A 15-Year-Old Boy Is Evaluated for Worsening Gait Instability, Dysmetria

A 15-year-old boy is evaluated for worsening gait instability, dysmetria, and dysarthria for the past several years.  The patient stops play basketball due to his worsening symptoms.  He is worried as his brother died of a neurologic disease at age 21.  Physical examination of the lower extremities reveals bilateral motor weakness and loss of deep tendon reflexes, joint position, and vibration sense.  MRI of the brain and spine shows degeneration of the posterior columns and spinocerebellar tracts.  Which of the following conditions has clinical manifestations that closely resemble this patient's disease?

A) Acute intermittent porphyria
B) Lead intoxication
C) Poliomyelitis
D) Prion disease
E) Thiamine deficiency
F) Vitamin E deficiency

Correct Answer:

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