Wrist drop and muscle weakness of the fingers induced by an upper cervical spine anomaly.
OBJECTIVE
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.
Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan.
Daisuke
D
Tsunoda
Haku
H
Iizuka
Yoichi
Y
Iizuka
Masahiro
M
Nishinome
Kenji
K
Takagishi
D000368:Aged; D002574:Cervical Vertebrae / Q000002:abnormalities* / Q000601:surgery; D019299:Decompression, Surgical; D006225:Hand; D006801:Humans; D007796:Laminectomy; D008279:Magnetic Resonance Imaging; D008297:Male; D018908:Muscle Weakness / Q000209:etiology*; D013117:Spinal Cord Compression / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D013130:Spinal Stenosis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery