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.11 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...
, 22 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...
References
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1Chhetri 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 -
2Lin 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
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Publication in this collection
05 June 2023 -
Date of issue
Apr 2023
History
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Received
07 Aug 2022 -
Reviewed
19 Oct 2022 -
Accepted
03 Nov 2022