A 58-year-old man presents with 6-month progressive hand weakness and muscle atrophy. Examination reveals visible fasciculations in bilateral upper extremities, brisk patellar reflexes bilaterally, and normal sensation throughout. Vital signs: BP 128/82, HR 82, RR 16, temp 37°C, SpO2 98%. Recent EMG shows denervation potentials and reduced motor unit recruitment. Bowel and bladder function remain intact. He takes no medications. Which diagnosis best explains these findings?
- A)Myasthenia gravis
- B)Amyotrophic lateral sclerosisGABARITO
- C)Guillain-Barre syndrome
- D)Subacute combined degeneration
- E)Multiple sclerosis
Explicação
Amyotrophic lateral sclerosis is the correct answer because combined upper motor neuron findings such as hyperreflexia and lower motor neuron findings such as atrophy and fasciculations with preserved sensation are classic for ALS. Ver explicação completa e trilha adaptativa →