Professor Shu Leong Ho, Dr Gary Lau, Dr Richard Chang, Dr Sonny Hon and Dr Joseph Kwan
This patient presented with a few week history of progressive weakness affecting the four limbs associated with muscle pain. He found it increasingly difficult to lift up his arms to above his shoulder level and also to climb stairs. There was in addition unintentional weight loss of 20 pounds (baseline of 180 pounds) during the…
This is a patient with neurofibromatosis type 1, an autosomal dominant neuro-cutaneous disorder. In the first two photos (Figures 1 and 2), multiple neurofibromasas well as café-au-lait spots are present on the trunk and upper limbs. In the third and forth photo (Figures 3 and 4), freckling can be seen at the axillary and inguinal…
This is a video from a middle-aged man with myotonic dystrophy type 1, an autosomal dominant multi-systemic disorder that not only affects the muscles, but also causes other problems such as cataracts, arrhythmias and diabetes mellitus. The video shown here is typical of myotonia which can be seen in these patients. The tone is usually…
This middle-aged man was admitted after a generalized tonic-clonic seizure that occurred at home. Physical examination did not reveal any significant external wounds as a result of the seizure and there were no focal neurological signs. However, examination of the oral cavity showed presence of a haematoma at the side of the tongue. This occasionally…
In this video, one can appreciate that the patient has a lower motor neuron type of weakness affecting the right facial nerve. On asking the patient to look upwards (stimulation of the frontalis muscles), one can appreciate the lack of wrinkles over the forehead on the right side compared with the left. On asking the…