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Progressive motor quadriparesis with wasting: a diagnostic conundrum
  1. Samhita Panda1 and
  2. Monalisa Vegda2
  1. 1Department of Neurology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
  2. 2Neurology, All India Institute of Medical Sciences—Jodhpur, Jodhpur, Rajasthan, India
  1. Correspondence to Dr Samhita Panda; samhitapanda{at}


The case of a man in his early 30s, presenting with slowly progressive, asymmetrical onset, pure motor quadriparesis over 9 months with bulbar involvement, absence of upper motor neuron features and significant weight loss, is reported. In view of presentation with diffuse lower motor neuron involvement of short duration, the diagnostic possibilities are discussed. Apart from motor neuron disease, its mimics including muscle and neuromuscular junction disorders were also considered and evaluated for. Carefully assessed clinical and electrophysiological markers which finally clinched the diagnosis of the rare disorder Lambert-Eaton myasthenic syndrome are elaborated. In the present context, recognition of the oddities on clinical and laboratory evaluation is of paramount importance to rule in causes of pure motor quadriparesis.

  • neurology (drugs and medicines)
  • clinical neurophysiology

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  • Contributors SP: guarantor, planning, conduct and reporting of the work. MV: planning, conduct and reporting of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.