9th September 2020

The following patient presents with extrapyramidal motor problems to primary care or emergency services (3)

The following patient presents with extrapyramidal motor problems to primary care or emergency services.

A man in his early 30s with recurrent tripping over surfaces and foot numbness. He also complains that recently he is finding it difficult to do up buttons on his shirts. He says that he has always had problems with weakness in his ankles since he was a teenager, but the hand symptoms seem to have been gradually progressing for the last year. On examination, he has a high stepping gait.

For the patient above, please select the SINGLE most likely underlying cause of their balance and/or movement problem. Select ONE option from the list above.