Case 27-2012: A 60-Year-Old Woman with Painful Muscle Spasms and Hyperreflexia

A 60-year-old woman was admitted to this hospital because of gradually progressive painful muscle spasms, weakness, and hyperreflexia in the legs. Brain and spine imaging revealed no parenchymal abnormalities. A diagnostic test was performed. Presentation of Case Dr. Mikael L. Rinne (Neurology): A 60-year-old woman was admitted to this hospital because of painful muscle spasms, weakness, and hyperreflexia. The patient had been well until approximately 4 months before admission, when stiffness and cramping developed in both legs, associated with pain in the back. She saw a rheumatologist; a diagnosis of fibromyalgia was made, and gabapentin was administered, without improvement. Two weeks before admission, muscle cramps in the legs progressively worsened. The cramps were more severe proximally, occurred after movement or pressure on the legs, and awakened the patient from sleep. In the days before . . .