52yrs old female presented with weakness of both lower limbs since two months , insidious onset and gradually progressive weakness .. mri dorsal spine suggestive of demylinating lesions from D7-D12 .. cpk mb is normal .. ultrasound muscle is prominent echogenic fasiculations in bilateral rectal femoris muscles , medial and lateral vastus muscles .. increased echogenicity noted in medial and lateral gastronemius muscles in medial and lateral compartment of leg .. Knee and ankle reflexes are absent No spasticity and flaccid No muscle wasting No sensory symptoms No bladder or bowel dysfunction Ncs done it suggestive of axonal demylination in both lower limbs