Demyelinating Diseases USMLE Step 1 Practice Question
A 31-year-old woman with multiple sclerosis presents with electric shock-like pain radiating down her spine triggered by neck flexion. Vital signs: BP 118/76, HR 82, RR 16, Temp 37°C, SpO2 98%. Physical examination reproduces symptoms with neck flexion; neurologic exam otherwise intact. Cervical spine MRI shows no acute demyelinating lesions. CSF oligoclonal bands are positive. Which of the following best explains her current symptoms?
Answer choices
- ASpinal cord syrinx
- BLhermitte sign from demyelinationCorrect answer
- CHerniated cervical disk
- DCervical spondylosis
- EPosterior column myelitis
- FTrigeminal neuralgia from brainstem demyelination
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