- Dedication
- Preface
- Acknowledgments
- 1 A 35-Year-Old Man with Progressive Left-Hand Weakness
- 2 A 54-Year-Old Male with Right-Hand Weakness
- 3 A 50-Year-Old Male with Speech, Swallowing, and Behavioral Difficulties
- 4 A 45-Year-Old Male with Toxin Exposure
- 5 A 48-Year-Old with Progressive Weakness and Pain
- 6 A 30-Year-Old Male Requiring Management of Progressive Weakness
- 7 A 61-Year-Old Male with Severe Shoulder and Cervical Pain
- 8 A 55-Year-Old Male with Right Foot Weakness
- 9 A 63-Year-Old Male with Severe Flaccid Weakness Post Motor Vehicle Accident
- 10 A 55-Year-Old Female with Slowly Progressive Weakness
- 11 A 40-Year-Old Female with Balance Problems and Numbness After Bariatric Surgery
- 12 A 55-Year-Old Female with a History of Right Foot Drop and Left Hand Weakness
- 13 A 40-Year-Old Female with Increasing Arm Pain and Numbness
- 14 A 59-Year-Old Man with Progressive Difficulties with Balance and Weight Loss
- 15 A 68-Year-Old Male with Progressive Numbness and Gait Difficulties
- 16 A 28-Year-Old Male with Weakness in the Setting of Cancer
- 17 A 44-Year-Old Man with Bilateral Facial Droop
- 18 A 41-Year-Old Male with Foot Drop and Malaise
- 19 A 44-Year-Old Female with Buttock Pain
- 20 A 50-Year-Old Woman with Burning Feet
- 21 A 56-Year-Old Woman with Small-Fiber Neuropathy and Progressive Leg Pain and Weakness
- 22 A 34-Year-Old Male with Possible Myopathic Process
- 23 A 39-Year-Old Man with Low Back Pain and Scapular Winging
- 24 A 52-Year-Old Female with Weakness and Droopy Eyelids
- 25 A 20-year-Old Male with Acute Lower-Extremity Weakness
- 26 A 19-Year-Old Male with Stiffness and Weakness After Waking
- 27 A 68-Year-Old Female with Progressive Pain and Weakness
- 28 An 18-Year-Old Male with Slowly Progressive Weakness
- 29 A 30-Year-Old Male with Severe Cramps
- 30 A 72-Year-Old Female with Facial Weakness and Droopy Eyelids
- 31 An 80-Year-Old Myasthenia Gravis Patient with Worsening Weakness
- 32 A 44-Year-Old Male with Subacute Onset of Syncope
- 33 A 46-Year-Old Man with Double Vision and Proximal Leg Weakness
- 34 A 2-Month-Old Boy with Acute Diffuse Weakness
- Index
(p. 9) A 54-Year-Old Male with Right-Hand Weakness
- Chapter:
- (p. 9) A 54-Year-Old Male with Right-Hand Weakness
- Author(s):
Jeffrey A. Cohen
, Justin J. Mowchun
, Victoria H. Lawson
, and Nathaniel M. Robbins
- DOI:
- 10.1093/med/9780190491901.003.0002
Early in its course, amyotrophic lateral sclerosis (ALS) is mistaken for a number of other neuromuscular problems, including spinal disease, multifocal motor neuropathy, and even carpal tunnel syndrome (CTS) when the weakness is distal and focal. In our patient CTS or cervical spine disease was considered. MRI scan of the appropriate spinal level is important to rule out spinal disease. Nerve conduction studies (NCS) and electromyography (EMG) help to exclude other possibilities and point to the diagnosis of ALS. Later in the clinical course, the clinical picture is pathognomonic with upper and lower motor neuron signs. The differential diagnosis of focal weakness is discussed, as is recognition of the more typical ALS clinical syndrome and familial ALS. NCS and EMG findings in ALS are discussed.
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- Dedication
- Preface
- Acknowledgments
- 1 A 35-Year-Old Man with Progressive Left-Hand Weakness
- 2 A 54-Year-Old Male with Right-Hand Weakness
- 3 A 50-Year-Old Male with Speech, Swallowing, and Behavioral Difficulties
- 4 A 45-Year-Old Male with Toxin Exposure
- 5 A 48-Year-Old with Progressive Weakness and Pain
- 6 A 30-Year-Old Male Requiring Management of Progressive Weakness
- 7 A 61-Year-Old Male with Severe Shoulder and Cervical Pain
- 8 A 55-Year-Old Male with Right Foot Weakness
- 9 A 63-Year-Old Male with Severe Flaccid Weakness Post Motor Vehicle Accident
- 10 A 55-Year-Old Female with Slowly Progressive Weakness
- 11 A 40-Year-Old Female with Balance Problems and Numbness After Bariatric Surgery
- 12 A 55-Year-Old Female with a History of Right Foot Drop and Left Hand Weakness
- 13 A 40-Year-Old Female with Increasing Arm Pain and Numbness
- 14 A 59-Year-Old Man with Progressive Difficulties with Balance and Weight Loss
- 15 A 68-Year-Old Male with Progressive Numbness and Gait Difficulties
- 16 A 28-Year-Old Male with Weakness in the Setting of Cancer
- 17 A 44-Year-Old Man with Bilateral Facial Droop
- 18 A 41-Year-Old Male with Foot Drop and Malaise
- 19 A 44-Year-Old Female with Buttock Pain
- 20 A 50-Year-Old Woman with Burning Feet
- 21 A 56-Year-Old Woman with Small-Fiber Neuropathy and Progressive Leg Pain and Weakness
- 22 A 34-Year-Old Male with Possible Myopathic Process
- 23 A 39-Year-Old Man with Low Back Pain and Scapular Winging
- 24 A 52-Year-Old Female with Weakness and Droopy Eyelids
- 25 A 20-year-Old Male with Acute Lower-Extremity Weakness
- 26 A 19-Year-Old Male with Stiffness and Weakness After Waking
- 27 A 68-Year-Old Female with Progressive Pain and Weakness
- 28 An 18-Year-Old Male with Slowly Progressive Weakness
- 29 A 30-Year-Old Male with Severe Cramps
- 30 A 72-Year-Old Female with Facial Weakness and Droopy Eyelids
- 31 An 80-Year-Old Myasthenia Gravis Patient with Worsening Weakness
- 32 A 44-Year-Old Male with Subacute Onset of Syncope
- 33 A 46-Year-Old Man with Double Vision and Proximal Leg Weakness
- 34 A 2-Month-Old Boy with Acute Diffuse Weakness
- Index