QUESTION: Here is your Question of the Week: A 52-year-old man comes to the physician because of muscle weakness. It began as weakness in the hands, which has progressively worsened over the past two months. He has noticed a sensation of “heaviness” in his legs and increasing worsening of his balance when walking. His speech has become slurred and difficult to understand. Physical examination shows muscle atrophy and fasciculations in the hands and the calves. The patient has difficulty rising from his chair and climbing onto the examination table. Handgrip strength is 1/5. Motor strength is 2/5 in the other major muscle groups of the upper and lower extremities. The sensory examination is normal. Biceps, patellar, and Achilles reflexes are all 3+. The Babinski reflex is positive bilaterally. Which of the following is the most likely course of this patient’s disease? (A) Complete spontaneous recovery (B) Complete recovery after treatment with riluzole (C) Periodic remission of symptoms followed by relapses (D) Progressive deterioration with death within 3-5 years (E) Survival without reversal of symptoms after treatment with riluzole
Posted on: Thu, 28 Aug 2014 18:33:33 +0000
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