Oct 24, 2018

The participant has had trouble walking her entire life.  As a child, she used foot braces and started using a cane when she was 35. In her 40s, she started having arm weakness as well. Currently she has numbness and sharp burning pain in her hands and feet. She is no longer able to walk and uses a power chair. She also has episodes that she describes as “drop attacks” where she loses consciousness and appears asleep. During these episodes, she cannot move and her husband reports that she grinds her teeth and that he cannot wake her.

In the last 5 years, she has also started having difficulty swallowing (dysphagia). As a result, she is only able to eat soft foods and has lost a significant amount of weight. She also has issues breathing (dyspnea) and with double vision (diplopia). Her husband has reported that she has been struggling with memory. An EMG was recently performed, which showed myopathy without denervation. There was no evidence of a motor neuron disease, like amyotrophic lateral sclerosis (ALS).

• Progressive muscle weakness
• Inability to walk
• Difficulty breathing (dyspnea)
• Difficulty swallowing (dysphagia)
• Muscle twitching in the face (facial-lingual fasciculations)
• Damaged nerve cells (peripheral neuropathy)
• Absent reflexes (areflexia)
• Impaired sense in the outer body (distal sensory impairment)
• Muscle cramps and myopathy
• Weight loss
• Weak bones (osteoporosis)
• Depression
• Memory impairment
• Migraine
• Double vision (diplopia)
• Curvature of the spine (scoliosis)
• Hand tremor
• Feet muscle (dorsiflexor) weakness
• Arthritis
• Abnormality in electrical activity of muscles (EMG abnormality)

• Baclofen – muscle twitches
• Neurotonin – seizures
• Rizatriptan, Propranolol – migraines