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Someone I know (female – age 58) is having painful pedal spasms for last 4 months. There is an onset of severe sharp pain in the foot that radiates towards the toes and the toes become wide-spaced and stiff. These episodes last for about 1-3 minutes on average. It affects one foot or the other at a time and does not affect both feet simultaneously. There is no history of similar spasms of hand. No history of panic attacks or hyperventilation. I will give the examination details, the drug history and as well as the investigation so far for this case..
10:06 am August 31, 2008
Zodac
Member
posts 3
2
Examination:
Both general physical and systemic examination is unremarkable. Chvostek’s sign is negative.
Past Medical and Surgical History:
Her past medical history is significant for diabetes, hypertension, and paroxysmal atrial flutter.
Her past surgical history is significant for modified radical mastectomy, epigastric hernial repair, cholecystectomy, hysterectomy with oophorectomy.
Drug History:
Atenolol, Fosinopril, Amlodipine, Insulin, Warfarin (temporarily discontinued due to recent development of multiple bruises), Atorvastatin (I advised her to discontinue it last week because she was having severe gum related problems and her gums have gradually receded). She has been taking Calcium + Vitamin D supplements regularly for last few years.
10:07 am August 31, 2008
Zodac
Member
posts 3
3
Investigations:
Her serum electrolytes, RFTs, and LFTs are within normal range.
She had MRI done some years ago when she had been experiencing numbness and tingling sensations in the lower limbs and was then told that she has Multiple Sclerosis. She had been prescribed Gabapentin and took it for a couple of years. More recently a different doctor has told her that she does not have MS.
Umm – So what may be causing these painful pedal spasms? What work-up would you recommend for this patient? Apart from keeping herself well-hydrated – what other general measures can be taken to prevent such pedal spasms till a definitive cause is discovered? Any thoughts?
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