A diagnostic approach to a patient with ascending sensory loss

Objective and method. Ascending sensory loss is a common reason for neurologic consultation. In this case report, we describe a 75-year-old male who presented with new onset ascending bilateral lower extremity sensory deficits, which rapidly progressed to include urinary retention and weakness. Outcome. In addition to blood work, neuroimaging and CSF analysis, the definitive diagnosis required serum protein electrophoresis and a bone marrow biopsy. Conclusion. This case highlights the formulation and diagnostic approach to patients with ascending sensory loss, considering the onset of the symptoms and comorbidities in a stepwise approach.