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< BACK TO CLINICAL BREAKTHROUGHS IN NEUROSCIENCES

February 2023

NEUROSCIENCES

CASE CHALLENGE: PROGRESSIVE MUSCLE WEAKNESS, PAIN IN 68-YEAR-OLD

A 68-year-old right-handed person with a history of osteopenia, dermographism and osteoarthritis presented with subacute progressive weakness and myalgias in March 2021. By May 2021, the patient went from walking four to five miles to having difficulty walking half a mile. They had difficulty getting up from a squatting position, getting off the toilet, climbing stairs, washing dishes and holding a gallon of milk. In June 2021, the patient developed difficulty with swallowing pills.

​What’s the diagnosis?
Figure 1. Vastus lateralis muscle. Hematoxylin & eosin stain shows necrotic myofiber (arrow).
Figure 2. Vastus lateralis muscle. Acid phosphatase stain shows increased staining in necrotic fibers (arrow).
Figure 3. Vastus lateralis muscle. MHC-I immunostain shows sarcolemmal and sarcoplasmic staining in necrotic (1) and nonnecrotic (2) myofibers.
Solve the case published in Practical Neurology >
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Arjun Seth, MD, assistant professor of Neurology (Neuromuscular Disease) at Northwestern Medicine, was co-author of the case report published in Practical Neurology.

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  • Home
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