Soused Stu's Stockings

Stu, a 52-year-old alcoholic man, had progressive pain and weakness in his legs for months. the symptoms rapidly intensifying over the previous few weeks. His legs had become so sensitive to touch that he was unable to tolerate even the touch of a bed sheet, and he was hardly able to walk. No one else in his family had ever had a similar problem, and he had not been ill otherwise.

On examination, he was malnourished and emaciated. His leg muscles were atonic, flaccid, and atrophic, especially distally. The knee and ankle jerks were absent. Sensation was disturbed in a stocking distribution in both legs to just below the knees. Touch, position, and vibratory sense were impaired, but he was hypersensitive to pin prick, and even light touch in the same area sometimes evoked diffuse burning pain. In the same "stocking" area, his skin was erythematous and edematous. He had a steppage gait. The remainder of his examination was normal.

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