{"ops":[{"insert":"A 32 year old woman presents with worsening lower back pain, difficulty in walking and weakness of both lower limbs for 6 months.\n\nThe pain was severe, exacerbated by activity and poorly responsive to analgesics. The lower limb weakness was pronounced when climbing stairs and getting up from chairs.\n\nShe also complains of a dry mouth, constipation and urinary frequency.\n\nSerum electrolyte levels are normal, while her ESR is 10 mm\/1h.\n"},{"insert":"\n"},{"insert":{"image":"\/storage\/case-images\/pd\/PD-M-015_en.png"}},{"insert":"\n"}]}
2
Investigate
Electrodiagnostic studies
{"ops":[{"insert":"The initial compound muscle action potential amplitude in the deep peroneal nerve was low while repetitive stimulation of the nerve showed an initial decremental response followed by an incremental response of \u003E100% after brief exercise.\n"}]}
VGCC & Ach antibodies
{"ops":[{"insert":"P\/Q type VGCC antibodies : positive\nAch receptor antibodies: negative\n"}]}