A 35-year-old patient presents with numbness over the neck. On examination decreased pain and temperature sensation is found in the distribution of C4, C5. Scalp sensation, cranial nerve function and limb examination are normal. Bladder and bowel sphincter control are normal. What is the diagnosis?

The patient is having features suggestive of central cord syndrome with involvement of lateral spinothalamic tract leading to decreased pain and temperature sensation. Amyotrophic lateral sclerosis - Asymmetric motor weakness with findings of LMNL and UMNL. Hence choice A is ruled out. Neurosyphilis can involve the spine - Tabes dorsalis. Presents as Lhermitte sign, sensory ataxia, and urinary incontinence. Hence choice C is ruled out. AIDP (Subtype of GBS) presents as fast onset paraplegia/ quadriplegia with/ without diaphragmatic paralysis. Hence choice D is ruled out.