Phenotype details |
35y proximal muscle weakness, wasting upper limbs; neurological examination diffuse hyperreflexia, neurophysiological testing chronic and active denervation, motor evoked potentials demonstrated increased central conduction time both corticospinal tracts, presentation consistent with flail arm ALS variant; no evidence of cognitive impairment; developed respiratory failure, electively tracheotomised 25m after onset ALS; alive 42m after onset ALS |