Persistent paraesthesia points to a serious and rare condition

When a patient presents with difficulty walking, his GP immediately suspects something serious is afoot

Rick, a 55-year-old man, presents with a two-month history of increasing difficulty walking and altered sensation in his legs, with associated low back pain.

walking stick

He describes needle-like sensations and burning in his feet, difficulty voiding and a tendency to fall.

Rick discloses his difficult life. An industrial accident left him with PTSD, and his history also includes depression, an MI, hypercholesterolaemia and obesity.

He abstains from alcohol because of past abuse