[A case of cervical spondylitis mimicking motor neuron disease]

The patient was a 65-year-old man who had noted mild weakness of the right hand since summer, 1990. In October, 1990, he had fever and developed apparent weakness of the upper extremities. Neurological examination on admission revealed distal dominant muscle weakness and atrophy of the upper extremities with fasciculation. Deep tendon reflexes were diminished in the upper limbs and exaggerated in the lower ones. No sensory disturbance or cerebellar signs were recognized. Laboratory examination of his blood showed leukocytosis and elevated levels of acute reactants. The needle EMG showed a neurogenic pattern. MRI study of the neck disclosed narrowing of the intervertebral space between C7 and Th1 and a low signal intensity of these vertebral bodies on T1 weighted image. Treatment with antibiotics improved his neurological symptoms and the abnormal MRI findings. The present case was diagnosed as having cervical spondylitis. Neurological symptoms and signs associated with cervical spondylitis have been reported to be paraplegia or quadriplegia. Like the present case, however, cervical spondylitis should also be considered as one of the diseases which could show symptoms and signs very similar to those of motor neuron disease.