A 58-year-old woman presents with a 2-year history of progressive leg stiffness and mild weakness. Examination reveals hyperreflexia, extensor plantar responses bilaterally, and upper motor neuron signs without lower motor neuron findings. Vital signs: BP 128/82, HR 78, RR 16, Temp 37°C, SpO2 98%. Cognitive function and speech remain intact. MRI brain shows no focal lesions. CSF analysis is normal. She takes no medications. Which of the following is the most likely diagnosis?
- A)Friedreich ataxia
- B)Primary lateral sclerosisGABARITO
- C)Hereditary spastic paraplegia
- D)Spinal muscular atrophy
- E)Amyotrophic lateral sclerosis
Explicação
Primary lateral sclerosis is characterized by isolated upper motor neuron degeneration causing progressive spasticity, weakness, and hyperreflexia without lower motor neuron signs. Cognition is preserved, distinguishing it from ALS with dementia variants. Ver explicação completa e trilha adaptativa →