26th August 2024

A 67-year-old man presents to the clinic describing a 3-month history of worsening fatigue and weight loss

A 67-year-old man presents to the clinic describing a 3-month history of worsening fatigue and weight loss. He’s lost 5 kilos of weight in the last few months despite maintaining his normal diet. When he wakes in the morning, he describes feeling incredibly tired, but this seems to improve throughout the day.  On examination, you note ptosis and 4/5 power in the proximal muscles of his arms and legs. Repetitive nerve stimulation shows increasing compound muscle action potentials (CMAPs) after exercise. What further testing should be carried out as soon as possible?

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