A 75-year-old woman complains about the lack of movement in her hands. Neurological examination reveals atrophy of the muscles of the upper extremities. Fibrillar and fascicular twitching of the shoulder girdle muscles. Muscle tone is lowered in the upper extremities. Tendon reflexes from the upper extremities are reduced. Muscle strength in the extremities is 3 points. The movements of the legs are not disturbed. What is the name of the described clinical syndrome?
That presentation is typical for lower motor lesion but there are need further workup due to the long list of DDx , the absence of pain make the cause less likely to be cervical radiculopathy but not rolled it out , I suggest that according to the purely motor involvement of upper limbs it is reasonable to consider (Multifocal motor neuropathy) as initial likely diagnosis. 😁