A 77-year-old female patient presents with increasing muscle weakness and numbness in both lower legs over the last week. She presents using crutches and with her daughter for walking assistance. The patient had influenza 3 weeks ago and was treated with amantadine. The patient denies recent trauma. Current medications include a beta blocker and ACE inhibitor. She denies use of tobacco or alcohol. On physical examination, the patient is alert and oriented x 3, afebrile, pulse 66 beats/min, respirations 16 breaths/min, blood pressure 110/70. Neck: no jugular venous distention, no thyromegaly, no bruits over carotid arteries. Heart: regular rate and rhythm, no murmurs. Lungs are clear to auscultation. Abdomen is nontender with no organomegaly. Extremities: skin is pink, cool to touch, and intact bilaterally. Hand grip strength: 5/5 bilaterally. Biceps deep tendon reflex +2/4 bilaterally. Left and right quadriceps muscle strength 4/5. Patella reflex 1/4 bilaterally. Achilles reflex 1/4 bilaterally. Ankle strength R +3/5 and L +3/5. Sensation to pinprick and cotton ball intact in face and upper extremities and bilaterally equal. Sensation to pinprick and cotton ball decreased in feet bilaterally. Dorsalis pedis pulses +1/4 bilaterally. Negative Homan's and Babinski's signs. The following disorder(s) should be high priority in the differential diagnosis:

Question

Quizplus · Accepted Answer

The patient's symptoms of increasing muscle weakness and numbness in the lower legs, following an influenza infection, are characteristic of Guillain-Barré syndrome (GBS). GBS often begins with weakness and tingling in the feet and legs that spreads to the upper body. The recent influenza infection is a common antecedent event in GBS, suggesting an immune-mediated mechanism.

A 77-Year-Old Female Patient Presents with Increasing Muscle Weakness and Numbness