Nbme ..motor neuron disease - poojy36

[ArchivalUser]

58 yr old man has progressive weakness over 8 months .he shows weakness and atrophy in the upper and lower limbs.his reflexes are increased in the lower lims and decreased in the upper limbs.he has no sensory deficit.wht is teh finding?

a) cystic lesions involving the midline stuructures and both ventral horns
b) demyelination of lft corticispinal tract
c) lesions of the lft anterolat quadrant of c2
d0 loss of myelin in dorsal colunm
e) loss of myelin in lat column and loss of ventral motor neurons

[ArchivalUser]

b ?

[ArchivalUser]

looks like als (bilateral spastic paralysis in lower limb,bilateral flacid paralysis in upper limb),with no sensory defects, i go with segapoo -b

[ArchivalUser]

hi..its motor neuron disease from the clinical discription......I had to chose between a ....c ...or e......

if it was a ,its is syringimyelia..and pain and temp shud also be lost
if it is c....they hv given only lft quadrant wheras the pt has all limbs involved
if it is e ....lat column involvement shud involved spinothalamic also...

so I am confused..i wrote a as teh answer...not sure at all

[ArchivalUser]

This is ALS, answer should be E. Refer FA p.105.

[ArchivalUser]

If choosing B., the Q stem didn't mention which side, so implying both sides. why do we choose only left side corticospinal tract lesion? I don't understand.

[ArchivalUser]

I agree with Calender..I didn't notice its saying left corticospinal tract..so It should be e..both ventral horn and later column lesion.

[ArchivalUser]

i didnt notice its left i agree with calender,but what about no sensory defects?

[ArchivalUser]

ALS is pure motor disease, no sensory defects involved.