Jayendra reported here with chief complaints of inability to walk effectively and unable to jump and manage stairs independently with generalized muscle wasting with stammering.

His birth history was suggestive of full term normal delivery. There was history of neonatal septicaemia in the second week of birth. All the early developmental milestones were achieved late (walking - 2½ years ; speech – 3 years). At 3 ½ years he had his first seizure. On investigation his EEG was found to be abnormal and he was started on carbamezapine. Repeat EEGs at 2-3 years intervals were always abnormal. He stopped attending school in between and his behavioural pattern was changed – became recluse and stopped communicating with others. At 14 years of age he had a sudden onset of inability to walk while travelling in a train. He recovered gradually from that episode but has developed gait abnormality (high steppage gait with mild pelvic tilt) since then. On investigation his EMG/NCV study was suggestive of severe sensory motor neuropathy in lower limbs of a mixed demyelinating and axonal degeneration type. Normal CT Scan was found.

On examination, mild intrinsic stiffness was found in the lower limbs with bilateral foot drop deformity with pes-cavus. He was walking with a broad based high steppage gait with dragging tendency of lower limbs. Jumping and running was not possible. Walking with sleepers was difficult. He was independent in his activities of daily living. Wasting of both extremities (distal more than proximal ) was also found. He was having limited social interaction with disturbed sleep.

Improvements noted with 1 years, 5 months of G – Therapy :

1. Can walk with sleepers now which was difficult before.
2. Clawing of toes has reduced.
3. Better active dorsi – flexion of both ankles now.
4. Better balance in single limb standing position now.
5. His recent EMG/NCV study is suggestive of increase in the amplitudes of both sural nerves.
6. Better sleep now.