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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