September 2016 Video Challenge: A Woman with Slowly Progressive Weakness of the Arms and Legs

A 65-year-old woman with 15-year history of slowly progressive weakness of the arms and legs as demonstrated in the video. She had no dysphagia and normal quadriceps strength. CPK level was normal and EMG revealed mixed small and large motor unit potentials in the bilateral distal arm and leg muscles. Left biceps biopsy is shown.

The most likely diagnosis is:
1. Inclusion body myositis
2. Polymyositis
3. Granulomatous myositis
4. Vasculitic myositis
5. Parasitic myositis

Click here for the answer


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About Practical Neurology

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.