Odd patient medical issue. Help?

[Pachinko]

I have a primary care patient who is demonstrating neuro changes. She developed numbness and tingling of fingers bilaterally and slow onset right-sided facial weakness over the past year. When I checked her lab work, she was found to have extremely low LDL (

I'm doing an MRI and will refer to neuro thereafter. To which specialty would you refer for evaluation for the lipid abnormality? Or would you keep it with neuro and let them navigate the work-up? Thanks.

[prelift]

hard to tell anything without a full history.

make sure its not medication related (do not know her history)

Most not so common lipid disorders present at a young age (do not know her age but in children) (also not talking about the basic high cholesterol/LDL stuff. as in, not so common.

I would check the usual B vitamins, folate, and neurology (depending on clinic/hospital) usually wants an MRI

Sounds like you are doing the right thing though so keep it up, they can evaluate whatever they think of the low LDL.

If hunting for specific lesions need to know if it is full face VS just lower face since upper face has bilateral cortical representation (as in each side gets represented by both cortical hemispheres. So if upper and lower and bilateral numbness tingling of upper extrem with unilateral facial weakness one could think possibly a pontine lesion (but these are rare)

Not textbook presentation of MS but also something to keep in mind since it varies greatly.

Neuro is a pain in the butt

[Pachinko]

Thanks for the help.

[YoutubeTheNP]

refer her to Ronald McDonald.