PPT Slide
George complained of pain, mainly in the neck
and shoulders with increasing generalized weakness.
The age of onset of his weakness was uncertain.
As a youth he could run and work as well as others.
At age 35 he was hospitalized for nephritis with hematuria
but since that time he hadn’t felt strong.
He soon began to note muscle tremors or shaking
but without movement of the limbs.
Muscle cramps, sometimes severe, began in
Definite weakness began in his late 30’s.
Fasciculations in the chin probably began earlier.