A Floppy Child
A 4-month-old boy was referred for valuation of weakness. He was born after a normal pregnancy and delivery at term, with Apgar scores of 7 and 8 at 1 and…
A Man With Acute Areflexic Paralysis and Central Nervous System Symptoms
A 43-year-old man presented initially to an ophthalmologist complaining of double vision for 3 weeks. Ten days later, he developed numbness and weakness in both upper extremities which then progressed…
A Man With Muscle Twitching and Poor Balance
A 37-year-old man presented with a 2-year history of loss of balance and weakness. He also had muscle cramps, twitching, and difficulty in speaking. Previous workup showed a normal magnetic…
A Man With Muscle Spasms and Elevated Serum Creatine Kinase
A 46-year-old, right-handed man presented with mild lower-extremity weakness of a year’s duration. He is a house painter who developed low back and neck pain with progressive upper-extremity weakness after…
A Man With One Large Calf
A 47-year-old man was referred because of weakness, tightness, and pain in the right calf for 5 years, becoming worse in the past 8 months. Past medical history was unremarkable….
A Young Man With Longstanding Weakness in Both Arms
A 29-year-old gentleman presented with a 10-year history of slowly progressive weakness. Previous workup revealed some evidence of cervical spondylosis. EMG showed diffuse denervation in the arms and there were…
A Man With Progressive Leg Muscle Weakness 20 Years After an Acute Paralysis
A 54-year-old man presented initially at age 24 with an acute episode of right lower extremity weakness and urinary hesitancy. Examination at that time revealed right lower extremity weakness of…
A Man With a Long History of Muscle Weakness in One Arm
A 35-year-old man presented with complaints of pain in the left shoulder and neck. Over the next 4 years, he developed progressive proximal left arm weakness and marked atrophy of…
A Man With a Dropped Head
A 64-year-old man developed weakness in his arms over 6 months. In the last 2 months, he noticed a tendency for his head to drop forward, and he had difficulty…
A Man in the “Barrel”
A 37-year-old man presented with a 3-week history of difficulty with his right handgrip. He denied numbness, paresthesias, or leg weakness. He had some mild chronic neck pain, but his…
