A 27-year-old scriptwriter is referred because of worsening disorientation and confusion over the last five months. Initially, her work colleagues noticed she was neglecting deadlines. She has been found in a supermarket with no idea of where she was or how she got there. Her mood has been variable, with crying episodes occurring without provocation. She has been given leave from her job because of problems with recognising colleagues and managing simple information. Generally, her partner feels her condition is rapidly worsening. Physical examination shows her to be withdrawn and poorly communicative. Her Mini-Mental Test score is no better than 6/10. There are no cranial nerve abnormalities. Tone is increased globally, and there are recurrent, asymmetrical, jerks in all four limbs. Her partner tells you she had a miscarriage two months ago. Tests for HIV and syphilis serology were performed as part of prenatal screening: they were normal. There is no family history of neurological disease. Which of the following investigations is likely to be LEAST useful in reaching a diagnosis? Lumbar puncture Serum autoantibody screen Tonsillar biopsy MRI of the brain EEG
Posted on: Fri, 18 Jul 2014 13:07:08 +0000
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