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Eight patients with midline cervical disc protrusion at the C3-4 intervertebral level showed unusual clinical signs:numbness in the finger tips and palms,clumsiness of the hands,and a tightening sensation at the midthoracic level.The proprioceptive and cutaneous sensory afferents essential for motor control of the upper limbs were preferentially involved,tactile discrimination of passively given stimuli being spared. Somatosensory evoked potentials subsequent to median nerve stimulation showed conduction failure through the faciculus cutaneous,as evidenced by absent or delayed and attenuated medullary and scalp potentials.The potential originating in the lower cervical cord(N13a)had a low amplitude, indicative of the caudal extension of the lesion.On the basis of the functional anatomy of the intraspinal pathways,especially of the dorsal columns,it is concluded that involvement of the central cord at the C3-4 intervertebral level and its caudal extension is responsible for the syndrome. |
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acrocyanosis
central cord syndrome
dexterity,impaired
dyspraxia
gait disorder
hand numbness
herniated disc
herniated disc,central
herniated disc,cervical
Horner's syndrome
myelopathy
numb clumsy hands syndrome
spinal cord,compression of
walking,difficulty with
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