Bilateral foot drop in a young woman

Excerpt

A 29-year-old previously healthy woman presented with a 5-year history of progressive bilateral foot drop. She reported no sensory complaints and there was no history of spinal or leg injury. No family history of neurological disorders was elicited. On examination, she was fully conscious with stable vital signs. Neurological assessment revealed high-arched feet and a high stepping gait. The muscle power of the left and right foot dorsiflexion was 0/5 and 2/5, respectively. Deep tendon reflexes were reduced in both legs. Sensation was intact. Neurological examination of her upper limbs and cranial nerves was unremarkable. Her laboratory tests were essentially normal. Electrophysiological studies (nerve conduction study and electromyogram) were suggestive of left common peroneal neuropathy and right deep peroneal neuropathy. Magnetic resonance imaging (MRI) of the thoracic and lumbosacral spines showed the following changes (Fig. 1). Lumbar puncture was not performed as she did not consent to it.

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