Best of Five 2.104

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BOF: 2.104

A 24-year-old male presents with a history of double vision, and difficulty in walking. He gives a history of a diarrhoeal illness a few weeks prior to the onset of these symptoms. He has been fit and well otherwise, he does not take any medication and does not drink nor does he smoke.

On examination he is found to have ophthalmoplegia, ataxia and areflexia but there is no limb weakness.

In this patient the most likely way to reach a diagnosis would be by:

a)      MR of the posterior fossa

b)      MR angiogram

c)      CT scan

d)      Give intravenous thiamine and assess response

e)      Lumbar puncture

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