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| 2000–2005 | Neurological alterations onset and progression: postural instability during deambulation, associated with paresthesias and hypoesthesia at anterolateral surface of thighs; in 2003, after prostatectomy, hypoesthesia extended to tailbone area, paralleled by pain worsening at inferior limbs |
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| | Medical neurological division/consultant | Lab test/analyses | Symptoms/diagnosis | Therapy |
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2006
(hospitalized) | San Raffaele Hospital, Cefalù, Italy | (i) Supra-aortic trunks and inferior limbs color-Doppler (CD)
(ii) Electromyography (EMG) and motor evoked potentials (MEP)
(iii) Encephalic and spinal column magnetic resonance imaging (MRI) | (i) Sensory-motor polyneuropathy at inferior limbs
(ii) Hyperintense Punctate frontobilateral subcortical foci of gliosis
(iii) Spinal disc herniations and lumbar discal bulging
(iv) Vertebral hemangiomas in some metameric segments at dorsal and lumbar levels | Gabapentin: lack of detailed pharmacological plan documentation
Therapeutic drug treatment self-suspended by the patient
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2007
(hospitalized) | San Raffaele Foundation Scientific Institute Hospital, Neurology, Clinical Neurophysiology and Neurorehabilitation, Milan, Italy | (i) Electromyography (EMG), motor evoked potentials (MEP), somatosensory evoked potential (SSEP) monitoring
(ii) Sural nerve biopsy
(iii) Haematochemical tests
(iv) Abdominal ultrasound | (i) Sensory-motor polyneuropathy
(ii) Alteration in peripheral and radiculomedullary somatosensory conduction
(iii) Motor and sensory nerve conduction abnormalities
(iv) Axonal damage
(v) Monoclonal gammopathy of the IgG lambda type
(vi) Gallbladder adenomyoma
Diagnosis
Cordonal syndrome and idiopathic peripheral neuropathy (unknown etiology) | Lack of documentation |
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2008
(January–March) | — | Self-evaluation | (i) Postural instability progression | Self-administration of betamethasone (2 mg/die) |
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2008
(September, hospitalized) | Neurology and Neurophysiology, Policlinico P. Giaccone Hospital, Palermo | (i) Motor evoked potentials (MEP) and somatosensory evoked potential (SSEP) monitoring
(ii) Haematochemical tests (including Antinuclear Antibody (ANA) test) | (i) Postural instability progression
(ii) Motor and somatosensory conduction abnormalities
(iii) ANA test positivity: 1 : 80
Diagnosis
“Sensorymotor neuropathy of undetermined cause and spondylogenic myelopathy”
paralleled by monoclonal gammopathy of undetermined significance (MGUS) | Lack of documentation |
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2009
(clinical consultation) | Carlo Besta Neurological Institute, Milan | (i) Neurological evaluation | Lack of documentation | Dexamethasone 25 mg/die |
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| 2010–January 2011 | Private consultation with a neurologist, Anversa, Belgium | (i) Blood mercury levels determination | (i) Postural instability progression
(ii) Sensory-motor polyneuropathy
(iii) Abnormal enhanced blood mercury levels (i.e., 36 microg/L at first control and 26.7 and 21 microg/L after the first and second chelation cycles, resp.) | Chelation therapy cycles with i.v. administration of 2,3-dimercapto-1-propanesulfonic (DMPS) acid |
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