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This patient (shown from behind) presented with slowly progressive weakness and wasting of the shoulder girdles, neurophysiological evidence of denervation and slightly raised serum creatine kinase, all compatible with the ‘flail arm’ variant of motor neurone disease. This patient (shown from behind) presented with slowly progressive weakness and wasting of the shoulder girdles, neurophysiological evidence of denervation and slightly raised serum creatine kinase, all compatible with the ‘flail arm’ variant of motor neurone disease. MRI (inset) of the cervical spine showed expansion of the dural space posteriorly with forward compression of the spinal cord and presumed chronic damage to the anterior horns cells. His progression arrested spontaneously. Martin R Turner, and Kevin Talbot Pract Neurol 2013;13: ©2013 by BMJ Publishing Group Ltd
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