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Case 47 

Case 47
Case 47

Sarah T Pendlebury

, Philip Anslow

, and Peter M Rothwell

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date: 18 November 2018

Case A An 81-year-old man presented with an 18-month history of progressive difficulty walking and painful paraesthesiae in the soles of his feet. His referral was prompted by the development of urinary urgency with mild incontinence and perineal numbness for the preceding 2 months. He described acute excacerbations of his symptoms when his legs became weaker and ‘like jelly’, often occurring after gardening or a hot bath. There was no weight loss and he felt otherwise well. He had a 30-year history of low/mid thoracic back pain that had begun mildly but had progressed very gradually over the years such that it was severe enough at times to interrupt his sleep at the time of presentation. Plain X-rays of the back performed some years previously, had shown nil of note. There was no other past medical history. He was on no medication other than analgesia for the back pain. He was a non-smoker and took little alcohol.

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