title: Thoracic sensory level as a false localizing sign in cervical spinal cord and brain lesions.
abstract: BACKGROUND
  In rare cases of cervical myelopathy, there may be a discrepancy between the sensory level and the site of cord lesion. This phenomenon is not well recognized. This study sought to investigate the characteristics of patients presenting with a false localizing thoracic sensory level.
  
  
  METHODS
  The databases of the neurology clinics of two major tertiary medical centers were reviewed for all patients who presented in 2000-2010 with a main complaint of paraparesis and a thoracic sensory level. Those whose initial thoracic magnetic resonance scan showed no spinal cord pathology were included in the study.
  
  
  RESULTS
  Twelve patients (mean age, 52 ± 31 years) met the study criteria. In all cases, the pathological lesion was visualized on magnetic resonance imaging of the cervical spine or brain. Eight patients had a compressive lesion of the spinal cord and 4 had demyelinating lesions. The difference between the false localizing sensory level and the level of the cervical lesion ranged from 6 to 11 segments.
  
  
  CONCLUSIONS
  Patients with a sensory thoracic level and normal findings on thoracic magnetic resonance imaging should be further evaluated with cervical spinal cord and, sometimes, brain imaging to search for potentially treatable lesions.
authors.affiliation: Department of Neurology, Rabin Medical Center, Petah-Tikwa, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Hellmann
authors.forename: Ruth
authors.initials: R
authors.lastname: Djaldetti
authors.forename: Judith
authors.initials: J
authors.lastname: Luckman
authors.forename: Ron
authors.initials: R
authors.lastname: Dabby
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology*; D002574:Cervical Vertebrae / Q000473:pathology*; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000175:diagnosis / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D020335:Paraparesis / Q000175:diagnosis / Q000473:pathology; D013116:Spinal Cord / Q000473:pathology*; D013117:Spinal Cord Compression / Q000175:diagnosis / Q000473:pathology*; D055815:Young Adult