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Arch Neurol. 2000;57:271.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

REPORT OF A CASE

A 91-year-old man with a 40-year history of progressively disfiguring tophaceous gout, hypothyroidism, and remote alcohol abuse presented to the hospital with a 4-month history of progressive weakness and numbness of the lower extremities (Figure 1 and Figure 2). Examination revealed a cheerful, elderly man with severe tophaceous gout affecting the proximal metacarpophalangeal and interphalangeal joints. He was clinically euthyroid.

Figure appears in full text version. Figure 1. The patient's hands show bilateral, severe, disfiguring tophaceous deposits and joint deformities involving the metacarpophalangeal proximal and distal interphalangeal joints.

Figure appears in full text version. Figure 2. Both feet show tophaceous gout deposits and joint deformities involving the great toes (halluces).

Strength in the upper and lower limbs was 4 of 5 proximally, but it was 4+ of 5 distally. Sensory examination showed decreased pinprick, light touch, and vibratory sensations up to the knees bilaterally, but intact proprioception in the feet. The tendon reflexes were 1+ at the biceps, triceps, and . . . [Full Text of this Article]

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