63F presents with a two week history of progressive weakness and dysphagia. There is no diurnal variation. On examination she has a violaceous rash over the eyelids and papules over the knuckles. Tone is normal. Shoulder abduction is 1/5 bilaterally and finger extension 4/5. Hip flexion is 1/5 bilaterally and foot dorsiflexion and plantarflexion is 4/5. Given the likely diagnosis, what is the pattern of weakness and where would you localise the lesion to?
7
votes
A. Distal pattern of weakness in keeping with peripheral nerve
B. Pyramidal weakness in keeping with UMN lesion
C. Fatiguable weakness in keeping with neuromuscular junction
D. Proximal pattern of weakness in keeping with muscle
E. Proximal pattern of weakness in keeping with UMN lesion