{"ops":[{"insert":"A 22-year-old woman presents with the inability to smile or frown since waking up around 6 hours ago. She has difficulty in moving her eyes, complains of double vision, and finds it difficult to walk.\n\nClose questioning reveals a mild diarrheal episode about 2 weeks ago, which resolved spontaneously. Her surgical and family histories are unremarkable.\n\nShe does not smoke, only drinks socially, and denies using recreational drugs. She is sexually active, with a single stable partner.\n"},{"insert":"\n"},{"insert":{"image":"\/storage\/case-images\/pd\/PD-M-075_en.png"}},{"insert":"\n"}]}
2
Investigate
Contrast MRI Brain
{"ops":[{"insert":"The gadolinium weighted MRI shows bilateral enhancement of the cranial nerves III, VI, and VII. No other abnormalities are present.\n"}]}
Lumbar Puncture
{"ops":[{"insert":"Appearance: clear and colorless \nCell count: 4 (0-5) \nTotal protein: 450 mg\/100 mL (15-60) \nGlucose: 65 mg\/100 mL (50-80) \nHIV serology: negative \nEBV serology: negative \nAnti-Borrelia burgdorferi antibodies: negative\n"}]}