59-year old right-handed white male, self-referred, with a history of progressive numbness in his lower extremities beginning in the early 1980's, as well as increasing horizontal diplopia beginning in 1991. The patient himself was a vague historian. He claims to have noticed joint discomfort in early 1980 which was diagnosed as "arthritis" and prompted therapy with low dose prednisone. Beginning in 1981 he complained of numbness in and around his upper and lower lip, as well as in his lower extremities. The numbness in the legs gradually increased up to his mid-thighs and to a lesser extent involved his hands. In the mid-1980's the patient had complaints of inability to maintain an erection. He was thought by his physician to have possible autonomic dysfunction. Beginning in 1990 the patient developed mild leg weakness and had balance problems, "walking like a drunk person". He denied any pain.
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