27th June 2023

A 50-year-old man comes to the neurology clinic presenting with clumsiness and feels like his legs are weaker

A 50-year-old man comes to the neurology clinic presenting with clumsiness and feels like his legs are weaker. He has a past medical history of diabetes mellitus, which is poorly controlled. His blood pressure and heart rate are within normal limits. On examination, he has fasciculations in the right calf muscle, diminished lower limb reflexes and brisk biceps reflex, weakness of both lower limbs, more marked on the right than the left, weakness of the hands, loss of vibration and pinprick sensation from the mid-shin to the toes.

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