Approach to differentiating lesions (motor neuron) Quiz: Ace Your Exams
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A 50-year-old woman comes to the primary care clinic for evaluation of weakness. Over the past five years, she has had progressive difficulty rising from a chair and climbing stairs without holding onto the railing. Medical history includes hypertension and depression, treated with lisinopril and fluoxetine. A sibling has been non-ambulatory since childhood due to a neuromuscular condition. Temperature is 37.0°C (98.6°F), pulse is 80/min, respirations are 15/min, and blood pressure is 118/72 mmHg. On exam, there is proximal lower extremity weakness, bilateral thigh atrophy, and areflexia without spasticity. Laboratory studies, including a comprehensive metabolic panel, muscle enzyme levels, thyroid function tests, and vitamin B12 level, are all within normal limits. Which of the following additional diagnostic tests would most likely help confirm the diagnosis?
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