Case 50-1991

Presentation of Case A 71-year-old woman was admitted to the hospital because of gradual progression of marked weakness of the lower extremities. The patient was well and vigorously active until eight months earlier, when she experienced the onset of weakness of the proximal and distal muscles of both lower extremities that caused her to give up regular participation in playing tennis and in walking. Magnetic resonance imaging (MRI) of the cranium, performed elsewhere, was reported to show evidence of old lacunar strokes. Tests of vestibular function were said to show a possible inner-ear problem. Five or six months before admission . . .