Monomelic amyotrophy (Benign Focal Amyotrophy, Hirayama Syndrome, O’Sullivan-McLeod Syndrome) is a benign anterior horn cell disorder, clinically presenting as wasting of a single limb, first described by Hirayama in 1959. In most cases, the cause is unknown, although there have been a few published reports linking monomelic amyotrophy to traumatic or radiation injury. Diagnosis is made by physical exam and medical history.