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A 54-year-old man was referred by his GP. He had lived with his mother until her death when he was 47 years old. He then moved into an assisted living facility. His father had died in his early 30s in a car accident. A sister was said to have died of a muscle disease and a brother had reportedly died of a heart attack at age 35 years. A niece from his father’s side was also reported to have a muscle disease. Apart from having difficulties opening his hands since childhood (upon request) he had had no complaints until his late thirties, when he experienced muscle weakness. This hampered him during his full-time work as a groundskeeper in public gardens, but he continued working. Two months ago, however, he had to give up this job because of severe fatigue and increasing generalized weakness.
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