17. A 46-year-old man comes to the physician because of a 6-month history of progressive right leg numbness and weakness that occurred over 1 month and has persisted since. Ten years ago, he had an episode of decreased vision in the right eye that came on over 1 week, then lasted 2 months and resolved without evaluation. Cranial nerve examination shows no abnormalities except for mild right optic atrophy. Mild weakness of right hip flexion and ankle dorsiflexion is present. There is numbness of the right lower extremity up to the midthigh. A Babinski sign is present on the right. Which of the following is the most likely cause of his current symptoms? A) Central nervous system demyelination B) Cerebral hemispheric ischemia C) Nerve root compression D) Peripheral system axonal loss E) Spinal cord compression
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This suggests a chronic and progressive condition. The patient also had a previous episode of decreased vision in the right eye that resolved without evaluation. This suggests a history of optic neuritis, which is often associated with demyelination. On Show more…
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