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What is that above diagram showing!!! Asap

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Quick answer

It isn't a diagram. It's a handwritten clinical case history, and it describes a likely Guillain-Barré syndrome (GBS) presentation. I read it from the image, and some of the handwriting is hard to make out.
What the note says
  • Patient: a 45-year-old man brought to casualty by relatives.
  • Complaints: weakness of both lower limbs, and distal weakness of both upper limbs, for 3 days.
  • Prior workup: he went to a private hospital first. CSF studies there showed albuminocytological dissociation. He was also newly diagnosed with diabetes mellitus.
  • Examination: vitals were normal. The power grid shows about 3/5 in the lower limbs and 4/5 in the upper limbs. This is my best reading of the handwriting, so please check it against the original. Tone is reduced. Reflexes are absent (the note writes "mute") in all limbs. The plantar response is also written as "mute", meaning no response.
  • MRI lumbosacral spine (done outside): a disc protrusion at L3-L4. A disc-osteophyte complex is compressing the existing left L4 nerve root.
  • Treatment: plasmapheresis was started prophylactically. He is currently undergoing 4 cycles of plasma exchange.
What it adds up to
  • Rapidly progressive, symmetric weakness with absent reflexes and albuminocytological dissociation (high CSF protein with normal cell count) is the classic picture of GBS (acute inflammatory demyelinating polyneuropathy).
  • The MRI shows an L3-L4 disc compressing the left L4 root. This is probably an incidental or coexisting finding. A single-root compression would not explain symmetric weakness with generalized areflexia.
  • Plasma exchange is a standard GBS treatment, along with IVIG. The usual course is 4 to 5 exchanges.
  • Diabetes is a relevant comorbidity. It can cause neuropathy of its own, which may complicate the picture.
What to watch for
  • Respiratory function (FVC or negative inspiratory force) and signs of bulbar weakness.
  • Autonomic instability, including arrhythmias and blood pressure swings.
  • DVT prophylaxis.
  • Nerve conduction studies to confirm the demyelinating pattern.
I answered from the image and my own knowledge. I didn't use the textbook library or check recent literature.
If you want, I can organize this into a formal case presentation, a differential diagnosis list, or a management plan.
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