Bilateral Finger Jerks as a Useful Sign for Diagnosis of Cervical Compressive Myelopathy

Naoki Kasahata

Abstract


Background: Bilateral finger jerks are very frequently observed when we examine cervical compressive myelopathy patients. It is very important to determine what sign or symptom is useful for the early diagnosis of cervical compressive myelopathy.

Methods: We studied 24 patients with cervical compressive myelopathy. We studied neurological signs and symptoms (bilateral finger jerks, the attitude of deep tendon reflexes, patients’ complaints especially tingling sensations of hands, Hoffmann’s signs) and compared with level diagnoses made by T2-weighted MRI.

Results: Eleven patients showed bilateral finger jerks: among these 11 patients, seven patients showed hyperreflexia of biceps and brachioradial reflexes and four patients showed hyporeflexia (inverted radial reflex). All patients with bilateral finger jerks showed lesions at the C5-6 or C4-5 intervertebral levels (C7 or C6 spinal cord levels) on MRI. Among four patients who showed bilateral finger jerks with hyporeflexia (inverted radial reflexes), two patients showed lesions at C5-6 intervertebral level (C7 spinal cord level). Nine patients showed generalized hyperreflexia. 14 patients developed tingling sensations of the hands: among these 14 patients, five patients were affected unilaterally and nine patients were affected bilaterally. Among these 14 patients with tingling sensations of the hands, seven had lesions at the C4-5 intervertebral levels and six had C5-6 intervertebral levels. Sensory levels were observed in five patients. Hoffmann’s signs were not observed in any patients. Therefore, 23 of 24 (96%) cervical compressive myelopathy patients showed bilateral finger jerks or generalized hyperreflexia or complained tingling sensations of hands.

Conclusions: We must conclude that deep tendon reflex examination especially the observation of bilateral finger jerks or generalized hyperreflexia and history taking of tingling sensations of hands are useful for the screening of cervical compressive myelopathy.




 doi:10.4021/jnr15w


Keywords


Bilateral finger jerks; Cervical compressive myelopathy; Generalized hyperreflexia; Tingling sensations of hands; Segmental sign

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Journal of Neurology Research, bimonthly, ISSN 1923-2845 (print), 1923-2853 (online), published by Elmer Press Inc.     
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