Almeida, RuiFelix, Ana CatarinaAndre, Ana LuisaNzwalo, Hipólito2018-12-072018-12-072017-042053-8855http://hdl.handle.net/10400.1/11080We report a case of progressive symmetric brachial weakness followed by cervical muscle weakness. The electromyogram confirmed the diagnosis of amyotrophic lateral sclerosis. After 3 years the patient remained able to walk unassisted and without significant bulbar manifestations or upper neuron signs. The concomitant presence of dropped head syndrome and man-in-barrel syndrome in an amyotrophic lateral sclerosis patient makes our case unique.engother10.1093/omcr/omx013