Year Seen Your Explained for Students (Easy Guide)

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Original Question

A 13-year-old boy is seen in your office on an urgent basis for complaints of lower extremity weakness. The patient was in his usual state of good health until that morning when he noticed that his legs were weak when getting out of bed. His symptoms seem to be getting worse because now he is having difficulty walking. The patient does not have any medical problems. He had an upper respiratory tract infection like all of his friends about 2 weeks ago but he did not experience any fevers. He plays football but denies any recent trauma. Vital Signs: Afebrile. General Examination: There is no nuchal rigidity or papilledema. Neurologic Examination: Mental Status: Alert. Language: He has fluent speech without dysarthria. Cranial Nerves: His pupils are equal, round, and reactive to light. His extraocular muscles are intact. His facial movements are symmetric and without weakness. There is a strong gag and his tongue is midline without fasciculations. Motor: He has normal bulk with mild hypotonia in the lower extremities. Strength in the upper extremities is 5/5 and there is no pronator drift. Lower-extremity strength is 3/5. Cerebellum: No dysmetria Gait: Unable to walk unassisted Sensory: Intact to light touch, temperature, vibration, and proprioception. Reflexes: (O) in the lower extremities. (+)the biceps and triceps. Bilateral plantar flexor responses are appreciated No meningeal signs Give the most likely diagnosis and provide a differential diagnosis in a table to rule in the diagnosis No using of AI

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