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 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.