Scott, a 37-year-old elementary teacher, is seeing his general practitioner for complaints of general weakness, especially in his lower extremities. He has also been feeling very fatigued lately and has trouble keeping up with his students throughout his work day. His physician notes that he has lost a significant amount of weight in the last 6 months. Scott reports that even simple tasks, such as brushing his hair and getting dressed, can seem like a chore. He has trouble climbing stairs because of his weakness and notices that his speech is slurred, especially at the end of the day.
Scott's physician uses a tongue depressor during his physical examination and Scott begins to gag and has difficulty swallowing. His physician notes muscle wasting and abnormal spasticity in upper and lower extremities bilaterally. All reflexes are normal except the Babinski reflex. Scott's toes fan out when the sole of his feet are stroked with the reflex hammer.
Scott's symptoms are primarily related to problems with:
- Sensory neurons
- Both sensory and motor neurons
- Motor neurons
- Neurons of the autonomic nervous system only