A 72-year-old hypertensive male with a history of coronary artery bypass developed slurring of speech and mild dysphagia over a period of 2 weeks. He was diagnosed with an upper respiratory infection and treated with antibiotic therapy without further diagnostic testing. He gradually improved a little over the next 1–2 months, but his symptoms returned subacutely after 4 months. In addition to dysarthria and dysphagia, he then experienced diplopia and mild ptosis for the first time. Examination reveals bilateral ptosis and a slurred voice towards the end of the consultation, but is otherwise normal. Which of the following is the most likely diagnosis? Lambert–Eaton syndrome Bulbar neuropathy Myasthenia gravis Motor neurone disease Small-vessel posterior circulation ischaemia
Posted on: Thu, 10 Jul 2014 17:18:47 +0000
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