A. Frontal view. B. Lateral view.  This 49-year-old patient has a FAS marked by a bilateral flaccid paralysis of the upper limbs contrasting with preserved independent ambulation. Wasting involves proximal muscle.

A. This 54 year old man with FAS has severe wasting of the arms causing profound weakness. Note the symmetric distribution and involvement of proximal musculature. Muscle bulk and strength were relatively preserved in the legs but lower limb reflexes were pathologically brisk and the plantar responses extensor. B. Note the very similar pattern of wasting in a patient with "progressive muscular atrophy" depicted in a 1888 text of Gowers.