A 23-year-old female complains of episodes of blurry vision, and numbness and tingling in the left foot. When the foot falls asleep, the patient feels imbalanced and a gait disturbance develops, making the patient fall. The patient has a medical-surgical history of appendectomy at age 10. Otherwise, the patient has no history of illness and takes no medications. She denies use of tobacco or alcohol. On physical examination, vital signs are: temperature 98°F, respirations 18 breaths/min, pulse 66 beats/min, and blood pressure 110/60. Vision: 20/20 os, 20/20 od, and 20/20 ou. Heart: regular rate and rhythm, no murmurs. Lungs are clear to auscultation. Abdomen is nontender with no organomegaly. Extremities: skin is pink, cool to touch, and intact bilaterally. Left and right quadriceps muscle strength 5/5. Deep tendon reflexes left and right are positive 2/4. No clonus. Negative Homan's and Babinski's signs. Sensation to pinprick and cotton ball intact in extremities and equal bilaterally. Dorsalis pedis pulses +1/4 bilaterally. No neurological deficits. The following disorder(s) should be considered in the diagnosis:

Question

Quizplus · Accepted Answer

The symptoms of episodes of blurry vision, and numbness and tingling in the left foot, along with gait disturbance and imbalance, are suggestive of multiple sclerosis (MS), a central nervous system disorder characterized by demyelination and neurodegeneration. The absence of symptoms or findings that would strongly suggest peripheral vascular disease or restless legs syndrome, and the presence of neurological symptoms without clear peripheral vascular or musculoskeletal causes, point towards MS as a likely diagnosis.

A 23-Year-Old Female Complains of Episodes of Blurry Vision, and Numbness