Clinical Reasoning: A 49-Year-Old Woman With Progressive Numbness and Gait Instability

A 49-year-old woman with no relevant medical history presented to an external neurology clinic progressive hand and foot paresthesia gait instability for over 6 months. Initially, she reported tingling shooting electrical-type sensations involving her feet. Within several weeks of the onset paresthesia, noted a burning pain sensation left hand. Sensory symptoms continued worsen felt pressure-like around neck scalp region. This was shortly followed by right numbness loss dexterity. Over next month, developed imbalance transitioned cane ambulation.