So, I have a case study for Anatomy and Phys. Wondering if anybody has any outside of the box ideas. I just keep coming up with multiple sclerosis or brain tumor.

He has always been active in athletics. He played basketball, soccer, and tennis in high school. He enjoys running and competing in road races. Brett has come to your office because lately he has felt a bit more tired than usual and has felt some weakness in his legs. Twice this past month during a run, the toe of his shoe caught the road and he fell and skinned himself up. He has noticed an occasional but worrisome hand tremor and he doesn't feel like his handwriting is as neat as it once was. He isn't sure, if it's just stress of advanced physical chemistry, but he feels he's having a harder time remembering things for school. What really made him decide to come to see you was that he began seeing double the other day while studying with his girlfriend.

So, I have a case study for Anatomy and Phys. Wondering if anybody has any outside of the box ideas. I just keep coming up with multiple sclerosis or brain tumor.

He has always been active in athletics. He played basketball, soccer, and tennis in high school. He enjoys running and competing in road races. Brett has come to your office because lately he has felt a bit more tired than usual and has felt some weakness in his legs. Twice this past month during a run, the toe of his shoe caught the road and he fell and skinned himself up. He has noticed an occasional but worrisome hand tremor and he doesn't feel like his handwriting is as neat as it once was. He isn't sure, if it's just stress of advanced physical chemistry, but he feels he's having a harder time remembering things for school. What really made him decide to come to see you was that he began seeing double the other day while studying with his girlfriend.

How old is the patient?

Also maybe you could detail out what your thought process is (I know you wrote two possible conclusions....but telling us how you got there might help us to get past whatever hurdle you're stuck behind).

This is all of the information that the instructor provided besides the fact that he is 22 years old and in college...multiple sclerosis tends to appear between 20 to 40.

It could be a neurological disorder. The brain sends signals to the legs, hands and effect the eyes. If something has happened then those signals can get crossed. I don't know if multiple sclerosis affects the eyes or not. You may want to look into it.

In multiple sclerosis, patches of myelin and underlying nerve fibers in the eyes, brain, and spinal cord are damaged or destroyed.

• The cause is unknown but may involve an attack by the immune system against the body's own tissues (autoimmune reaction).
  
• Usually, periods of relatively good health alternate with episodes of worsening symptoms.
  
• People may have vision problems and abnormal sensations, and movements may be weak and clumsy.
  
• Usually, doctors base the diagnosis on symptoms and results of a physical examination and magnetic resonance imaging (MRI).
  
• Treatment includes corticosteroids, drugs that help keep the immune system from attacking the body, and drugs to relieve symptoms.
  
• Often, the disorder slowly worsens, disabling some people, but life span is unaffected unless the disorder is very severe.
  

Hope this information helps

Myastenia Gravis fits much of this. It is progressive and can affect the limbs and eyes causing weakness and lessening of control. Don't know about the memory stuff though. That's my out of the box shot.

My out of the box idea could be guillion barre syndrome...my father had this, prior to glioblastoma (brain tumor) that also fits much of the weakness and tremor scenarios but not sure about the memory aspect.