08-04-2006, 10:44 AM
A 37-year-old man comes to the physician because of a 3-month history of increasing pain of his shoulders and upper arms. Over the past 2 weeks, he has also had difficulty lifting heavy objects off shelves in his garage. Two days ago, he burned his hand by touching a hot pan and felt little discomfort. He sustained a concussion in a motor vehicle collision at the age of 29 years. He has no allergies. He takes no medications. He does not smoke cigarettes or use illicit drugs, and he drinks one to two beers daily. Muscle strength is decreased equally in both arms. Temperature and pain sensation are decreased in both hands, but light touch is normal. Muscle strength and sensation are normal in the lower extremities. Neurologic examination shows no other abnormalities. Which of the following is the most likely diagnosis?
A) Alcoholic peripheral neuropathy
B) Ankylosing spondylitis
C) Guillain-Barre syndrome
D) Herniated intervertebral disc
E) Multiple sclerosis
F) Polymyositis
G) Syringomyelia
A) Alcoholic peripheral neuropathy
B) Ankylosing spondylitis
C) Guillain-Barre syndrome
D) Herniated intervertebral disc
E) Multiple sclerosis
F) Polymyositis
G) Syringomyelia