Babs' Breaking Body

Babs, a 28-year-old woman, has had blurred vision in her right eye steadily for 24 hours. This worsened temporarily after exercise, but then stabilized. A neurological review of systems reveals that she has had electrical paresthesias across her shoulders and abdomen for the past 2 months, especially after exercise. She has had no other neurological symptoms. She takes no medications and is not on birth control pills.

Examination reveals a corrected visual acuity of 20/50 in the right eye, and 20/15 in the left eye. Pupils are equally round and reactive, but during the swinging flashlight test, both pupils dilate when the light is moved from the left eye to the right. There is normal strength and normal sensation. There is left ankle clonus and a left Babinski sign. When she walks, she swings her left arm less than the right.

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