A man in his mid-60s had a 6-week progression of motor and sensitive disturbances in all 4 limbs. He had a history of episodic cervicalgia but no active neck pain. Examination revealed distal 3/5 paresis in the arms, distal 4/5 paresis in the legs, paresthesia-hypoesthesia in all limbs without radicular pain, 3/4 hyperreflexia, Ashworth 1 spasticity with mild clonus, and sensitive gait ataxia. Lhermitte sign was absent. Bilateral Hoffmann, Babinski, and Dejerine reflexes were present.
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