THERAPEUTIC TEST - II suspected cervical disc degeneration, restriction of neck movements by rest or by wearing a collar

Cerebral angiography - If suspicion of expanding mass or vascular abnormality 3 BLOOD - (I) Megaloblastic anaemia In subacute combined degeneration. (II) VDRL positive In spinal syphilis. (Ill) Protein electrophoresis lor multiple myeloma. (iv) Prostaiic specific antigen for prostalic malignancy rt incfcaied. 4. GASTRIC ANALYSIS Peniagastrin fast achlorhydria In subacute combined degeneration 5. FUNDUS - Papilloedema in iniraoraniat tumour. Temporal pallor in multiple sclerosis. 6. URINE - for fluorine estimation In endemic fiuorosis. 7. THERAPEUTIC TEST - II suspected cervical disc degeneration, restriction of neck movements by rest or by wearing a collar for lew weeks will often produce marked improvemenl in walking DD of Flaccid paraplegias (paraparesis) 1 Poliomyelitis -(i) Acute onset with possibly signs ol meningeal irriialion (ii) Muscular weakness and flaccid parafysis til scattered muscle groups (ill) Not bilalerally symmetrical. 2. Peripheral neuritis - (I) Numbness and tingling at onset, (ii) Tenderness ol calf muscles. (iii) Glove and stocking type of anaesthesia (iv) Vasomotor and trophic changes - oedema, dyness. desquamation. (v) Bilaterally symmetrical paresis. 3, Acute lolopalhlcdernyelinating poly neuropathy - (i) Precetfng viral illness. (II) Weakness usually starting In lower limbs. Increases in severity over next tew days and then ascencte up to involve Trunk its , upper limbs and in some cases neck, face and bulbar ms. (lii) Areftexla Is the key to diagnosis..