Numbness, Weakness and Decreased Proprioception

🗒️ Question

A 36 year old woman presents with a 2 week history of progressive weakness in her lower limbs. She describes numbness and tingling in her feet that started 10 days ago and has since ascended to her knees. She has had difficulty climbing stairs and rising from a chair. She reports no significant past medical history but had a respiratory infection 3 weeks ago.

On examination, she has reduced reflexes in the lower limbs but normal cranial nerve function. Sensory examination reveals decreased vibration and proprioception in the lower limbs.

Which of the following is the most likely diagnosis?

(A) Acute transverse myelitis
(B) Amyotrophic lateral sclerosis
(C) Guillain-Barré syndrome
(D) Multiple sclerosis
(E) Myasthenia gravis