Hirayama disease is an initially progressive disease caused by cervical neck flexion compressing the anterior horns of the lower cervical spinal cord. It is primarily seen in young males of Indian or Asian descent. With increasing dispersion of these populations this condition is increasingly being encountered internationally. This grand round reviews this rare but increasingly recognized condition.
Materials and methods
We present a classic case of a young Indian male with progressive hand and forearm weakness. We discuss the typical clinical presentation, appropriate investigations and management of this condition.
Our patient presented with oblique amyotrophy and underwent a diagnostic flexion MRI scan which revealed anterior translation of the posterior dura with compression of the anterior horns of the lower cervical cord. He has been successfully treated in a cervical collar.
This case illustrates the typical presentation, diagnostic investigations and treatment of Hirayama syndrome. It is hoped that this review will alert clinicians of this condition and optimize the management of affected individuals.
KeywordsHirayama Oblique amyotrophy Atrophy Juvenile spinal muscular atrophy Juvenile muscular atrophy Monomelic amyotrophy Asymmetric segmental spinal muscular atrophy
Glynny Kieser for her editorial input.
Compliance with ethical standards
Conflict of interest
None of the authors have any potential conflict of interest.
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