Sensory ataxia-plus secondary to cervical spondylotic myelopathy

Ataxia sensitiva-plus secundária a mielopatia espondilótica

A 45-year-old male patient presented a 2-week history of progressive gait imbalance. He also presented impaired proprioception, symmetric distal quadriparesis (grade 4/5), gait ataxia with a positive Romberg sign, bilateral upper limb dysmetria, and dysdiadochokinesia. The patient did not present nystagmus and/or dysarthria. A cervical spine magnetic resonance imaging (MRI) scan revealed severe degenerative disk disease and compressive spondylotic myelopathy at C3-C4 and C5-C6 (►Figure 1A). He was submitted to posterior decompression and laminoplasty involving C3-C7 (►Figure 1B), and presented improvement in gait. Mild cerebellar signs in a patient with a positive Romberg sign, without dysarthria and nystagmus, point to a sensory ataxia-plus rather than a cerebellar etiology.¹, ²

Figure 1
Cervical spinal cord T2-weighted MRI revealing severe degenerative disk disease and compressive spondylotic myelopathy at the levels of C3-C4 and C5-C6 (A). Cervical spinal cord T2-weighted MRI showing signs of posterior cervical decompression and cervical laminoplasty involving C3-C7 (B).

References

• ¹
  Chhetri SK, Gow D, Shaunak S, Varma A. Clinical assessment of the sensory ataxias; diagnostic algorithm with illustrative cases. Pract Neurol 2014;14(04):242–251. Doi: 10.1136/practneurol-2013-000764
  » https://doi.org/10.1136/practneurol-2013-000764
• ²
  Lin HC, Chen CH, Khor GT, Huang P. Upper limbs dysmetria caused by cervical spinal cord injury: a case report. BMC Neurol 2009; 9:50. Published 2009 Sep 24. Doi:10.1186/1471-2377-9-50
  » https://doi.org/10.1186/1471-2377-9-50

Publication Dates

• Publication in this collection
  05 June 2023
• Date of issue
  Apr 2023

History

• Received
  07 Aug 2022
• Reviewed
  19 Oct 2022
• Accepted
  03 Nov 2022