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AE.01. Hima Theresa - Mr Michael Weir


 

Dr M McLaren

Neurologist

Suit 3

67 The Cresant

Newtown


09 August 2014


Dear Dr McLaren


Re: Mr Michael Weir, DOB: 20 September 1920


Thank you for seeing Mr. Michael, who has been suspected to having multiple sclerosis. He requires expertised assessment and diagnostic management at your facility.


On 29 June, Mr Michael was presented for general checkup with stress and other minimal disturbances. During assesment, his vital signs and skin were not suspicious. Complete blood round and lipid profile were advised. After one week, he re-presented with tiredness and weakness on left leg. Blood values were quite low except cholestrol level; it was high.


After three months, he had the same symptoms including depression. Modificational changes in smoking , exercise and recreational activities had been advised.Mr Michael has been sertraline hydrochloride since September 2012 for the depression.


Today, he had complaint of dizziness and two episodes of blackouts.Hands had lingling and left leg with the same; where reluxes was diminished. CT Scan has been sujected according to the prespective symptoms.


Based on the above mentioned circumstances, confirmation of diagnosis with appropriate studies and further management of Mr Micheal's condition would be extremely grateful.


You may require to contact with me for further clarification.


Yours sincerely


Registered Nurse



 

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