Madras pattern of motor neuron disease: case report from Thailand.

A 38-year-old male farmer with classical features of Madras type motor neuron disease was reported. The benign focal atrophy of extremities especially the upper extremities and associated hearing impairment are important clues to the clinical diagnosis. Although there is no pathologic proof of this subgroup of motor neuron disease our data and previous reports strongly suggest anterior horn cell disease and motor nuclei involvement in the brainstem. The nature of the lesion which is responsible for auditory impairment is still controversial.