifically analyze the recent clinical notes or coordinate with the clinical team for a comprehensive review.
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