My Leg Is on Fire

"My Leg is on Fire": A Case Study on Spinal and Peripheral Nerve Anatomy

Sarah Mitchell is a 68-year-old female who is normally healthy. However, about five days ago she began to feel very fatigued and started to experience a burning and tingling sensation on hera right thigh.

You ask to see the area and upon visual inspection you notice 3–4 small, red, swollen areas with vesicles on the posterior aspect of her right thigh. She describes the pain to you, saying “it feels like the back of my leg is on fire and it hurts so bad.” She denies being exposed to any excessive heat sources, any changes in her diet, and any changes in the type of body soap, lotion, or laundry detergent she is using. All other physical findings are within normal limits, but her oral temperature is 100.6˚F. She complains about being under a lot of stress for the past three months because she has been helping take care of her husband, who is in the end stages of Alzheimer’s disease. She has no known drug allergies, is a non-smoker, and attends a water aerobics class twice a week. You suspect she may be suffering from a particular viral infection, so you ask if she had chicken pox as a child. Sarah confirms that she had chicken pox and measles during childhood. Her answer confirms your suspicions that she is likely suffering from shingles (herpes zoster) due to varicella-zoster virus infection.

Short answer questions

1. Define the following terms, used in the case and also in associated questions.

a. Paresthesia-an abnormal sensation, typically tingling or pricking (“pins and needles”), caused chiefly by pressure on or damage to peripheral nerves.

b. skin vesicle- a membranous and usually fluid-filled pouch

c. dorsal- Of, toward, in, on, or near the back

d. Ventral -situated on or toward the lower, abdominal plane of the body; equivalent to the front, or anterior, in humans.

e. Dormant- in a state of minimal metabolic activity with cessation of growth, either...