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Cervical Conundrum

History of Present Illness

Ms. Q, a right-handed female in her early 30's with an approximate 10 year history of right side numbness. The numbness began in the right fingers, progressing to the right upper extremity, into the right trunk, to the face, and finally throughout the entire right side. She reported the progression of numbness as gradual. She also noted difficulty with left hand hot-cold discrimination, first noted approximately 9-12 months prior to presentation. She had noted progressive weakness of the right upper extremity, and heaviness in her right foot. At times, she would stumble due to right foot-drop.

She reported frequent posterior-occipital headaches, which were described as a pressure sensation, often associated with nausea. The headaches ranged from moderate to severe in intensity. The headaches were not associated with coughing, sneezing or straining. Shortness of breath was also noted over the past 12 months; however, she denied any history of respiratory disorders.

She noted significant constipation, requiring the use of laxatives every other day. She reported no incontinence or change in bladder function. For the previous 12 months, she noted occasional blurring in her right eye and mild right hearing loss.