PMC7325212_01
Clinical photograph of lower limbs. Despite marked bilateral foot drop, there is no significant soft tissue atrophy, which would be atypical for chronic denervation. Two separate sensory levels are indicated for impairment of pinprick/pain (lower third of tibia, long arrow) and light touch (mid-foot, arrowhead).
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F1
Sensory testing showed length-dependent sensory impairment for pinprick/pain and light touch (Fig. 1), with normal perception of vibration and proprioception.
Representative whole-body coronal MRI sections (TE: 87, TR: 2,000, FA: 150). a At the level of the trunk, there is marked fatty replacement of lumbar paraspinal muscles (long black arrow) whereas the psoas muscles are relatively spared (arrowhead). There is also moderate fatty streaking of the gluteus medius muscles (star), more prominently than in the gluteus maximus. b At two different anteroposterior levels of the calf, there is marked fatty replacement of the tibialis anterior (long black arrow), medial gastrocnemius (arrowhead), and soleus muscles (star).
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F2