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QUESTION

Increase muscle spasm and increase edema started 2 days ago.

HPI: Increase muscle spasm and increase edema started 2 days ago. Bedside nurse reported that patient has been having frequent bilateral muscle spasms which are resulting of lack of sleep for patient at night per night shift nurse. When the patient sits in the chair with his legs held down in a 45 angle degree position, the muscle spasm of his legs decrease, however, the patient is not able to tolerate sitting down for long periods of times. Also, patient and staff report that patient has increased edema on his legs bilaterally. Beds side nurse reports that for the past 3 days leg edema has been noted to increase. Edema increase from +1 to +2 pitting edema. Pt. indicated that he has been in the long term care for spinal infections. Pt. stated that he woke up one day about 6 month ago and he was unable to move his arms or legs. Pt. was admitted to the hospital where they performed all sorts of testing but were not able to have a clear diagnosis of his case. Pt. reports that after he was discharged from hospital, he transferred to another LTC facility where he became febrile and was admitted to the hospital one more time. Pt. reported that at the hospital, he was diagnosed with spinal infection. Pt. is currently receiving received IV antibiotics via a PICC line places on his left upper arm for his spinal infection. Pt. indicated that since that time he is not able to move his legs or arms bilaterally. Pt. reported that today he is feeling well and his able to move the fingers of his right arm.

question: Any ideas as to the pending possible diagnosis due to these presenting symptoms?

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