Jimmie Bowman was seen in followup for CIDP, causing previous weakness and numbness of his distal lower extremities. He states that the strength of his distal lower extremities [____] continues improved and is staying normal. He has occasional mild feeling of numbness of his feet, but states this is staying down to what he can tolerate. He is not having pain of his feet. He is no longer on Imuran. He was on this previously for CIDP.
ROS: Genitourinary - History of BPH, for which he is on tamsulosin.
EXAMINATION: He continues awake and alert. He converses easily and appropriately. He is in no acute distress. Blood pressure 120/78. Pulse 70 and regular. Weight 177 pounds. Height 5 '6". Cranial nerves continue intact, including the extraocular eye movements being intact without nystagmus. Visual fields are full in both eyes. He had no papilledema or atrophy of either optic disc. Pupils react from 4 down to 2 mm, bilaterally brisk and round to light and accommodation. He continues to have good strength with normal bulk and tone throughout his extremities. He had normal sensation to light touch, pinprick, and vibration sensation throughout both upper and
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He has no Romberg 's sign.
IMPRESSION: History of chronic inflammatory demyelinating polyradiculoneuritis. The strength and sensation of his extremities continues to improve after this, with no recurrence of symptoms from this with weaning off of Imuran.
PLAN: Continue off of Imuran. Continue observation from a neurological standpoint. Followup in one year to make sure he is not having any worsening of the strength or sensation of his extremities. I have advised him to contact me soon than this, though, should he have worsening of the strength or sensation of his extremities, especially of his distal lower extremities or other neurological difficulties before then.
Thank you for allowing me to participate in this patient 's care, Craig Johnson,