Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 32-1994. A 61-year-old man with muscular weakness: A 61-Year-Old Man with Muscular Weakness

Presentation of Case A 61-year-old man was admitted to the Neuromuscular Clinic because of muscular weakness. The patient had been well and athletic until nine months earlier, when he experienced severe fatigue, promptly went to bed, and slept for most of the next 25 hours. Thereafter he experienced increasing weakness in the early morning that diminished during the day. He found it difficult to open screw-capped jars and was even more disabled by leg weakness on climbing stairs and getting out of automobiles. Early in the course of the illness he had muscle cramps in the legs and less frequently.