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 2002, Practical Neurology is a publication uniquely dedicated to presenting current approaches to patient management, synthesis of emerging research and data, and analysis of industry news with a goal to facilitate practical application and improved clinical practice for all neurologists. Our straightforward articles give neurologists tools they can immediately put into practice.