Nero Exam

The patient seems to just have a generalized weakness. He moves all his extremities, but it isat at most perhaps two out of five in both arms and legs. A lower motor neuron lesion causing weakness would go along with the hypo reflexor flaid tonea reflexes there. There are other things that you don't consider like miasthena or lambert eatonsindrome. His lungs are clear, so probably not associated with something like long canter.