(A) This 54 year old man with the flail arm syndrome has severe wasting of the arms causing profound weakness. (A) This 54 year old man with the flail.

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Presentation transcript:

(A) This 54 year old man with the flail arm syndrome has severe wasting of the arms causing profound weakness. (A) This 54 year old man with the flail arm syndrome has severe wasting of the arms causing profound weakness. Note the symmetric distribution and involvement of proximal musculature. Muscle bulk and strength were relatively preserved in the legs but lower limb reflexes were pathologically brisk and the plantar responses extensor. (B) Note the very similar pattern of wasting in a patient with “progressive muscular atrophy” depicted in a 1888 text of Gowers.2 M T M HU et al. J Neurol Neurosurg Psychiatry 1998;65:950-951 ©1998 by BMJ Publishing Group Ltd