A Fisherman Who Can Not Peel Shrimp Any More

By Aziz Shaibani, MD, FACP, FAAN

A 21-year-old shrimp peeler developed weakness of his fingers five years earlier that progressed to a degree that was not compatible with his job. He had no neck pain, arm numbness, dysphagia or muscle twitching. Family history was not relevant. Examination is shown. CPK was 530 U/L and EMG revealed chronic diffuse denervation of the arms muscles with normal sensory and motor responses. EMG of the legs was normal.

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Launched in January 2002, Practical Neurology strives to enhance quality of care and improve the daily operation of neurology practices. Each month, our experts explain the real-world significance of recent advances in neurologic science and offer step-by-step advice on how to overcome the clinical and business challenges neurologists face. Our straightforward, how-to articles give neurologists tools they can put into practice right away.