07-30-2018, 08:04 PM
A 57 year old woman comes to the physician because of a 3-month history of progressive slurred speech and gait unsteadiness. She also had had mild occipital headache each morning for 3 weeks. She has type 2 DM well controlled with diet. She take no medications. Examination shows atrophy and fasciculation of the right side of the tongue. The tongue deviates to the right on protrusion. Other cranial nerve are intact. Her gait is stiff with a normal base. Muscle strength is 4/5 in the triceps, wrist extensors, interossei, and iliopsoas muscles bilaterally. Deep tendon reflexes are 3+ diffusely. Babinski sign is present bilaterally. Sensory examination shows no abnormalities. Which of the following is the most likely diagnosis?
a) Epidural abscess
b) Epidural spina cord metastasis
c) Syringomyelia
d) Tumor of the foramen magnum
e) Vertebral osteomyelitis.
Hi gys, I think the answer is d) because cranial nerve 12 travel through the foramen magnum. It is a step 1-like question appear in CK. However, please give your opinion and thank you.
a) Epidural abscess
b) Epidural spina cord metastasis
c) Syringomyelia
d) Tumor of the foramen magnum
e) Vertebral osteomyelitis.
Hi gys, I think the answer is d) because cranial nerve 12 travel through the foramen magnum. It is a step 1-like question appear in CK. However, please give your opinion and thank you.