Khan MD, Khan MA, Mustafa SI, Khan M, Alamgir MA. Adolescent-onset asymmetric muscle wasting and motor-sensory dysfunction with subsequent neurological recovery: A case report. World J Clin Cases 2026; 14(28): 127887 [DOI: 10.12998/wjcc.127887]
Corresponding Author of This Article
Muhammad Daniyal Khan, MD, Shalamar Medical and Dental College, Lahore 63100, Punjab, Pakistan. tcs203886@gmail.com
Research Domain of This Article
Clinical Neurology
Article-Type of This Article
case-report
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Khan MD, Khan MA, Mustafa SI, Khan M, Alamgir MA. Adolescent-onset asymmetric muscle wasting and motor-sensory dysfunction with subsequent neurological recovery: A case report. World J Clin Cases 2026; 14(28): 127887 [DOI: 10.12998/wjcc.127887]
World J Clin Cases. Oct 26, 2026; 14(28): 127887 Published online Oct 26, 2026. doi: 10.12998/wjcc.127887
Adolescent-onset asymmetric muscle wasting and motor-sensory dysfunction with subsequent neurological recovery: A case report
Muhammad Daniyal Khan, Muhammad Arbaz Khan, Shahzadi Iram Mustafa, Maryam Khan, Muhammad Ahmad Alamgir
Muhammad Daniyal Khan, Shalamar Medical and Dental College, Lahore 63100, Punjab, Pakistan
Muhammad Arbaz Khan, Maryam Khan, Medicine, Shahida Islam Medical and Dental College, Bahawalpur 63100, Punjab, Pakistan
Shahzadi Iram Mustafa, Anatomy, Quaid e Azam Medical College, Bahawalpur 63100, Punjab, Pakistan
Muhammad Ahmad Alamgir, Medicine, Rai Medical College, Sargodha 63100, Punjab, Pakistan
Author contributions: Khan MD contributed to gathering of data and project head; Khan MA contributed to data curation and proof reading; Mustafa SI contributed to analysis and review; Khan M contributed to review and design; Alamgir MA contributed to final review.
AI contribution statement: No AI tools used.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Muhammad Daniyal Khan, MD, Shalamar Medical and Dental College, Lahore 63100, Punjab, Pakistan. tcs203886@gmail.com
Received: September 10, 2026 Revised: October 14, 2026 Accepted: October 22, 2026 Published online: October 26, 2026 Processing time: 44 Days and 14.1 Hours
Abstract
BACKGROUND
Progressive focal muscle wasting in adolescents may result from motor neuron, peripheral nerve, spinal cord, or muscular disorders. Atypical distribution and subsequent recovery can complicate diagnosis.
CASE SUMMARY
The patient initially developed pain in the left posterior leg musculature, followed by marked muscle wasting. Involvement subsequently extended to the left upper limb, particularly the biceps, and later progressed more mildly on the right side. At its worst, the illness caused significant functional impairment requiring a walking stick. Marked sensory loss was reported in the affected left limb, with reduced or absent reflexes early in the course. Magnetic resonance imaging of the cervical, thoracic, and lumbar spine revealed no clear structural cause. Following symptomatic management, substantial recovery occurred over the subsequent years, with near normal strength and reflexes and no meaningful functional limitations. However, asymmetric muscle wasting persisted, most prominently in the left calf and upper limb.
CONCLUSION
This case highlights an unusual adolescent-onset neurological syndrome characterized by progressive asymmetric muscle wasting, motor and sensory involvement, severe functional impairment, and substantial recovery with residual atrophy. The atypical distribution and clinical course do not fit neatly into a single classical neurological entity, warranting consideration of an atypical-spectrum presentation of Parsonage Turner syndrome (neuralgic amyotrophy).
Core Tip: Adolescent-onset progressive asymmetric muscle wasting with combined motor and sensory dysfunction can undergo a substantial, functional recovery, even after reaching a severe clinical nadir, although some localized residual muscle atrophy may persist permanently.
