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Case 42 

Case 42
Chapter:
Case 42
Author(s):

Harutomo Hasegawa

, Matthew Crocker

, and Pawan Singh Minhas

DOI:
10.1093/med/9780199599837.003.0042
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date: 25 August 2019

A 47-year-old accountant is referred by his GP with 3 months of ascending numbness that began in his toes and spread upwards towards his umbilicus. He was initially investigated for diabetes and presumed peripheral neuropathy, but fasting blood glucose was normal (4.7 mmol/l). He has had stiffness in his legs which is troublesome first thing in the morning. His bladder and bowel function are normal and he reports no symptoms in his upper limbs.

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