{"ops":[{"insert":"A 34-year-old woman presents with painful blurring of vision in her right eye and progressive weakness of both lower limbs for 2 days. She denies any bowel or bladder dysfunction. There is no history of febrile illness, recent vaccination, or ingestion of tinned food.\n\nHer medical history is unremarkable except for an episode of bilateral lower limb weakness 3 months ago, which was of sudden onset and lasted for less than a day. She was diagnosed with a transient ischemic attack, and started on long-term aspirin. The remainder of her stroke work-up, including an MRI brain, was unremarkable.\n\nHer basic laboratory tests including a full blood count, electrolytes, inflammatory markers, renal and liver function tests are unremarkable.\n\n"},{"insert":{"image":"\/storage\/case-images\/pd\/PD-M-055_en.png"}},{"insert":"\n"}]}
2
Investigate
CSF analysis
{"ops":[{"insert":"Appearance: clear\nCell count: 20 cells\/mm3 (\u003C5 cells\/mm3) \n 80% lymphocytes\nProtein: 45 mg\/dl (15-40 mg\/dL)\nGlucose: 56 mg\/dL (\u00bd to \u2154 of blood glucose)\nGram stain and Ziehl-Neelsen stain: no organisms\nVDRL on CSF: non reactive \nCSF oligoclonal bands: negative\nRandom Plasma Glucose: 80 mg\/dL\n"}]}
Nerve conduction studies
{"ops":[{"insert":"You realize nerve conduction studies are not indicated right now.\n"}]}