A 64 year old man presents with a history of weakness and fatigue. He has lost 3 stone in weight. On systemic enquiry, he has no other clinical symptoms, other than a mild dry cough which he has had for 3 days and some occasional dysuria, present intermittently for 6 months. His examination findings are as follows:
- No Jaundice , anaemia, cyanosis, jaundice or lymphadenopathy
- noted rash under both eyelids.
- BP 134/66
- Pulse 78 regular
- Sats 98% air
- BM 4.5 mmol/l RR 16
- Normal Cardiovascular Respiratory Gastrointestinal examination.
Neurology as follows:
- Grade 4 power upper and lower limbs symmetrically.
- Normal sensory examination.
- Normal reflexes.
- No clonus
- No fatigability
Where is the likely pathology?
Central Brain Lesion
Acetylcholimesterase enzyme problem
None of the above
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