Larry's Lone Lazy Leg

Larry, a 63-year-old right-handed, diabetic man, who had been sitting and watching television for some time, stood up and found that his right leg was weak. There were no other neurologic symptoms. Over the next hour, the weakness progressed, so that he was unable to walk. He was then brought to the hospital.

On examination, Larry was awake and alert, with normal speech and mentation. The cranial nerves functioned normally. The right leg was flaccid and weak, with only a trace of movement in the toes; the other extremities were normal. Deep tendon reflexes were depressed in the right leg, but normal elsewhere, and there was a Babinski sign. Sensation in the right leg was also abnormal. With his eyes closed, he was able to identify hot, cold, and painful stimuli; however, he could not identify the direction of passive joint movement, judge the position of his leg in space, or accurately localize a tactile stimulus. Sensation over the rest of the body was normal.

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