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Case Records of the Massachusetts General Hospital
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Volume 355:296-304 July 20, 2006 Number 3
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Case 22-2006 — A 77-Year-Old Man with a Rapidly Progressive Gait Disorder
Gilmore N. O'Neill, M.B., M.Med.Sci., R. Gilberto Gonzalez, M.D., Didier P. Cros, M.D., Robert H. Ackerman, M.D., Robert H. Brown, Jr., M.D., Ph.D., and Anat Stemmer-Rachamimov, M.D.

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Presentation of Case

Dr. Robert H. Ackerman: A 77-year-old man was admitted to this hospital because of recent episodes of falling. He had been well until 18 months earlier, when an abscess of the right foot caused by Staphylococcus aureus developed. This was treated with surgical débridement, ciprofloxacin, and rest. Six weeks later, a right popliteal deep venous thrombosis developed that responded to warfarin. After these illnesses he felt chronically fatigued and reduced his physical activity, but returned to work. Eight months before admission he resumed working out at a gym and playing tennis, but his pace had slowed; he tired easily, which . . . [Full Text of this Article]

Differential Diagnosis

Pure Motor Syndromes

Combined Upper and Lower Motor Neuron Disease

Amyotrophic Lateral Sclerosis

Clinical Diagnosis

Dr. Gilmore N. O'Neill's Diagnosis

Pathological Discussion

Final Diagnosis


Source Information

From the Departments of Neurology (G.N.O., D.P.C., R.H.A., R.H.B.), Radiology (R.G.G., R.H.A.), and Pathology (A.S.-R.), Massachusetts General Hospital; and the Departments of Neurology (G.N.O., D.P.C., R.H.B.), Radiology (R.G.G., R.H.A.), and Pathology (A.S.-R.), Harvard Medical School.


Related Letters:

A Man with a Gait Disorder
Mast H., Kejda J., Mohr J. P., O'Neill G. N.
Extract | Full Text | PDF  
N Engl J Med 2006; 355:1740, Oct 19, 2006. Correspondence

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