Case Report
Spinal Cord (2007) 45, 637–640; doi:10.1038/sj.sc.3101999; published online 28 November 2006
Cervical spinal cord neurapraxia in the setting of Klippel–Feil anomaly: a diagnostic and therapeutic challenge
S N Gupta1, J H Piatt Jr2 and B Belay3
- 1Section of Child Neurology, Department of Pediatrics, Temple University School of Medicine, Philadelphia, PA, USA
- 2Section of Neurosurgery, St Christopher's Hospital for Children, Philadelphia, PA, USA
- 3Section of General Pediatrics, Department of Pediatrics, Temple University School of Medicine, Philadelphia, PA, USA
Correspondence: SN Gupta, Section of Child Neurology, Department of Pediatrics, Temple University Children's Medical Center, 3509 North Broad Street, Philadelphia, PA 19140, USA
Abstract
Study design:
Case report.
Setting:
Temple University Children's Medical Center in USA.
Objectives:
To report a patient whose recurrent and transient episodes of quadriplegia mimicked cervical cord neurapraxia. Cervical spine neuroimaging revealed congenital intersegmental fusion of C5 through C7 (consistent with Klippel–Feil anomaly), corresponding abnormal spinal cord signals on T2-weighted images and enhancing focal lesion opposite the C4 vertebral body. A posterior cervical decompression at C4–C5 and lateral mass fixation was performed, and the episodic quadriplegia has not recurred.
Conclusion:
Understanding of the biomechanics of Klippel–Feil anomaly may facilitate prompt referral for surgical management and avoidance of permanent disability.
Keywords:
Klippel–Feil anomaly, cervical cord neurapraxia, magnetic resonance imaging, laminectomy and vertebral fusion
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