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20-year-old male with a skin lesion of the back of the neck who presented to clinic with 3 weeks of progressively worsening weakness of his left lower extremity. The patient and his parents indicate that approximately 3 weeks ago he started requiring lifting his leg with his hands when he was moving from his wheelchair and standing has been significantly more difficult. He had 3/5 strength in his left lower extremity on exam, a positive Babinsky sign and clonus at the left ankle.

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