Question of the day: Neurology exam
A 44 year old builder presents with weakness over the past 48 hours.
A neurological exam reveals the following (N=normal):
|
Upper Limbs |
Lower Limbs |
||||
|
Right |
Left |
Right |
Left |
||
|
Tone |
N |
reduced |
N |
N |
|
|
Power (MRC) |
4/5 |
4/5 |
3/5 |
4/5 |
|
|
Coordination |
N |
N |
N |
N |
|
|
Sensation Fine touch Proprioception |
N N |
N N |
N N |
N N |
|
|
Reflexes Biceps Reflexes triceps Reflexes supinator |
- (absent) - (absent) + |
- (absent) - (absent) + with reinforcement |
Knee Ankle Plantar |
- (absent) - (absent) down |
- (absent) - (absent) down |
Which of the following is the most likely diagnosis?
a. Polio
b. Motor Neurone disease
c. Myasthenia gravis
d. Stroke
e. Multiple sclerosis
f. Creutzfeldt Jacob disease
g. Guillain Barre Syndrome
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g. Guillain Barre Syndrome
Motor Neurone Disease
c. Myasthenia gravis
G. Guillian Barre
Guillain Barre Syndrome
symetrical goes with GUILLAIN BARRE
guillan barri syndrome
motor neurone disease
Guillain Barre Syndrome
guillan barri syndrome
G B syndrome
guillan barri syndrome
guillian barre
guillain barre as there is symetrical weakness and areflexia
guillain barre as there is symetrical weakness and areflexia
it is nothing else but gb syndrome. gen areflexia
MOst likely Gullian Barre syndrome.
The acute onset of weakness and areflexia supports the diagnosis. Motor neuron diseae is possible but the short history makes it less likely. Age of onset and bilateral neurology is against polio. In myasthenia gravis are usually normal until late in the disease . Creutzfeldt Jacob disease is not ajoke. This disease is very serious and involves dmentia and impairment of higher brain function .