Approach to differentiating lesions (motor neuron) Quiz: Ace Your Exams
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A 44-year-old man comes to the primary care clinic for evaluation of frequent falls. There has been gradually worsening weakness over the past 10 years. It has become increasingly difficult to rise from a chair or climb stairs without using the railing. There have been more frequent episodes of tripping. The patient’s partner reports new-onset snoring during sleep. Medical history includes well-controlled hypertension treated with lisinopril. Family history is notable for a sibling who died in infancy due to respiratory failure. Temperature is 37.0°C (98.6°F), pulse is 80/min, respirations are 15/min, and blood pressure is 122/75 mmHg. Physical examination reveals proximal lower extremity weakness, bilateral thigh atrophy, and areflexia. Which additional symptom or physical examination finding is also most likely to be present?
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