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A 64-year-old male presents to the clinic with complaints of gradual onset of weakness to the left hand. He is left hand dominant. He has had ongoing numbness and tingling that feels as though it starts at his elbow. However, over the past 2-3 days he had been dropping items due to the weakness. He denies any recent injuries but states that he sustained a crushing injury to the left thumb 4 years ago. He is employed as a mechanic. Several years ago, he tripped over a tire and fell backwards, striking his head on the fender of a car. He didn’t seek medical attention because he only had a small scrape on his elbow. A CT of the head is within normal limits and all labs are normal with the exception of a slightly elevated, non-fasting blood sugar (135). He has no history of diabetes. An x-ray of the neck reveals mild-to-moderate degenerative disc disease at C6-C7 with neuroforaminal narrowing and slight impingement of the exiting nerve root.
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