Welcome to the Emergency Medicine Cases podcast. I'm your host, Dr. Anton Hellman, bringing you Canada's brightest minds in emergency medicine from EMC studios in Toronto.

EM cases is part of Shremi, the Schwartz-Riseman Emergency Medicine Institute. That's the nonprofit organization dedicated to improving EM care through high

quality research and education. The opinions expressed on this podcast are intended for general information and educational purposes only and should not be used to diagnose treat or prevent any medical condition, nor should they be used as a substitute for medical advice from a qualified practicing position. Unless stated otherwise, the opinions expressed by the hosts or guests are made in their individual capacity, not on behalf of the Institute nor medicine cases. Just in case you missed part one of this two-part series, an approach to acute motor weakness.

Here are a few outtake. the Institute, nor medicine cases. Just in case you missed part one of this two-part series, an approach to acute motor weakness.

Here are a few outtakes.

Neck flexion weakness, which would have similar innervation to the diaphragm, is a very good

thing to check as a poor man's way of signing with your patients in trouble.

Most of them tend to be hypokalemic and they tend to be exacerbated by high carbohydrate loads

or exercise. If you can remember that, then you can make this rare diagnosis.

The abrupt onset of a stroke is pertinent for either cardiomboemolicic stroke or thrombo-emolic stroke.

But a small vessel stroke, you know, that might give you hemibody pure motor syndrome

or hemibody pure sensory syndrome, they can often have a very slow-stuttering onset.

And that can often be very misleading because as an emergency room physician,

you're thinking stroke, hyper-acute onset, we learn that stroke comes on quickly. But subcortical

strokes due to small vests disease often have the stuttering onset. Amazing. The bladder's spared.

It's unlikely that you have a spinal cord problem. Of course, this is a generality, not always.

I love it.

So, associated symptoms after you've sorted out the pattern of decreased power,

number one is left hemisphere stuff like dysphasia.

Number two, right hemisphere stuff like neglect.

Number three, we're talking brainstems, so diplopia, difficulty swallowing, etc.

Bulber symptoms.

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