Young Lady with Severe Arm Pain

Abstract

30-year-old very active, hardworking woman attended our clinic with sharp pain in the left arm and hand. Her left leg “probably felt a bit different too”. On further questioning she mentioned some discomfort in the abdomen on the left as well. Pain was present for 11 months; started as paresthesias (pins and needles) and was gradually progressive. She denied other symptoms including sphincters. She did not respond to neuropathic pain treatments. On objective testing we found monofilament sensation reduced and proprioception and vibration sense was impaired as well in left upper extremity. There was no convincing objective sensory deficit in lower extremities (only subjective as above). Sensory deficit/light touch hypoesthesia was seen in the abdomen and chest with no convincing sensory level. Reflexes were present and symmetrical and there was no paresis. From sensory point of view face was spared and cranial nerves and cerebellar functions were normal.