Clinical Reasoning: Reversible gait ataxia

Abstract

A 65-year-old right-handed man presented with a 7-year history of progressive gait impairment and unsteadiness. He was only able to ambulate at home with a frame for very short distances and started using a wheelchair outside his home to prevent falls 4 years prior to presentation. The patient had no autonomic, dermatologic, or rheumatologic symptoms, unintentional weight loss, or night sweats. He was an ex-smoker, with a 20-pack-year history of smoking, and did not consume alcohol. There was no family history of neurologic conditions.