A 19-year-old man goes swimming in an inland pond in Puerto Rico. Within a few days, he notices itching of his skin over several surfaces of his body. He is unconcerned until several weeks later when he develops lancinating pains extending down his legs and all of his toes. Over the course of just a few days, he develops paraparesis and problems with bladder and bowel control. Within one week, he is unable to stand and has severe urinary retention. Which of the following is the most appropriate plan of action on an emergency basis?

a. Initiate anticoagulation

b. Perform sensory-evoked potential testing

c. Order an MRI scan

d. Place a cervical collar

e. Perform spinal angiography

the answer is below…

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