A 25-year-old female visits to the hospital with a difficulty in walking. She has been feeling ‘pins-and-needles’ sensation in her hands and feet from the past one week. Initially, she experienced numbness on the soles of both the feet, which gradually spread up to her knees and eventually her hands. She also complained of weakness in her arms and legs. Examinations: Pulse and blood pressure: normal Eye movements: full and there was no diplopia. Difficulty in swallowing liquids, but the voice was normal, and there was no facial weakness.
Bowel and bladder functions: normal The cranial nerves: normal. The limbs: normal on inspection, with no fasciculations. Muscle strength: reduced. The strength score was symmetrical to 3/5 in all muscle groups in the legs and 4/5 throughout the arms. Glove and stocking pattern: Altered sensation in all modalities in the legs and arms. All the reflexes…
