Adolescent-onset asymmetric muscle wasting and motor-sensory dysfunction with subsequent neurological recovery: A case report

Table 1 Current muscle measurements

Muscle group	Right	Left
Calf circumference, cm	38	35
Upper arm/biceps circumference, cm	25	24.5

Table 2 Lower limb examination

Parameter	Strength in left lower leg at initial assessment	Strength in left lower leg post recovery
Hip flexion	3/5	5/5
Knee extension	2/5	5/5
Knee flexion	2/5	5/5
Ankle dorsiflexion	1/5	5/5
Ankle plantarflexion	1/5	5/5
Great toe extension	3/5	5/5
Ankle inversion	3/5	5/5
Ankle eversion	3/5	5/5

Table 3 Upper limb examination

Parameter	Strength in the left arm at initial assessment	Strength in left arm post recovery
Shoulder abduction	4/5	5/5
Elbow flexion	3/5	5/5
Elbow extension	4/5	5/5
Wrist extension	4/5	5/5

Table 4 Clinical timeline

Time point	Clinical course
Age 16	Onset with left posterior lower-leg pain
Early course	Progressive dysfunction and wasting of posterior left leg muscles
Subsequent period	Left upper-limb involvement, predominantly biceps
Later course	Slow, milder involvement of the right side
Peak severity	Severe functional impairment; walking stick required
Initial evaluation	Reduced/absent reflexes; marked sensory impairment reported
Approximately 1 year	Recovery; reflexes returned almost to normal, with substantial functional recovery
Following years	Gradual, continued functional recovery
Approximately 3 years	Normal daily function, strength, and reflexes; persistent left calf and left arm muscle wasting