DefinePK

Abstract

A 64-year-old previously-healthy male presented with 2-year history of progressive neurological symptoms of numbness and muscleweakness involving all 4 limbs. There was gait disturbance, urinary and fecal incontinence. On examination, the left upper limb had normaltone, diminished deep tendon reflexes and power of 4/5 with wasting both in proximal and distal muscles. There were reduced pinprick pain andtemperature sensations below the elbow bilaterally with intact vibration and proprioception. Both lower limbs had increased tone, diminisheddeep tendon reflexes, power of 3/5 with wasting both in proximal and distal muscles with unequivocal plantar reflex bilaterally. There werereduced pinprick pain and temperature sensations below the knee on right and below the ankle on left with intact vibration and proprioception.Nerve Conduction Studies (NCS) were done which showed axonal type of denervation in all limbs. MRI scan of Cervical Spine showed T2Whyperintense signals and narrowing of spinal canal from C3 to C7 region. The final diagnosis was spinal cord edema in the cervical region andcervical spondylosis causing spinal cord compression.