Fatiguing weakness: an initial symptom in cervical compressive radiculopathy

Area of Science:

• Neurology
• Orthopedics
• Physical Medicine and Rehabilitation

Background:

• Cervical compressive radiculopathy can present with subtle symptoms.
• Functional diagnoses are sometimes considered due to atypical presentations.

Observation:

• Three patients experienced exercise-induced weakness (fatiguing) exclusively at work.
• Two patients faced life-threatening situations due to this weakness.
• Initial medical evaluations often lacked objective findings, leading to diagnostic challenges.

Findings:

• Precise patient history and targeted examination techniques were crucial for correct diagnosis.
• The observed fatiguing weakness is hypothesized to represent early or mild neurological involvement.
• This weakness appears to be unmasked by exercise rather than caused by direct compression or ischemia.

Implications:

• Highlights the importance of considering neurological causes for exercise-induced symptoms.
• Suggests that subtle neurological signs can be unmasked by specific activities.
• Emphasizes the role of thorough clinical evaluation in diagnosing challenging neurological conditions.