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Pyramidal versus inverse pyramidal patterns in functional limb weakness
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Charles Mark Wiles makes some excellent points about pyramidal weakness.1 What we observe is largely just the ‘normal’ pattern of asymmetry of strength in the upper and lower limbs, amplified by disease and sometimes spasticity, and can often be found in lower motor neurone syndromes as well as upper.
But there is one clinical scenario where I would argue it remains …
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Competing interests None declared.
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