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Arch Neurol. 2004;61:428.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

A 50-year-old man was examined because of a 2-year history of decreased upper-limb dexterity. Thirty years earlier, a cervical spinal cord lesion had been operated on and postoperative radiotherapy had been given. On neurological examination at the time of his current evaluation, abnormality was limited to the upper limbs. The patient had marked upper-limb atrophy with diffuse fasciculations, distally accentuated mild upper-limb weakness, decreased perception of light touch and pinprick from the C5 to C8 dermatomes, decreased perception of position at the fingers, and depressed upper-limb reflexes. Results of lower-limb examination, gait, and plantar response were normal. Magnetic resonance imaging of the cervical spine (Figure 1, A) showed a 1.7 x 1.4 x 1-cm oval enhancing lesion at the C2 to C3 level. There was a syrinx extending cephalad from this lesion up to C1, and posterior tethering of a markedly atrophic cord segment extending from C3 to . . . [Full Text of this Article]

Neeraj Kumar, MD
Department of Neurology
Mayo Clinic
200 First St SW
Rochester, MN 55905

Dudley H. Davis, MD
Rochester

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