PURPOSE: This report presents a case of wrist drop and muscle weakness of the fingers as a false localizing sign induced by stenosis of the upper cervical spine caused by a bony anomaly. METHODS: A 77-year-old male complained of severe muscle weakness of the right hand. Cervical spine MRI showed a severe and sharp compression of the spinal cord from the dorsal side between C2 and C3 with intramedullary intensity changes and mild stenosis at C3/4 and C4/5. RESULTS: The patient underwent laminectomy of C2, cranial side laminotomy of C3, and laminectomy of C4. Decompression of the spinal cord was demonstrated 1 year after surgery. The patient achieved full recovery of the muscle weakness 1 year after undergoing surgery. CONCLUSIONS: The pathophysiology of false localizing signs remains controversial; however, we believe that this unusual compression pattern and level had the possibility to induce atypical myelopathies such as drop hand and finger of the unilateral hand in this case.
PURPOSE: This report presents a case of wrist drop and muscle weakness of the fingers as a false localizing sign induced by stenosis of the upper cervical spine caused by a bony anomaly. METHODS: A 77-year-old male complained of severe muscle weakness of the right hand. Cervical spine MRI showed a severe and sharp compression of the spinal cord from the dorsal side between C2 and C3 with intramedullary intensity changes and mild stenosis at C3/4 and C4/5. RESULTS: The patient underwent laminectomy of C2, cranial side laminotomy of C3, and laminectomy of C4. Decompression of the spinal cord was demonstrated 1 year after surgery. The patient achieved full recovery of the muscle weakness 1 year after undergoing surgery. CONCLUSIONS: The pathophysiology of false localizing signs remains controversial; however, we believe that this unusual compression pattern and level had the possibility to induce atypical myelopathies such as drop hand and finger of the unilateral hand in this case.
Authors: J O Espersen; M Buhl; E F Eriksen; K Fode; A Klaerke; L Krøyer; H Lindeberg; C B Madsen; P Strange; L Wohlert Journal: Acta Neurochir (Wien) Date: 1984 Impact factor: 2.216