Doença de Hirayama: Relato de caso*

Abstract: A 26-year-old previously healthy patient who, at the age of 18 years, began progressive loss of distal strength, rest tremor, and muscle atrophy in the left upper limb. Upon examination, the patient presented moderate distal atrophy, degree 4 in muscular strength, and minipolymioclonus. Electromyoneurography revealed (EMNG) chronic preganglionic bilateral involvement of bilateral C7/C8/T1, worse on the left, with signs of active C8/T1 denervation. A cervical spine magnetic resonance imaging (MRI) scan showed spondylodiscal degenerative changes with central protrusions in C4-C5, C6-C7, and right central in C5-C6, which touched the dural sac. The anteroposterior diameter of the medulla in neutral position, in the C5-C6 plane, was of 5.1 mm. There was a reduction of the spinal cord caliber to 4.0 mm after the dynamic maneuver of forced flexion of the spine, as well as signal increase in the anterior horns. The clinical findings and those of the complementary tests were compatible with Hirayama disease (HD), a rare benign motor neuron disease that affects cervical spinal segments and is most prevalent in men, with onset in the early 20s. Unilateral and slowly progressive weakness is typical, but self-limited. Sensory disturbances, and autonomic and upper motor neuron signals are rare. Management is usually conservative, with the use of a soft cervical collar. Although rare, HD should be considered in young patients with focal asymmetric atrophy in the upper limbs. The early diagnosis of HD depends on the degree of suspicion, as well as on the cooperation and communication among the various specialties involved in the investigation.

Weitere Titel
Hirayama Disease: Case Report*
Standort
Deutsche Nationalbibliothek Frankfurt am Main
Umfang
Online-Ressource
Sprache
Englisch

Erschienen in
Doença de Hirayama: Relato de caso* ; volume:57 ; number:04 ; year:2022 ; pages:697-701
Revista Brasileira de ortopedia ; 57, Heft 04 (2022), 697-701

Beteiligte Personen und Organisationen
Rodrigues, Victor Alves
Klettenberg, Matheus Rocha Pereira
Farage, Luciano
Seguti, Lisiane

DOI
10.1055/s-0042-1742339
URN
urn:nbn:de:101:1-2411072102295.269162676689
Rechteinformation
Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
Letzte Aktualisierung
15.08.2025, 07:36 MESZ

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Beteiligte

  • Rodrigues, Victor Alves
  • Klettenberg, Matheus Rocha Pereira
  • Farage, Luciano
  • Seguti, Lisiane

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