Case 31-1977

Presentation of Case A 50-year-old postal worker was admitted to the hospital because of respiratory distress. He was in his usual state of health until four months previously, when he began to complain of fatigue and ankle edema. Three weeks before admission he experienced low-back pain that radiated down the posterior aspect of both legs to the feet, accompanied by weakness in the lower extremities. Two weeks before entry he was admitted to another hospital. Examination disclosed tenderness over the low lumbar spine, with weakness of the gastrocnemius and anterior tibial muscles, more prominent on the left side. Reflexes were . . .