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En 52-årig kvinnlig lärare inkommer till akutmottagningen pga successivt tilltagande svaghet i extremiteterna sedan 5d. Pat beskriver svårigheter att gå i trappor. I status finner du måttlig symmetrisk kraftnedsättning i proximal och distal extremitetsmuskulatur, bortfall av extremitetsreflexer samt diskret perifer facialispares på hö sida. Ange sannolik diagnos. 1p
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