CASE OF MILL’S SYNDROME AS A VARIANT OF ATYPICAL ALS IN A CENTRAL ASIAN PATIENT
DOI:
https://doi.org/10.5281/zenodo.17427528Keywords:
Mill’s syndrome, amyotrophic lateral sclerosis (ALS), motor neuron, hemiplegia, N-shaped progression.Abstract
Mill’s syndrome is an atypical variant of amyotrophic lateral sclerosis (ALS) characterized by progressive,
idiopathic motor neuron damage. This syndrome presents with an initial unilateral impairment in the lower limb, which
then progresses to the ipsilateral upper limb before affecting the contralateral limbs.
In this case, we describe a patient with Mill’s syndrome whose symptoms first appeared in the left leg. After one year, the
symptoms progressed to the left arm, followed by the right leg and arm. Three months later, bulbar symptoms emerged.
MRI examination at our clinic revealed periventricular hyperintense foci in T2/FLAIR mode, which did not correlate with the
patient’s condition. MRI scans of the cervical and thoracic spinal cord showed no pathological changes. Electromyography
(EMG) of the legs and arms demonstrated generalized motor neuron damage with reinnervation-denervation processes.
In conclusion, Mill’s syndrome and possibly other atypical variants of ALS may be more common in the Central Asian
population than previously assumed, yet they remain underdiagnosed and rarely documented. Moreover, incidental MRI
findings, such as those in our patient, may be asymptomatic and should not mislead specialists in diagnosis.
Author Biographies
Rahimberdiyev Shoxruh Ravshanbekovich, Kimyo International university in Tashkent, PhD
Safarov Saydullo Ubaydullayevich, Kimyo International university in Tashkent, PhD
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