PLAB03-161

Michael is a 62 year old male who has noticed he has been dropping objects over the last few months and had difficulty turning keys and opening bottles. He is unsure whether he has imagined the occasional muscular twitch.

You are both concerned about the possibility of Motor Neurone Disease and you go on to take a thorough history.

Which of the following features in his history would not be in-keeping with a diagnosis of MND?

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