title: Surfer's myelopathy without surfing: a report of two pediatric patients.
abstract: BACKGROUND
  Surfer's myelopathy (SM) is a rare disorder described in subjects presenting with acute paraparesis while learning how to surf. It is thought to be secondary to spinal ischemia triggered by hyperextension. Spinal magnetic resonance imaging (MRI) shows changes consistent with spinal cord ischemia on T2-weighted and diffusion-weighted imaging (DWI).
  
  
  METHODS
  We report two patients who presented with acute onset paraplegia shortly after spinal hyperextension. They had no physical or radiological evidence of soft tissue injury. Their clinical and imaging findings closely resemble those described in SM.
  
  
  CONCLUSIONS
  We propose the use of the term 'acute hyperextension myelopathy' to categorize patients with spinal cord infarction secondary to hyperextension. DWI sequencing on MRI should be considered to evaluate for early signs of spinal cord ischemia in these patients. Use of a broader term for diagnostic classification can help include patients with spinal cord infarction due to a common mechanism.
authors.affiliation: Department of Neurology, University of Kentucky , Lexington, KY, USA.
authors.forename: Ana C
authors.initials: AC
authors.lastname: Albuja
authors.affiliation: Department of Neurology, University of Kentucky , Lexington, KY, USA.
authors.forename: Sharoon
authors.initials: S
authors.lastname: Qaiser
authors.affiliation: Department of Neurology, University of Kentucky , Lexington, KY, USA.
authors.forename: Donita D
authors.initials: DD
authors.lastname: Lightner
authors.affiliation: Department of Radiology, University of Kentucky , Lexington, KY, USA.
authors.forename: Flavius D
authors.initials: FD
authors.lastname: Raslau
authors.affiliation: Department of Neurology, University of Kentucky , Lexington, KY, USA.
authors.forename: Muhammad S
authors.initials: MS
authors.lastname: Zafar
authors.affiliation: Department of Pediatric Critical Care, University of Kentucky , Lexington, KY , USA.
authors.forename: Philip A
authors.initials: PA
authors.lastname: Bernard
authors.affiliation: Department of Neurology, University of Kentucky , Lexington, KY, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Baumann
keywords: Paediatric neurological disorders; Spinal cord diseases