Generally, a healthy 40-year-old man was presented with a 3-week history of paresthesia and inability to control his hands. Examination Physical examination revealed generalized areflexia, marked loss of position sense, loss of feeling in glove and stocking distribution, but motor strength was preserved. He also had a broad-based gait and dysmetria in all four limbs. Romberg's sign was observed. After stretching his arms, his fingers showed involuntary, constant, slow writhing movements which became apparent with eye closure.
Similar yet lesser movements were also observed in his toes as well . MRI of the brain and spinal cord and laboratory studies of serum and CSF did not reveal abnormalities. Identify this pattern of movement in this patient. *This case is from Docplexus editorial team for educative purpose only. Source: NEJM Stay connected, the answer will be posted in the next 48h!
