Please help me with this Case StudyPast medical history is relatively unremarkable.

Question Answered step-by-step Please help me with this Case StudyPast medical history is relatively unremarkable.David, a 43 year old male, presents to your practice with complaints of fatigue, numbness in his extremities, and muscle cramping. He states these symptoms have been on and off for the past 6 months lasting more than 24 hours with increasing frequency and duration. He reports a lot of stress at work and reports just getting over “flu-like symptoms” a few weeks ago during which his neurologic symptoms significantly worsened.Family history is significant for high blood pressure and type 2 diabetes. EXAMINATION:BP 118/68; HR 72 regular; RR 10; afebrileNEUROLOGIC EXAMINATION:Cranial Nerve II – disks are sharp and of normal color. Funduscopic examination is normal. Cranial Nerves III, IV, VI – no extraocular motor palsy or difficulties with smooth pursuit or saccades are seen. Remainder of the cranial nerves are also unremarkable.Motor examination reveals relatively normal strength in the upper extremities throughout. However, rapid alternating movements are decreased in both upper extremities. Mild paraparesis is noted in both legs without severe spasticity.Sensory exam reveals paresthesia on the right to touch and decreased pin sensation on the right diffusely. The patient has mild vibratory sense loss in the distal lower extremities.Deep tendon reflexes are +2 and symmetrical in the arms, +3 at the ankles and at the knees. Bilateral extensor toe sign are present.Which diagnosis is most likely?What is the differential diagnoses? What is your detailed treatment plan with diagnostic work-up? Are there any other tests you need? Health Science Science Nursing NURSING NUR 3011 Share QuestionEmailCopy link Comments (0)