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Cervical Conundrum

Differential Diagnoses

Reviewing the information obtained thus far:

Chief Complaint

Right side numbness, posterior occipital headaches, progressive weakness of the right upper extremity.

Major Neurologic Findings

• Diffuse numbness throughout right upper, lower extremity and trunk
• Weakness of the right upper and lower extremity
• Ataxia
• Positive Romberg
• Reflexes brisk, with clonus
• Tongue fasciculations
• CN V, VII, IX, X abnormal

With these data, list your top 7 diagnoses which could result in these symptoms.

What would you want to do next? Given the patient information described previously, and the list of differential diagnoses, what additional information or tests would you want to obtain?