s Hopkins Case #15: Rapidly Progressing Leg Weakness from Medscape Neurology & Neurosurgery

[Guest guest]

http://www.medscape.com/viewarticle/439453_3

s Hopkins Case #15: Rapidly Progressing Leg Weakness

from Medscape Neurology & Neurosurgery

Clinical Course

The patient's condition continued to deteriorate at JHH. Although his mental

status, cranial nerve, and upper extremity motor exam remained unchanged,

within a few days, his lower extremities had become flaccid and hip flexion,

knee flexion, and knee extension had diminished in strength to 2-3/5; he

could wiggle his toes but could not push or resist with them. Patellar

reflexes were now absent and his toes had ceased to " respond " to the

Babinski maneuver. Furthermore, he could no longer walk.

What's Your Diagnosis?

Guillain-Barré syndrome

Chronic inflammatory demyelinating polyradiculoneuropathy

Neoplastic polyradiculoneuropathy

Vacuolar myelopathy

Virus-related polyradiculopathy

Toxoplasmosis

Lyme disease

Tuberculosis

Transverse myelitis