title: Clinical features of the localized girdle sensation of mid-trunk (false localizing sign) appeared in cervical compressive myelopathy patients.
abstract: Cervical compressive myelopathy patients sometimes show localized girdle sensation in the mid trunk (so-called false localizing sign). This symptom often confuses physicians, but the clinical features and mechanism of this symptom are still unclear. We investigated the clinical features and possible mechanism. In each of five cases of cervical compressive myelopathy disease with and without mid-truncal girdle sensation, the clinical features, degree and shape of cord compression were analysed. The girdle sensation was expressed as a vague or burning sensation, and was localized with a width of 3 or 4 dermatomes from the T3 to T11 level. There was no correlation between the appearance of the girdle sensation and etiology and level of cervical cord compression. Pyramidal tract signs and disturbance of superficial sensation were observed in all cases. Furthermore, on axial MRI, the midline ventral surface of the cervical cord was remarkably compressed in cases with girdle sensation, as if the compressive lesion entered the anterior medial fissure of the cervical cord. From these findings, this false localizing sign may be caused by severe compression of midline ventral structure of the cervical cord. Ischemia of the thoracic watershed zone of the anterior spinal artery from the compression of the anterior spinal artery at the cervical level might also be considered to be a possible cause.
authors.affiliation: Department of Neurosurgery, Miyazaki Medical College, 5200, Kihara, Kiyotake, Miyazaki 889-1692, Japan. hochiai@fc.miyazaki-med.ac.jp
authors.forename: Hidenobu
authors.initials: H
authors.lastname: Ochiai
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Yamakawa
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Minato
authors.forename: Keiichi
authors.initials: K
authors.lastname: Nakahara
authors.forename: Shinichi
authors.initials: S
authors.lastname: Nakano
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Wakisaka
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002574:Cervical Vertebrae / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007088:Illusions / Q000502:physiology*; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009434:Neural Pathways / Q000293:injuries / Q000473:pathology / Q000503:physiopathology; D017887:Ossification of Posterior Longitudinal Ligament / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D010146:Pain / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology*; D012737:Sex Factors; D020886:Somatosensory Disorders / Q000473:pathology / Q000503:physiopathology*; D013115:Spinal Canal / Q000473:pathology*; D013116:Spinal Cord / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology*; D013117:Spinal Cord Compression / Q000473:pathology / Q000503:physiopathology*; D013223:Statistics as Topic