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A 20-year-old man presented with neck pain radiating to the right shoulder for 6 months, difficulty in holding and lifting weight above his head for 4 months, difficulty in walking as well as standing from a squatting position for 4 months, and loss of sensation for 4 months. There was no history suggestive of bowel and bladder involvement. General examination did not show any lymphadenopathy, pallor or skin lesions. Vital signs were normal and stable. Central nervous system motor examination showed atrophy of the small muscles of the hand, increased tone, grade 4/5 power proximally and 3/5 power distally in …
Competing interests None.
Ethics approval This study was conducted with the approval of the BHU.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.