Hereditary spastic paraplegia accompanied by motor axonal polyneuropathy: A case report

Background and aims: Hereditary spastic paraplegia (HSP) encompass a diverse set of uncommon neurodegenerative conditions characterized by stiffness in the lower limbs resulting from the degeneration of the corticospinal tract. Although the primary pathology in HSP involves the degeneration of the long motor axons in the corticospinal tracts, which are responsible for voluntary muscle control, there may be associated features of peripheral neuropathy. Case Presentation: We report a 26-year-old lady who was referred to us with progressive spastic gait abnormality. She underwent electrodiagnostic evaluation, and a neurogenic pattern, especially in distal muscles, was observed. Results: Neurologic examination revealed muscle weakness, spasticity, and deep tendon reflexes in all limbs without sensory symptoms or ataxia. Along with the patient’s history and physical examination, complicated HSP associated with motor axonal neuropathy was suggested. Conclusion: This case highlights the importance of a comprehensive evaluation, combining clinical examination and electrodiagnostic studies, in understanding the intricate manifestations of neurogenetic disorders.