A man with small vessel vasculitis presenting with brachial diplegia, multiple cranial mononeuropathies and severe orthostatic hypotension in diabetes mellitus: a case report

Table 1 Serial confrontational motor strength testing, Montreal cognitive assessment testing, and orthostatic vitals

Muscle group	Muscle strength grade – data on initial examination	Muscle strength grade – data at 3-month follow up	Muscle strength grade – data at 1-year follow up
Shoulder flexors	2/5 (L), 3/5 (R)	2/5 (L), 3/5 (R)	3/5 (L), 4/5 (R)
Shoulder extensors	2/5 (L), 2/5 (R)	2/5 (L), 2/5 (R	4/5 (L), 5/5 (R)
Shoulder abductors	2/5 (L), 2/5 (R)	2–/5 (L), 2/5 (R)	2/5 (L), 5/5 (R)
Shoulder adductors	3/5 (L), 3/5 (R)	3/5 (L), 3/5 (R)	4/5 (L), 5/5 (R)
Elbow flexors	3–/5 (L), 3/5 (R)	3–/5 (L), 3/5 (R)	4/5 (L), 5/5 (R)
Elbow extensors	3/5 (L), 3/5 (R)	4–/5 (L), 4+/5 (R)	3+/5 (L), 4+/5 (R)
Wrist flexors	2/5 (L), 2/5 (R)	3/5 (L), 4/5 (R)	3/5 (L), 4/5 (R)
Wrist extensors	2/5 (L), 2/5 (R)	3–/5 (L), 4/5 (R)	3/5 (L), 4/5 (R)
Finger flexors	2/5 (L), 3/5 (R)	2+/5 (L), 4–/5(R)	3+/5 (L), 4/5 (R)
Finger extensors	3/5 (L), 3/5 (R)	2+/5 (L), 4/5(R)	3/5 (L), 3+/5 (R)
Finger abductors	2/5 (L), 3/5 (R)	2/5 (L), 3/5 (R)	2/5 (L), 3+/5 (R)
Finger adductors	3/5 (L), 3/5 (R)	3/5 (L), 3/5 (R)	3/5 (L), 3/5 (R)
MoCA score	16/30	16/30	16/30
Orthostatic vitals
Supine	BP 142/90, pulse 68	BP 143/96, pulse 71	Not recorded
Sitting	BP 97/64, pulse 77	BP 128/84, pulse 72	BP 132/88, pulse 73
Standing	BP 65/40, pulse 81	BP 98/62, pulse 74	BP 102/70; pulse 83

Muscle strength data is based on the six-point Medical Research Council scale (0, no movement; 1, some movement with an inability to move the joint; 2, movement of the joint but inability to overcome gravity; 3, ability to overcome gravity but not passive resistance; 4, ability to overcome partial resistance but not full resistance; 5, normal strength).
Key: +, indicates slightly more; – indicates slightly less; BP, blood pressure (measured in mmHg); L, left; MoCA, Montreal Cognitive Assessment; R, right. Pulse measured in beats per minute.

ISSN: 1752-1947