23rd August 2024

A 32-year-old female is referred by her GP due to weakness. She reports a 6-month history of progressive weakness

A 32-year-old female is referred by her GP due to weakness. She reports a 6-month history of progressive weakness in her upper limbs. She reports stiffness in her back, shoulder and arms and feels she is struggling with fine hand movements.

On examination she has atrophy of the intrinsic hand muscles bilaterally and loss of upper limb reflexes. There is a loss of sensation to pain and temperature in both her upper limbs and shoulders.

What is the most likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.