Dr. Naveen Kumar on Instagram: "35 year old male presented with chief complaints of 1.both upper limb weakness x 8 years. 2. Wasting of contour of both shoulders x 8 years Weakness is proximal, symmetrical, no PARESTHESIAS or numbness. Initially weakness was proximal from last 6 years , since 2 years it's involving distal parts. There is twitching of muscles in both arms . No family history O/e - power both UL Proximal-2/5, distal -4/5 , movement at shoulder joint reduced. Both LL - 5/5 Tone- HY