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+--- Thread: neuro Q14 - tacrolimus99 (/showthread.php?tid=405491)
neuro Q14 - tacrolimus99 - ArchivalUser - 04-29-2009
A 66-year-old man is evaluated for a 6-month history of progressive gait disturbance. For the same period of time, he has also noted numbness and tingling in his hands and an occasional œelectric shock sensation into his arms and down his spine when he bends his neck.
Examination shows normal mental status and cranial nerves. Upper-extremity strength is normal except for mild (4/5) weakness of the intrinsic muscles of his hands. Lower-extremity strength is 4/5 diffusely. There is vibratory loss in the hands and from the knees down. Reflexes are 2+ in the biceps bilaterally, with 3+ reflexes in the triceps and knee jerks, with sustained clonus in the ankles. An extensor plantar response is present bilaterally. Gait is stiff and narrow based, and his legs tend to œscissor over each other as he walks forward.
Which of the following is the most likely diagnosis?
A Cervical spondylotic myelopathy
B Lumbar spinal stenosis
C Multiple sclerosis
D Normal pressure hydrocephalus
E Amyotrophic lateral sclerosis
0 - ArchivalUser - 04-29-2009
A..
0 - ArchivalUser - 04-29-2009
a.
0 - ArchivalUser - 04-29-2009
Cervical spondylosis is a chronic disorder of degenerative and hypertrophic changes of the vertebrae, ligaments, and disks that may narrow the spinal canal and cause cervical spinal cord compression.
Lhermitte's sign, an œelectric shock“like sensation down the neck, back, or extremities occurring with neck flexion, is a helpful historical clue to a cervical spinal cord disorder.
correct answer aaaaa