ABSTRACT
CASE PRESENTATION A 56-year-old woman presented with a 3-year history of progressive ‘cramping’ in her left leg and back, associated with poor balance. Her symptoms had started with intermittent posturing of the left foot. At the time she was under considerable stress at work and at home. There was plantar flexion at the ankle and clawing of the toes while walking, which evolved to a fixed posture of the foot. She had been unable to put the foot flat on the floor for 2 years. Occasionally, the left leg would twitch involuntarily, mainly with kicking movements. There was pain involving the lumbar region and left leg. Mobility was impaired, including difficulty walking (especially if there was nothing to reach out to for support) and activities such as getting in and out of a car. She had multiple falls despite the use of a walking stick.
