new_n_lost
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A 45-year-old man presented with diplopia, dysarthria and difficulty with swallowing. Over the next few days he developed weakness of the upper and lower limbs. On day 4 he was unable to walk unaided.
He denied any sensory symptoms or bladder disturbances. His previous medical history is unremarkable. He is a non-smoker, does not drink alcohol excessively. He does not take any drugs On examination he was apyrexial. His general medical examination was normal. His higher mental function was unremarkable. There were no signs of meningism. Cranial nerve examination showed bilateral dilated and fixed pupils. He had binocular diplopia but no obvious ophthalmoplegia. He was dysarthric with weak cough. His vital capacity was 3.15 standing and 2.00 lying flat. He had lower motor neuron tetraparesis of power 3/5. He was hyporeflexic with normal sensation. He was unable to walk unaided.
Blood tests including FBC, U+Es, LFTs, TFTs, Ca, Autoantibody screen, ESR, CRP were normal. ECG and CXR were unremarkable. CT brain was normal. Nerve conduction studies and
EMG were normal. What is the most likely diagnosis?
1 ) Guillain Barre Syndrome
2 ) Lyme disease
3 ) Myasthenia gravis
4 ) Botulism
5 ) Vasculitis
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| kity
Certified.............
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I would go with 4.Botulism...
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| sprint123
Forum Guru
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I will go with Botulism too....
Reasons :
GBS : No sensory involvement-ruled out
MG : emg normal
Vasculitis : esr normal
Lyme disease : No fever,No associated symptoms
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| damngood
Forum Newbie
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i think it is D
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| chemamr
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4
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| new_n_lost
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The Answer is 4
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"never argue with a fool, they'll bring you down to their level and beat you with experience" FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| Justice
Just signed contract
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Yes, botulism
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| mdwannabe
Forum Guru
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Botulism...classical Dessending Paralysis.
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