Constitutional syndrome, loss of strength and dysphagia

Abstract

A 52 year-old man who refers a constitutional syndrome and weakness in his legs since several months ago. In his background he used to drink alcohol in abusive way. We performed an electroneuromyogram that showed suggestive data of an axonal polyneurophaty. The study was completed with blood sample, thoracic CT scan, abdominal doppler and an endoscopy; all of them showed no explanation for the patient's symptoms. During follow-up, despite the patient stopped drinking alcohol, he continued with weakness, amyotrophy and dysphagia. In his physical exploration is noted a loss of strength 4/5 and twitching of the tongue which made us suspect of a motor neuron disease. This was confirmed by a new electrophysiological study.

This case demonstrates that the diagnosis of a motoneuron disease requires an exhaustive clinical exploration and a high clinical suspect. The presence of some signs, almost pathognomic, provides the diagnosis.