Monday, February 16, 2009


A 70 year old man presents with asymmetric limb weakness. He complains that he often drops things with his right hand and cannot write, type, button, use zippers, or pick up small objects anymore. He also has a new onset foot drop which has caused him to trip and fall. On exam, you find increased reflexes and a spastic rigidity. You also notice some atrophy and fasciculations of the muscles.

Challenge: What's the diagnosis?


deardoc said...

Amyotrophic Lateral sclerosis....i love the little hints you provide in the title of the cases!!

Craig Chen said...

Good job!

This is amyotrophic lateral sclerosis (ALS) or Lou Gehrig’s disease, a relentlessly progressive and incurable neurodegenerative disease. The familial version comprises 10% of all cases. The characteristic feature is both upper and lower motor neuron findings.

Source: UpToDate.