Neurological Emergencies—What to do?

First, to make your neurosurgeon happy, get an MR of this man's spine stat.

Yes, it walks and quacks like a duck, but you'd sure hate to miss that occasional spontaneous epidural hematoma or benign tumor which would make this guy a quad needlessly.

MR negative? Aaah, that's better.

Next, put this man in a place where his ventilation can be watched carefully, as the disease has ascended to knock out his intercostals (innervated segmentally by the thoracic roots) and is now threatening his phrenic nerves (C 3,4,5) which go to the diaphragm.

If the phrenic N is affected too, he quietly stops breathing without any way to hit the nurse's call buzzer. Oh dear.