Needle EMG showed myopathic changes. Motor

nerve conduction velocities in median, ulnar, peroneal and tibial nerves were normal, on both sides, as well as the lower legs somatosensory evoked potentials (SEPs). Parameters of the blink-reflex were within normal limits. Computed tomography (CT Scan) of the legs showed a fatty replacement of some thigh and lower leg muscles (Fig. ​(Fig.2A,2A, B). Muscle biopsy (supraspinatus) showed myopathic changes. Brain and spinal MRI was normal. Figure 2A, B CT of leg muscles of patient aged 39 years: Inhibitors,research,lifescience,medical A). CT of mid-thighs showed fatty substitution of semi-membranosus, semi-tendinosus, biceps femoris (caput longus), sartorius and partially gracilis and adductor magnus muscles on left side and semi-membranosus … DNA analysis revealed a p13E-11 EcoRI/BlnI Inhibitors,research,lifescience,medical DNA fragment size of 28 kb (double digestion) on chromosome 4q35 (Dr. K. Arahata). The patient was

re-examined after 6 years (April 15, 2002). His status had greatly changed: the weakness of the pelvic selleck chemicals girdle and posterior of thigh muscles was increased; Inhibitors,research,lifescience,medical he could not stand up from a squatting position, while walking had become more difficult because the stepping gait was aggravated by ataxia. Leg muscle tone remained low but knee reflexes were deteriorated with bilateral Babinski signs and clonus of the feet, and delay of urine. Coarse troubles of the joint position sense in the toes and ankles, less pronounced in the knee, associated with Inhibitors,research,lifescience,medical hyperalgesia on the legs were found on both sides. Sensitive ataxia was

noticed. Romberg’s test was positive. On EMG study of the arm and leg muscles, myopathic changes were evident. Motor nerve conduction velocities in ulnar, peroneal and tibial nerves were normal but sensory sural nerve conduction velocities were slightly decreased (39 m/sec.). The lower leg SEPs Inhibitors,research,lifescience,medical were abnormal: cervical cord and cortical responses were practically absent on both sides and inter-peak latencies, between lumbar and cervical responses, were increased bilaterally suggesting a disorder in the posterior column. Spinal MRI showed a tumour formation (2.0 x 1.3 cm) with intradural extramedullar growth compressing the spinal cord at T6–T7 vertebral level (Fig. ​(Fig.3A,3A, B). Total resection of the tumour was carried out (June 30, also 2002); The histological study showed a meningioma. Figure 3A, B The patient aged 39 years. MRI of thoracic column showed right intradural extramedullary tumour of spinal cord on the T6 – T7 spine level: a. longitudinal section, b. transversal section. The patient was re-examined after surgical treatment in March 30, 2004. The pattern of muscle involvement remained the same. However, the strength of the pelvic girdle muscles increased and the patient could stand up from squatting without help of arms; leg muscle tone remained low, knee and Achilles reflexes were extremely reduced. There was no clonus of the feet nor Babinski signs. There were no urinary disturbances.