A 21-year-old man presented with right-hand intrinsic muscle wasting and right-hand tremor on neck flexion. MR scan of cervical spine was normal in the neutral position, but on neck flexion showed anterior shift and flattening of the cervical cord, with prominent posterior epidural space and engorged epidural venous plexus. We diagnosed Hirayama disease and his condition stabilised with a neck collar and physiotherapy.
- spinal muscular atro
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Contributors THL collected the clinical material and prepared the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Obtained.
Provenance and peer review Not commissioned; externally peer reviewed by Martin Turner, Oxford, UK.