Approach to dysarthria or dysphagia Quiz: Ace Your Exams
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A 29-year-old woman presents to the primary care clinic for evaluation of choking and coughing with eating and drinking for six months. The patient has had trouble swallowing both liquids and solids. There is no chest pain or pain upon swallowing. The patient endorses feeling clumsier, tripping easily. Past medical history includes generalized anxiety managed with citalopram. The patient’s father developed similar symptoms, which she attributes to alcohol use. There is no personal history of substance use. Temperature is 37.0°C (98.6°F), pulse is 70/min, respirations are 14/min, and blood pressure is 118/78 mmHg. On exam, the patient is alert with loud, explosive speech, pausing after each syllable. The patient sways slightly to and fro while seated. There is ataxia on finger-nose-finger testing, and her gait appears wide-based. Results of which of the following diagnostic tests is most likely to confirm the diagnosis?
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