[A case of very slowly progressive, high-cervical spondylotic myelopathy presenting with XXXX in the palms].

@entity1 @entity40206 @entity3949 @entity51 @entity158 @entity2055 @entity2693
We report a case of very slowly progressive, high-cervical spondylotic myelopathy with @entity51 in the palms. A 76-year-old @entity1 began to feel tingling sensation in the second fingers of the bilateral hands 30 years prior to admission. The abnormal sensation spread from the first to the third fingers, and subsequently all over the palms. He noticed intermittent sharp @entity158 in the dermatomes of @entity40206 bilaterally from his late sixties, and later he developed clumsiness of fine finger movements. In recent years he experienced @entity2693 in the thighs while walking. On neurological examination, there was a mild @entity51 in light touch over the bilateral palms, while perception of temperature and @entity158 was normal. Vibration sense was severely and position sense mildly impaired. Discriminative sensation, including graphesthesia, stereognosis, two-point discrimination and texture recognition, was severely impaired over the bilateral palms. On the other hand, all modalities of sensation were normal in the lower limbs. Gross motor dysfunction, such as weakness of limbs, @entity3949 or gait disturbance, was not present. He did not show @entity2055 , but the dexterity of his fingers was severely impaired. Deep tendon reflexes were mildly increased except for the Achilles tendons that were hyporeactive. Plantar responses were flexor bilaterally. Nerve conduction study revealed giant F waves and H reflexes by stimulations of the median and ulnar nerves bilaterally.(ABSTRACT TRUNCATED AT 250 WORDS)
