At age 34, she developed ‘severe deep, achy bone pain’ (not relieved by gabapentin or opioids) in her legs associated with increased tone and involuntary leg extension and plantar flexion. She also reported an inability to perceive the position of her legs covered by a blanket while in bed. Bilateral facial numbness (‘novocain type sensation’), ‘freezing’ of her legs and arms with inability to move them at times unless she touched them, and short-term memory loss began at 38. She subsequently developed urinary urgency and urinary incontinence. By age 41, she required a wheelchair and suffered from chronic insomnia, diplopia and worsening dysphagia (both liquids and solids). Her chief complaint was severe pain in her legs that took on a persistenty stiff posture.