Article type: CME Quiz
Article
title: Mimicking amyotrophic lateral sclerosis: cervical spondylotic myelopathy
Journal: Current
Medical Issues
Year: 2019
Authors: Jamir Pitton Rissardo, Ana Letícia Fornari
Caprara
E-mail: jamirrissardo@gmail.com
ABSTRACT
An 80‑year‑old
male was admitted to our hospital for urinary catheter change. The patient
stated that he went to other clinic 1 year ago because he had experienced
progressive weakness in all extremities and leaky bladder. The neurological
examination at that time showed a wheelchair patient with weakness in the upper
and lower limbs, fasciculations in the upper limb, left plantar extension, and
hyperreflexia in the upper and lower limbs. Laboratory tests and brain magnetic
resonance imaging (MRI) were normal. A diagnosis of amyotrophic lateral
sclerosis (ALS) was made, and riluzole 50 mg twice daily was started. On follow‑up, he reported relative improvement of urinary
incontinence and deambulation. On admission in our hospital, after the urinary
catheter was changed, he also mentioned cervicalgia with >6 months of onset.
His family history was unremarkable. Physical examination showed a wheelchair
patient with the previous neurological signs described in addition to decreased
tactile sensitivity. Laboratory tests were within normal limits.
Electromyography showedincreased insertional activity, sharp positive waves,
fasciculations, and a diminished motor unit recruitment with prolonged central
motor conduction time. In addition, sensory amplitudes and velocities in the
upper limb were abnormal. A cervical MRI was requested.
Keywords: Amyotrophic lateral sclerosis, cervical spondylotic myelopathy, spondylosis, diagnosis
Full text
available at:
DOI
10.4103/cmi.cmi_36_19
Citation
Rissardo JP, Caprara AL. Mimicking amyotrophic lateral sclerosis: cervical spondylotic
myelopathy. Curr Med Issues 2019;17:155-6
