Lab Studies:
Complete blood count (CBC), Comprehensive metabolic panel (CMP), Magnesium, troponin, Hemoglobin A1c, lipids: Within normal limits (WNL) <br>Nasopharyngeal swab: Negative for COVID and other viruses <br>Protein C&S, cardiolipin antibodies, Factor V Leiden, prothrombin gene: WNL/negative <br>Thrombophilia testing: No thrombotic diathesis <br>Cerebral spinal fluid (CSF): Protein, glucose, RBCs, WBCs: WNL; culture: no growth; Lyme polymerase chain reaction (PCR), IgG, Oligo-clonal bands: WNL/negative <br>HIV, syphilis: Negative <br>Tick-borne: Acute PCR panel: negative; Lyme western blot antibodies: positive IgG x7 bands (pre-existing from 2015), IgM negative <br>C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), antinuclear antibody (ANA), Angiotensin converting enzyme (ACE), Myelin oligodendrocyte glycoprotein antibodies (MOG), Neuromyelitis optica / aquaporin 4 antibodies (NMO / AQP4) antibodies, Anti–Sjogren's-syndrome-related antigen A antibodies – RO (SSA-RO), SSB-LA: WNL/negative

Other Studies:
EKG: Normal sinus rhythm (NSR), normal PR & QT intervals <br>CXR: Negative <br>CTA chest: No evidence of PE, aortic dissection or aneurysm <br>Initial ED MRI C-spine w/o contrast: Unchanged from previous MRIs in the past <a href="CaseStudyImages/CS1PainandParalysisH-1047.jpg" title="Case Photo #1" data-lity><b>Case Photo #1</b></a> <br>MRI brain w/ & w/o contrast: No acute infarct or mass <br>Follow-up MRI C-spine and thoracic spine (T-spine) w/o contrast diffusion weighted on hospital day (HD) #1: New increased T2 and STIR signal intensity from the inferior endplate of C6 <a href="CaseStudyImages/CS2CS1PainandParalys-1047.jpg" title="Case Photo #2" data-lity><b>Case Photo #2</b></a> extending to the level of T6 <a href="CaseStudyImages/CS3CS2CS1PainandPara-1047.jpg" title="Case Photo #3" data-lity><b>Case Photo #3</b></a> . At the C6 level it predominantly involves the anterior third of the cervical cord <a href="CaseStudyImages/CS4CS3CS2CS1PainandP-1047.jpg" title="Case Photo #4" data-lity><b>Case Photo #4</b></a> that extended into the thoracic cord to varying degrees. <br>Transthoracic echocardiogram (TTE): Normal biventricular size and function, no significant valvular abnormalities and no evidence of intra-arterial communication per bubble study

Consultations:
Neurology <br>Physical Medicine and Rehabilitation (PMR)

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