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A 62 year old retired woman was admitted to hospital with a 10 month history of pain and weakness in the muscles of both arms and legs. Her problems began with episodic weakness in both legs such that on occasions her legs gave way and she fell to the ground. She had a gradual deterioration in her muscle strength and after a fall five months before admission she became confined to bed.
Over the month before hospital admission her weakness had progressed to the extent that she was unable to lift her head off a pillow. She had also developed pain in the muscles of the arms and legs. Of note, she had no sensory, visual, speech, or swallowing disturbance. Relevant ...