ID/CC A 30 year old man is

ID/CC A 30 year old man is referred to a neurologist because of progressive anesthesia and weakness of both arms, occipital headaches, and a stiff gait. HPI He has no history of significant trauma in the past. PE No motor deficits; lack of pain and temperature sensation in hands and arms but preserved position and tactile sensation; intact pain and temperature sensation below arms; dorsal columns & proprioceptive sensation spared; thenar muscles of both hands atrophied with contractures of fingers (see pic); areflexia in both upper limbs; brisk deep tendon reflexes in both lower limbs. MR/CT-spine- see images (arrows). SCIENCE HEALTH SCIENCE NURSING NURS 6411

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