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This 46-year-old man presented with a 20-year history of progressive distal wasting and weakness of the right hand and forearm muscles. This 46-year-old.

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Presentation on theme: "This 46-year-old man presented with a 20-year history of progressive distal wasting and weakness of the right hand and forearm muscles. This 46-year-old."— Presentation transcript:

1 This 46-year-old man presented with a 20-year history of progressive distal wasting and weakness of the right hand and forearm muscles. This 46-year-old man presented with a 20-year history of progressive distal wasting and weakness of the right hand and forearm muscles. Symptoms developed in the left hand 5 years prior to presentation. Upper limb reflexes were depressed. Needle electromyography revealed chronic neurogenic changes in clinically affected muscles. There were no sensory abnormalities. (A and B) Asymmetrical wasting of the hands and forearm affecting C7-T1 musculature with striking preservation of brachioradialis in the right upper limb; (C) sagittal T2-weighted STIR image demonstrating a linear hyperintensity within the cervical cord at C6 and C7 associated with cord atrophy; (D) axial T2-weighted image with ‘snake eyes’ appearance in the anterior horns. STIR, Short TI Inversion Recovery. Nidhi Garg et al. J Neurol Neurosurg Psychiatry 2017;88: ©2017 by BMJ Publishing Group Ltd

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