Case 18-2006: A 57-Year-Old Woman with Numbness and Weakness of the Feet and Legs

A 57-year-old woman had had progressive numbness and weakness of the feet and legs since her early 30s. She had had dilated, fixed, and unequal pupils since adolescence. Her father had similar symptoms with his feet and legs, as well as dilated pupils and impotence. Two of her brothers, her son, and her daughter had neuropathy, dilated pupils, or both. A diagnostic procedure was performed. A 57-year-old woman had had progressive numbness and weakness of the feet and legs since her early 30s. She had had dilated, fixed, and unequal pupils since adolescence. Presentation of Case A 57-year-old woman was seen in the neurology clinic of this hospital because of longtime numbness and weakness in her feet and legs. In adolescence, she had noticed that her pupils were dilated, fixed, and unequal in size. Evaluation at that time did not reveal a cause. She had occasional difficulty seeing in bright light or at night. She did not have orthostatic symptoms. She occasionally had a choking sensation when she swallowed solids or liquids. When she was in her early 30s, numbness developed over the anterior surfaces of her shins and ankles. She described the . . .