Demyelinating Diseases USMLE Step 1 Practice Question
A 28-year-old man presents with acute transverse myelitis causing total paraplegia and sensory level at T6. Vital signs show BP 128/82, HR 88, RR 16, temp 37.2°C, SpO2 98%. Days later, he develops severe bilateral optic neuritis with blindness. Brain MRI shows no demyelinating lesions. Serum aquaporin-4 (AQP4) antibodies are positive. CSF oligoclonal bands are negative. He takes no prior medications. Which diagnosis best explains these findings?
Answer choices
- ATransverse myelitis from viral infection
- BSpinal cord infarction with coincidental optic neuritis
- CMultiple sclerosis
- DAcute inflammatory demyelinating polyradiculoneuropathy
- ENeuromyelitis optica spectrum disorderCorrect answer
- FNeurosarcoidosis with concurrent myelitis and optic nerve involvement
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