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406181046 - CYNTHIA
406181054 - ANDI PANDU
NEUROLOGY BAGUS ALLAM
ROYAL TARUMA HOSPITAL
FACULTY OF MEDICINE
TARUMANAGARA UNIVERSITY
Case 1
Identity
Name : Ms. B
Age : 55 years old
Adress : Kembangan, West Jakarta
Weakness in both legs since 1 month ago
Initially the patient has aching legs on
both legs since 6 months ago
There is no history of trauma
Patient have a hipertension
Physical examination
Awareness :
GCS = 15
VitalSign BP : 160/80mmhg RR : 20 ; HR :
72 ; T : 36,7 ; Weight : 65 kg
Physical examination
Menigeal sign (-)
N III, IV,VI : ocular alignment : symentic, pupil position in the
middle, direct light reflex (+), Indirect light reflex (+), ocular
movement to all direction
Refleks Physiologist
Refleks bicep +/+
Patella ++/+
Refleks Pathologist
Babinski : -/-
Chaddok : -/-
Gordon : -/-
Hoffman tromner : -/-
Motoric :
Strength : 5555/5555
1111/1111
Tonus : normotoni
Trofy : normotrofy
Sensory : no abnormality found
Sensibility : no abnormality found
MRI
Scoliosis to the right
Signal intensity Vertebrae Thoracal to Lumbar 1 in
homogeneous especially L 1 dominant
hyperintense and tissue around edematous this is
a suspicious aspect of metastasis
Sagittal cuts appear in disc bulging at L1, L2, to L5
S1 pressing on the spinal cord and causing
moderate canal stenosis
Axial cuts appear on L4 L5 S1 bulging disks which
cause a slight narrowing of the neural foramen on
the left side and appear to be local radix irritation
There is a picture of facet joint edema at L4 L5
and L5 L1 levels
Working diagnosis
Paraplegia Inferior
Treatment
Methlyprednisolone 3x125
Ketorolac
1x30 mg
Mecobalamin 1x500 mcg
Case 2
Low magnesium level
Causes
Every organ in the body, especially the heart, muscles, and kidneys, needs the
mineral magnesium. It also contributes to the makeup of teeth and bones.
Magnesium is needed for many functions in the body, including the physical and
chemical processes in the body that convert or use energy (metabolism).
When the level of magnesium in the body drops below normal, symptoms of low
magnesium may develop.
Common causes of low magnesium include:
Alcohol use
Burns that affect a large area of the body
Chronic diarrhea
Excessive urination (polyuria), such as in uncontrolled diabetes and during recovery
from acute kidney failure
High blood calcium level (hypercalcemia)
Hyperaldosteronism (disorder in which the adrenal gland releases too much of the
hormone aldosterone into the blood)
Malabsorption syndromes, such as inflammatory bowel disease
Malnutrition
Medicines : diuretics, proton pump inhibitors, and aminoglycoside antibiotics
Symptoms
Convulsions
Fatigue
Muscle spasms or cramps
Muscle weakness
Numbness
Treatment
Fluids given through a vein (IV)
Magnesium by mouth or through a vein
Medicines to relieve symptoms
Possible Complications
Cardiac arrest
Respiratory arrest
Death