Abstract
To analyse the disease progression along 28years in one patient with ALS evolving from the brachial amyotrophic diplegia (BAD) to a clinical form fulfilling the El Escorial criteria for definite ALS. A 47-year-old man (no affected relatives, left clavicular fracture at 17years of age) presented with a 28-year history of progressive painless hands, arms and shoulder girdle weakness and later on pyramidal signs in lower extremities and bulbar signs. Weakness in the left hand began at 19years of age.
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