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Clinical Reasoning: A 39-year-old man with abdominal cramps

Lookup NU author(s): Dr Stephan Jaiser, Dr Mark Baker, Dr Roger Whittaker, Dr Daniel Birchall, Professor Patrick Chinnery

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This is the final published version of an article that has been published in its final definitive form by Lippincott Williams & Wilkins, 2013.

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Abstract

A 39-year-old lawyer presented with intermittent spasms and pain in his abdominal muscles, particularly the right upper quadrant. These had occurred since his mid-20s and there had been long asymptomatic periods, including 8 years prior to the most recent 4-month exacerbation. Trivial movement triggered a spasm of the abdominal muscles, leading to severe pain, which made breathing uncomfortable and interfered with sleep. The symptoms subsided spontaneously after 4 to 5 days, leaving him with a sore abdomen for several weeks. Past attacks had also been precipitated by specific forms of repetitive exercise such as jogging. He described ill-defined numbness in the left leg, but denied any muscle twitching, weakness, back pain, or sphincter disturbance. There was no significant past medical or family history.


Publication metadata

Author(s): Jaiser SR, Baker MR, Whittaker RG, Birchall D, Chinnery PF

Publication type: Article

Publication status: Published

Journal: Neurology

Year: 2013

Volume: 81

Issue: 2

Pages: e5-e9

Print publication date: 09/07/2013

ISSN (print): 0028-3878

ISSN (electronic): 1526-632X

Publisher: Lippincott Williams & Wilkins

URL: http://dx.doi.org/10.1212/WNL.0b013e31829a335e

DOI: 10.1212/WNL.0b013e31829a335e

PubMed id: 23836948


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