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ss nucleus - autumn 1993,  Differential Diagnosis 5

Differential Diagnosis 5

1 Kings 13:1-6 - When King Jeroboam reprimanded the prophet of Judah, the hand he stretched out towards the man 'shrivelled up so that he could not pull it back'(v 4). The Hebrew word yabesh (NIV=shrivelled) is alternatively translated withered (Jon 4:7) or dried up (Gn 8:7).

Although details are sketchy the context suggests an acute paralysis of the upper limb, which was healed in response to the prophet's prayer.

Possible diagnoses include transient ischaemic attack, axillary artery embolus, hysterical paralysis or brachial plexus neuropraxia. In view of the age and constitution of the patient, apparent absence of pain and onset of the deficit during violent movement, Luke favours a neuropraxia.

Differential Diagnosis 6

Mephibosheth, son of Jonathan, was 'crippled in both feet' (2 Sa 9:3). From the clinical context (2 Sa 4:4, 9:1-12) comment on the likely diagnosis and degree of disability.

Luke's opinion in next issue.

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