MRCP2-3382

MRCP2-3382

A 35-year-old woman presents with a complaint of reduced sensation. She reports that over the course of six months, she has not been able to feel when hot water splashes on her hands, despite developing blisters afterwards. Her husband has urged her to seek medical attention. She denies any other issues, including weakness, weight loss, or difficulty with daily activities. She has a history of asthma but only uses her salbutamol inhaler infrequently. She has no known allergies or other medications. Upon examination, she exhibits sensory loss in the dermatomes C4 to C6, with a symmetrical distribution affecting her hands and arms when tested for temperature and pain. There is no tenderness upon spinal examination, and her cranial nerve and lower limb examinations are normal. What is the most likely diagnosis?