AANEM Connect
Join this vibrant community of professionals eager to exchange ideas, share resources, and engage in meaningful discussions. Use this platform as a sounding board to seek advice for navigating challenging cases or career decisions, and receive expert guidance from generous peers who want to help you succeed.
Iliofemoral vein thrombosis and neurologic déficit
A 34 yo woman was reffered to emg lab.
During puerperium she had a diagnosis of iliac vein thrombosis.
She had right leg edema, a little pain and weakness on the limb
She complainned about hyperstesia on the foot and distal third of the leg
now, about 3 months after diagnosis and symptom presentation she came to emg lab
she had suspended anticoaglutaion for the needle exam in the past 24h
- ncs:
motor, right deep peroneal: reduced amplitude
tibial nerve h reflex: absent in the right
sensory, superficial peroneal nerves normal and symetric
sensory, sural: on the right (symptomatic side) = 23 mcv / on the left side = 44 mcv
i repeated ncs in the next day. same results
- emg:
at rest: a lot of spontaneos activity in gluteus medius, tibialis anterior, tibialis posterior, peroneus longus
contraction: chronic neurogenic pattern in tibialis anterior, tibialis posterior, peroneus longus
She had a normal lombossacral spine MRI.
I fisished my report suggesting lombossacral plexopathy (right sural 48% lower), thought could not eliminate pré-ganglionar etiology for sure.
I would like to hear critics and ideias about the case, and wonder if anyone has had any case similar.
thank you
In order to comment on posts and view posts in their entirety, please login with your AANEM member account information.
I enjoy participating in the AANEM Connect Forum for a number of reasons. There are very fundamental questions posed on a frequent basis that cause me to pause and ask myself, ‘Why didn’t I think of that?’ Also, I continue to learn new things when others contribute their thoughts and experiences. Connect is an excellent opportunity for members to interact and to address any topic, including those that may not be discussed at an annual meeting or journal article.
Daniel Dumitru, MD, PhD