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Sensory abnormality (e.g., ache, numbness, paresthesias)? Muscle cramping or aching? Bowel and/or bladder signs? Ocular involvement (e.g., double vision, droopy eyelids)? Bulbar involvement (e.g., voice change)? What actions/movements do you've bother with? Duration or pattern? Acute-onset suggests a vascular etiology. Fatigability and waxing/waning suggest myasthenia gravis. Weakness distribution: - Proximal vs. Upper vs. lower extremities? Brainstem infection or inflammation (e.g., sarcoidosis, neuromyelitis optica spectrum disorder). Structural lesion compressing the brainstem. Acute disseminated encephalomyelitis (ADEM). Distribution: Motor and sensory findings could localize to a spinal degree. Reflexes: Upper motor neuron signs might seem, particularly subacutely (e.g., hyperreflexia, spasticity, Babinski sign). Acutely, patients may have transient spinal shock, with lack of spinal perform below the extent of the lesion and areflexia. Sensation: - Frequently concerned. Sensory degree could also be current. Bowel and bladder dysfunction could happen. Spinal cord compression (e.g., trauma, epidural abscess, malignancy). Inflammation (e.g., idiopathic transverse myelitis |
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