The Tired Swimmer, Case Study Example

Annie

In this particular case, Annie is suffering from several vital symptoms that can be used as clues to make a diagnosis for her.  Most of her symptoms worsen after periods of exertion, such as swimming and climbing stairs. She experiences blurred vision even with glasses, eye strain that worsens during the day, hands and fingers that are achy and weak, constant fatigue, drowsiness, and gasping for air.

The nervous system plays a role in all of these vital symptoms. It is the control and communication center for the body. Annie’s vision is controlled by the part of the brain from the central nervous system called the cerebrum. Annie’s joints and muscles are controlled by the peripheral nervous system. Annie’s lungs gasping for air is controlled by the autonomic nervous system.

The condition that Annie has is causing her breathing problems because her lungs are not functioning correctly. Since the lungs are controlled by the autonomic nervous system, it likely that there is a disruption in the communication processes to the lungs. This can be in the form of a lost signal, a signal not reaching the target, the target ignoring the signal, too much signal, or a combination of them all. These signals tell the lungs to inhale and exhale.

Annie is exhibiting many signs of multiple sclerosis. According to The National Multiple Sclerosis Society, multiple sclerosis is a disease of the nervous system that disrupts the communication processes from the brain to the body. Some of the symptoms include those that Annie experienced like, fatigue and weakness, vision problems, and breathing problems.

The Doctor’s Office

Annie has also starting experiencing droopy eyelids and improvement with rest as other vital signs.

Eyes are controlled by three muscles working together, called extrinsic muscles. These muscles work together and constantly balance each other. A decline in these muscles mean that they no longer work together to focus. If the muscles are not receiving the signals from the brain to contract and relax, then eye muscles will work against each other, instead of with each other.

With the added symptoms of droop eyelid and improvement with rest, Annie still fits the criteria for multiple sclerosis, but she is also showing signs of myasthenia gravis or lyme disease.

The Neurologist

Annie’s nerve conduction test results were normal with no nerve fatigue.

Annie’s first part of the EMG test were normal, but the second part showed muscle response fatigue over time.

The muscle response fatigue occurred from nerve stimulation because somewhere there is a disruption in the communication between nerve and muscles.

The Neurologist Cont’d

The thymus is a gland of the lymphatic system that plays a role in the production of the immune system’s T lymphocytes cells.

An antigen is a substance foreign to the body that causes the immune system to   start producing antibodies against it.

These drugs work by slowing the breakdown of acetylcholine in the body. When acetylcholine is released from the nerve endings and searching for a muscle receptor to attach to, the more acetylcholine present, the better the chance of attachment. This results in improved strength of the muscles.

If Annie’s condition if left untreated she may end up in a wheel chair. Death may also occur from organs failing to function such as the lungs or heart.

Annie continued to become weaker because her acetylcholine was being destroyed at a faster rate during periods of exertion. During her periods of rest, when the body processes slowed, her muscle weakness improved.