POSTPOLIO SYNDROME OR CHRONIC ASYMMETRICA L SPINAL MUSCULAR-ATROPHY

A 19-year old male developed within 5 years a slowly progressive and g eneralised painless atrophy of the foreleg with a club-tip foot. Initi ally an undefined bone disease was diagnosed. The first neurologic dia gnostic procedure led to the tentative diagnosis of post-polio syndrom e or chronic asymmetrical spinal muscular atrophy. However, after path ological SSEPs, lumbar magnetic resonance tomography showed a tethered cord syndrome with a huge intraspinal lipoma. Typically, the tethered -cord syndrome is combined with congenital malformations and leads to a conus syndrome with bilateral symptoms. Assuming unilateral symptoms , the lack of pain or vegetative symptoms, isolated atrophy and atypic al EMG findings, the diagnosis had been misled.