CASE OF MILL’S SYNDROME AS A VARIANT OF ATYPICAL ALS IN A CENTRAL ASIAN PATIENT

Mill’s syndrome is an atypical variant of amyotrophic lateral sclerosis (ALS) characterized by progressive,idiopathic motor neuron damage. This syndrome presents with an initial unilateral impairment in the lower limb, whichthen progresses to the ipsilateral upper limb before affecting the contralateral limbs.In this case, we describe a patient with Mill’s syndrome whose symptoms first appeared in the left leg. After one year, thesymptoms progressed to the left arm, followed by the right leg and arm. Three months later, bulbar symptoms emerged.MRI examination at our clinic revealed periventricular hyperintense foci in T2/FLAIR mode, which did not correlate with thepatient’s condition. MRI scans of the cervical and thoracic spinal cord showed no pathological changes. Electromyography(EMG) of the legs and arms demonstrated generalized motor neuron damage with reinnervation-denervation processes.In conclusion, Mill’s syndrome and possibly other atypical variants of ALS may be more common in the Central Asianpopulation than previously assumed, yet they remain underdiagnosed and rarely documented. Moreover, incidental MRIfindings, such as those in our patient, may be asymptomatic and should not mislead specialists in diagnosis.

Перевод пока недоступен