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Occult gastro-intestinal cause of spastic paresis of the legs
  1. V Verma1,
  2. A Dhar1,
  3. P F Chinnery2
  1. 1
    Department of Gastroenterology, Bishop Auckland General Hospital, County Durham, UK
  2. 2
    Department of Neurology, Newcastle Hospitals NHS Foundation Trust and Newcastle University, Newcastle upon Tyne, UK
  1. Dr A Dhar, Department of Gastroenterology, Bishop Auckland General Hospital, Cockton Hill Road, Co. Durham DL14 6AD, UK; anjan.dhar{at}cddft.nhs.uk

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CLINICAL PRESENTATION

A 40-year-old man with diabetes presented with difficulty in walking and paresthesia affecting both feet. Examination revealed pes cavus (fig 1), lower limb hypertonia, sustained ankle clonus and symmetric hyper-reflexia. There was no muscle weakness and cerebellar signs were absent. …

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