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Lyu F, Zheng C, Wang H, Nie C, Ma X, Xia X, Zhu W, Jin X, Hu Y, Sun Y, Zhu Y, Kuwabara S, Cortese R, Maqbool Hassan K, Takai K, Paredes I, Webere R, Turk M, Kimura J, Jiang J. Establishment of a clinician-led guideline on the diagnosis and treatment of Hirayama disease using a modified Delphi technique. Clin Neurophysiol 2020; 131:1311-1319. [DOI: 10.1016/j.clinph.2020.02.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 01/21/2020] [Accepted: 02/11/2020] [Indexed: 11/27/2022]
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Khadilkar SV, Yadav RS, Patel BA. Hirayama Disease and Other Focal Amyotrophies. Neuromuscul Disord 2018. [DOI: 10.1007/978-981-10-5361-0_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Polavarapu K, Preethish-Kumar V, Nashi S, Vengalil S, Prasad C, Bhattacharya K, Verma A, Pruthi N, Bhat DI, Nalini A. Intrafamilial phenotypic variations in familial cases of cervical flexion induced myelopathy/Hirayama disease. Amyotroph Lateral Scler Frontotemporal Degener 2017; 19:38-49. [PMID: 28938856 DOI: 10.1080/21678421.2017.1374977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Hirayama disease is generally considered to be a sporadic disorder, except for a few reports of familial occurrence. In this study, we describe eight patients from four families with cervical flexion induced myelopathy (CFIM)/Hirayama disease (HD) and intra-familial phenotypic variations. All underwent clinical and electrophysiological evaluation, while seven of them had contrast MR imaging of cervical spine in flexion. There was significant intra-familial variability: distal bimelic form in four patients, classical monomelic form in three and proximo-distal form in one. Irrespective of the clinical phenotype, MRI showed characteristic dynamic changes of posterior dural detachment with prominent epidural enhancement extending variably from C3 vertebral level to dorsal spine in six patients. One patient with 28 years of illness, had only lower cervical cord atrophy without dynamic changes while another patient demonstrated forward dural displacement with epidural enhancement even after 38 years of disease duration.
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Affiliation(s)
- Kiran Polavarapu
- a Department of Neurology , National Institute of Mental Health and Neurosciences , Bengaluru , India.,b Department of Clinical Neurosciences , National Institute of Mental Health and Neurosciences , Bengaluru , India
| | - Veeramani Preethish-Kumar
- a Department of Neurology , National Institute of Mental Health and Neurosciences , Bengaluru , India.,b Department of Clinical Neurosciences , National Institute of Mental Health and Neurosciences , Bengaluru , India
| | - Saraswati Nashi
- a Department of Neurology , National Institute of Mental Health and Neurosciences , Bengaluru , India
| | - Seena Vengalil
- a Department of Neurology , National Institute of Mental Health and Neurosciences , Bengaluru , India
| | - Chandrajit Prasad
- c Department of Neuro Imaging and Interventional Radiology , National Institute of Mental Health and Neurosciences , Bengaluru , India , and
| | - Kajari Bhattacharya
- c Department of Neuro Imaging and Interventional Radiology , National Institute of Mental Health and Neurosciences , Bengaluru , India , and
| | - Abha Verma
- c Department of Neuro Imaging and Interventional Radiology , National Institute of Mental Health and Neurosciences , Bengaluru , India , and
| | - Nupur Pruthi
- d Department of Neurosurgery , National Institute of Mental Health and Neurosciences , Bengaluru , India
| | - Dhananjay I Bhat
- d Department of Neurosurgery , National Institute of Mental Health and Neurosciences , Bengaluru , India
| | - Atchayaram Nalini
- a Department of Neurology , National Institute of Mental Health and Neurosciences , Bengaluru , India
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Paredes I, Esteban J, Ramos A, Gonzalez P, Rivas JJ. A severe case of Hirayama disease successfully treated by anterior cervical fusion. J Neurosurg Spine 2014; 20:191-5. [DOI: 10.3171/2013.10.spine13508] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Hirayama disease, or juvenile amyotrophy of distal upper extremity, is a benign, self-limiting cervical myelopathy consisting of selective unilateral weakness of the hand and forearm. The weakness slowly progresses until spontaneous arrest occurs within 5 years of onset. The condition predominantly affects Asian males and is thought to be secondary to spinal cord compression during neck flexion, because of a forward displacement of the posterior dural sac.
The authors present what is to their knowledge the first reported case of a Caucasian male with a severe form of Hirayama disease, suffering from weakness of the leg as well as the forearm. An abnormal range of cervical flexion was observed at the C5–6 level. The patient was successfully treated by anterior cervical discectomy and fusion.
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Affiliation(s)
| | | | - Ana Ramos
- 3Neuroradiology Service, 12 de Octubre University Hospital, Madrid, Spain
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