•FSHD1 may present with bilateral foot drop in adulthood.•Clinical examination, EMG and muscle MRI may additionally guide genetic testing.•Targeted genetic testing is crucial in atypical cases, particularly in light of new therapies.
Keywords: Electromyography; Facioscapulohumeral muscular dystrophy type 1; Genetic testing; Muscle MRI.
© 2024 The Authors. Published by Elsevier B.V.