Mills syndrome as a rare and significant motor neuron disease: a case report

Mills' syndrome is a rare motor neuron disease characterized by progressive upper motor neuron dysfunction. As the disease advances, there may be manifestations of bulbar involvement, such as dysarthria, dysphagia, and possibly pseudobulbar affect and progression to the contralateral side may occur lately in patients. Since it was first described by Mills in 1900, there are few cases of Mills' syndrome that have been reported in the literature. Here, we present a case, diagnosed as Mills' syndrome, with 5 years of gradually progressive weakness and stiffness in her left-side limbs with recently added difficulties in speech. Neurological examination revealed bilateral asymmetrical upper motor neuron signs, including increased tone, brisk reflexes, and muscle weakness with dysarthria and dysphagia. There was no sensory involvement as well as sphincter dysfunction and her cognition was contact.