The patient was a 75 year old man who had an 8 - 10 month history of progressive difficulty walking. He had noted some left lower extremity weakness and some difficulty with memory and concentration. He was alert and oriented, but had slow and hesitating speech. He could recall only 1 of 3 objects at five minutes. Cranial nerves were normal. Upper extremity tone and power were normal. Both lower extremities were weak in an extensor distribution, and were graded at 4+/5. Sensation was normal. Muscle stretch reflexes were active and equal. Babinski signs were negative. Gait was slow, broadbased, and tandem walking was ataxic. He underwent craniotomy and tumor resection.
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Keith A. Johnson (, J. Alex Becker (