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CERVICAL TETRAPARESIS CAUSED BY HERNIATED DISCS: A CASE REPORT Djunadi, Joshua; Suryo, Martin Firman
INFOKUM Vol. 10 No. 5 (2022): December, Computer and Communication
Publisher : Sean Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58471/infokum.v10i5.1121

Abstract

Tetraparesis means weakness of muscle strength in all four extremities. Tetraparesis is one of the most common symptoms in daily practice but is often treated in a less comprehensive manner without finding out the root cause of the problem causing increased progression and worsening the prognosis of the disease. We report a case of cervical tetraparesis due to disc herniated in a 63-year-old woman with complaints of cramping in both hands for 10 months ago and lower back pain. Complaints such as tingling, fever, night pain, unexplained weight loss, nausea, and vomiting were denied. On physical examination, there was a decrease in motor strength in all four limbs, an increase in physiological reflexes, pathological reflexes positive, and decrease in sensory function. Cervical MRI examination revealed cervical spondylosis with degenerative discs. HNP Central discs C2 to C3, C4 to C5, and C5 to C6 pressing heavily on the thecal sac, no neural foramen narrowing was seen. Protrusion of C3 to C4 and C6 to C7 centers compressing the thecal sac and neural foramen bilaterally, suggestive of compression irritating to bilateral C3 and C6 roots. The treatment given was laminectomy surgery with pedicle fixation and pharmacologic such as Methylprednisolone 4 x 125 mg, Omeprazole 2 x 20 mg, Tizanidine 1 x 2 grams, Provlyn 3 x 50 mg, and Ketorolac tromethamine 3 x 10 mg with good results without any complication. The patient's prognosis is good.
Multiple Myeloma Presenting with Severe Back Pain: A Case Report Sopian, Fitri Rahmawati; Suryo, Martin Firman
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : Syntax Corporation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36418/syntax-literate.v9i10.16573

Abstract

This study aims to highlight the diagnostic challenges and management strategies in a case of Multiple Myeloma (MM), a hematologic malignancy characterized by malignant plasma cells in the bone marrow. The case involves a 40-year-old male who presented with persistent back pain for two months, impacting his mobility. Initial physical and neurological assessments were largely unremarkable, but laboratory and radiological investigations revealed multiple osteolytic lesions suggestive of MM. Typical MM symptoms include hypercalcemia, renal dysfunction, anemia, and bone pain, though this patient did not present all the classical signs, which underscores the diagnostic complexity. A bone marrow puncture was planned for definitive diagnosis. The study emphasizes the importance of radiological evaluation in MM diagnosis and the need for prompt treatment addressing acute symptoms, such as hypercalcemia and renal insufficiency, followed by a comprehensive long-term management plan. Early oncology consultation and a multidisciplinary approach are critical for improving patient outcomes. The case demonstrates the importance of a holistic, symptom-based approach in MM management, incorporating regular monitoring and coordinated care to address the multifaceted nature of the disease.