Open Access Letter to Editor

Man-in-the-Barrel Syndrome as an Atypical form of Amyotrophic Lateral Sclerosis

Jacqueline Fernandes DO NASCIMENTO1, Marco Orsini2*, Marcos RG de Freitas3, Nicole Nunes1, Marco Azizi1, Eduardo Rodrigues Davidovich3, Janie Fernandes DO NASCIMENTO1, Acary Bulle Oliveira4,Renata Castro1, Marco Azizi1 and Antônio Marcos da Silva Catharino1

1Iguaçu University - UNIG/RJ, Nova Iguaçu, Brazil

2Fluminense Federal University (UFF), Iguaçu University (UNIG) RJ, Brazil

3Fluminense Federal University (UFF) - RJ, Brazil

4Federal University of São Paulo (Unifesp) - SP, Brazil

Corresponding Author

Received Date: August 27, 2020;  Published Date: September 10, 2020

TMF, 58 years old, retired, reports that for approximately two years she has been showing amyotrophy, fasciculations and paresis in the upper limbs and pectoral girdle (Figures 1-2). Lower limbs with muscle strength grading 4, in addition to live reflexes. The electroneuromyography demonstrated a pre-ganglionic\purely motor chronic peripheral neurogenic involvement in the four limbs without conduction block. After excluding other possible diagnoses, it is an atypical case of Amyotrophic Lateral Sclerosis presenting as “Barrel Man” syndrome. Such nomenclature refers to a picture of bilateral brachial paresis that disables patients in basic and instrumental activities of daily life that requires elevation of the upper limbs. Since its description, there are some cases of patients with this syndrome, of varying etiologies (Figure 1 & 2).

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