title: The diagnostic dilemma of progressive muscular atrophy.
abstract: Progressive muscle atrophy is a rare subtype of motor neuron disease that affects only the lower motor neurons and presents as asymmetrical rapidly progressive muscle weakness, atrophy and normal sensations. The diagnostic electrophysiological findings are denervation potentials in three out of four body segments (bulbar, cervical, thoracic and lumbosacral). The disease is fatal and the management is supportive. We present the report of a 45-year-old female patient who presented with unilateral foot drop and rapidly progressed to profound weakness in muscles of all limbs, neck and back along with dysarthria and dysphagia. She had been operated twice for suspected cervical and lumbosacral intervertebral disc herniations and ultimately guided in right direction after muscle biopsy, nerve conduction studies and electromyography.
authors.affiliation: Armed Forces Institute of Rehabilitation Medicine (AFIRM), Abid Majeed Road, Rawalpindi-46000.
authors.forename: Saeed Bin
authors.initials: SB
authors.lastname: Ayaz
authors.affiliation: Armed Forces Institute of Rehabilitation Medicine (AFIRM), Abid Majeed Road, Rawalpindi-46000.
authors.forename: Sumeera
authors.initials: S
authors.lastname: Matee
authors.affiliation: Armed Forces Institute of Rehabilitation Medicine (AFIRM), Abid Majeed Road, Rawalpindi-46000.
authors.forename: Zaheer Ahmed
authors.initials: ZA
authors.lastname: Gill
authors.affiliation: Armed Forces Institute of Rehabilitation Medicine (AFIRM), Abid Majeed Road, Rawalpindi-46000.
authors.forename: Atif Ahmed
authors.initials: AA
authors.lastname: Khan
mesh_terms: D003680:Deglutition Disorders / Q000503:physiopathology*; D003937:Diagnosis, Differential; D004401:Dysarthria / Q000175:diagnosis / Q000503:physiopathology*; D004576:Electromyography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009133:Muscular Atrophy / Q000209:etiology*; D009134:Muscular Atrophy, Spinal / Q000175:diagnosis*; D013116:Spinal Cord / Q000473:pathology