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A 12-Year-Old Boy Is Brought to the Emergency Department by His

question 706

Multiple Choice

A 12-year-old boy is brought to the emergency department by his parents as "he cannot walk anymore." The patient has had a pins-and-needles sensation and weakness in both feet for the past few days. This morning, he could not stand or move his legs and has bilateral thigh pain. Two weeks ago, the patient had a febrile diarrheal illness that resolved on its own. He has had no headaches, nausea, vomiting, or recurrent diarrhea. He and his family are vegetarians, and they recently visited a petting zoo. The patient has no significant past medical history, and vaccinations are up to date. On arrival, temperature is 36.7 C (98.1 F) , blood pressure is 150/90 mm Hg, pulse is 92/min, and respirations are 16/min; pulse oximetry is 99% on room air. Physical examination shows symmetric flaccid paralysis of the lower extremities and absent ankle and patellar deep tendon reflexes. Sensation is intact to light touch in both legs. The upper extremities are weak and hyporeflexic. There is no photophobia or nuchal rigidity. Which of the following structures is primarily impaired in this patient's condition?

Definitions:

Walter Cannon

Walter Cannon was an American physiologist who coined the term "fight or flight response," describing an animal's response to threats with a general discharge of the sympathetic nervous system.

Spinal Cord

A part of the central nervous system that runs down the vertebral column, transmitting messages between the brain and the body.

Sympathetic Nervous System

A part of the autonomic nervous system responsible for the body's 'fight or flight' response, regulating involuntary physiological functions.

Thalamus

The brain's relay center, directing sensory and motor signals to the cerebral cortex and the regulation of consciousness, sleep, and alertness.