A 28 yo female presented to the ED with a two to three day history of progressive difficulty walking, double vision, and slurred speech. She complains of a very mild diffuse headache and reports paresthesias of the face, hands, and feet. Her husband states they were exposed to a cleaning solvent containing trichlorethane in the last two days. She reports having some cold symptoms during the preceding week. Denies any unusual ingestions or recent travel.
Immunizations are up to date.
The next day the patient a left lateral gaze palsy. Answer is due by May 10th.