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Background Facial-onset sensory and motor neuronopathy (FOSMN) is a rare disease whose cardinal features are initial asymmetrical facial sensory deficits slowly evolving and followed by bulbar symptoms and spreading of sensory and motor deficits from face to scalp, neck, and extremities. Case presentation We described a 70-year-old man who presented with 6-month history of facial numbness on the left side, and gradual worsening of symptoms. Over several months, facial muscle weakness, dysarthria, and fasciculation had progressed. NCS, needle EMG and blink reflex responses suggested the diagnosis of FOSMN. The ganglioside panel (anti-GM1 and Gd1b) was positive. Considering the FOSMN autoimmune pathology hypothesis, IVIG treatment was given. Conclusion In this case, we aimed to highlight the key clinical aspects of FOSMN and how to differentiate it from motor neuron disease and bring FOSMN to the attention of neurologists as a recently recognized and distinctive disorder.

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Neuralgic amyotrophy (NA), also known as Parsonage-Turner syndrome or idiopathic brachial plexopathy, is a multifocal inflammatory neuropathy that usually affects the upper limbs. The classic picture is a patient with acute onset of asymmetric upper extremity symptoms, excruciating pain, rapid onset of multifocal paresis often involving winged scapula, and a monophasic course of the disease. We present an unusual case of recurrent NA characterized first by right brachial plexitis and then isolated left posterior interosseous nerve palsy.