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J Electrodiagn Neuromuscul Dis > Volume 20(2); 2018 > Article
J Korean Assoc EMG Electrodiagn Med 2018;20(2):112-118.
DOI: https://doi.org/10.18214/jkaem.2018.20.2.112    Published online December 30, 2018.
Bibrachial Amyotrophy Associated with Epidural Cerebrospinal Fluid Leakage: A Case Report
Received: 16 March 2018   • Revised: 11 June 2018   • Accepted: 27 June 2018
Abstract
We describe a case of a 71-year-old male patient who experienced progressive bilateral proximal upper limb weakness and atrophy without sensory symptoms and signs over 5 years. Electromyography demonstrated denervation potentials and neuropathic motor unit action potentials on C5-C7 myotome muscles bilaterally. Cervical spine magnetic resonance imaging revealed engorged anterior epidural venous plexus, T2 hyperintensity localized to grey matter (“snake-eye” appearance) at C2-C6 vertebral level, and ventral epidural fluid collection from C6 to T8 vertebral level. This case indicates that bibrachial amyotrophy associated with epidural fluid leak should be suspected in patients presenting with progressive bilateral upper limb weakness and atrophy without sensory involvement.
Key Words: amyotrophy, cerebrospinal fluid leak, magnetic resonance imaging (MRI)


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