open access

Vol 45, No 6 (2011)
ARTYKUŁ ORYGINALNY
Submitted: 2011-02-20
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Spinal cheiro-oral syndrome: a common neurological entity in an unusual site

Hung-Sheng Lin, Hsin-Ling Yin, Chi-Chui, Chun-Chung Lui, Wei-Hsi Chen
DOI: 10.1016/S0028-3843(14)60126-2
·
Neurol Neurochir Pol 2011;45(6):583-589.

open access

Vol 45, No 6 (2011)
ARTYKUŁ ORYGINALNY
Submitted: 2011-02-20

Abstract

Background and purpose

Cheiro-oral syndrome (COS) is an established neurological entity characterized by a sensory impairment confined to the mouth angle and ipsilateral finger(s)/ hand. The current understanding of localization is a concomitant involvement of the spinothalamic and trigeminothalamic tract between the cortex and pons. The cervical spinal cord has not been mentioned in this situation yet, and this unusual location may heretofore increase the risk of misdiagnosis.

Material and methods

Six patients who presented with unilateral COS due to cervical cord disorder are reported.

Results

All patients were women and their age ranged between 42 and 70 years. Their neurological deficits included unilateral paraesthesiae restricted to cheiro-oral distribution, positive radicular sign, and mild change of tendon reflex. Cervical spinal stenosis at middle/lower cervical spine with variable magnitude of cord compression and intrinsic cord damage was found. A diagnostic dilemma obviously arises from the lack of tangible neurological signs or typical pattern of myelopathy, in addition to the previous concept of cerebral involvement. A benign course ensued in all reported patients.

Conclusions

Cheiro-oral syndrome can be an early neurological sign for cervical cord disorder; it further suggests that it is a strong neurological but weak localizing sign. A reciprocal influence of multiple factors is considered to generate COS at the cervical cord. Therefore, an absence of brain pathology should lead to a thorough examination of the cervical cord in case of COS.

Abstract

Background and purpose

Cheiro-oral syndrome (COS) is an established neurological entity characterized by a sensory impairment confined to the mouth angle and ipsilateral finger(s)/ hand. The current understanding of localization is a concomitant involvement of the spinothalamic and trigeminothalamic tract between the cortex and pons. The cervical spinal cord has not been mentioned in this situation yet, and this unusual location may heretofore increase the risk of misdiagnosis.

Material and methods

Six patients who presented with unilateral COS due to cervical cord disorder are reported.

Results

All patients were women and their age ranged between 42 and 70 years. Their neurological deficits included unilateral paraesthesiae restricted to cheiro-oral distribution, positive radicular sign, and mild change of tendon reflex. Cervical spinal stenosis at middle/lower cervical spine with variable magnitude of cord compression and intrinsic cord damage was found. A diagnostic dilemma obviously arises from the lack of tangible neurological signs or typical pattern of myelopathy, in addition to the previous concept of cerebral involvement. A benign course ensued in all reported patients.

Conclusions

Cheiro-oral syndrome can be an early neurological sign for cervical cord disorder; it further suggests that it is a strong neurological but weak localizing sign. A reciprocal influence of multiple factors is considered to generate COS at the cervical cord. Therefore, an absence of brain pathology should lead to a thorough examination of the cervical cord in case of COS.

Get Citation

Keywords

cheiro-oral syndrome, radicular sign, spinal cord, myelopathy, sensory, localization

About this article
Title

Spinal cheiro-oral syndrome: a common neurological entity in an unusual site

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 45, No 6 (2011)

Pages

583-589

DOI

10.1016/S0028-3843(14)60126-2

Bibliographic record

Neurol Neurochir Pol 2011;45(6):583-589.

Keywords

cheiro-oral syndrome
radicular sign
spinal cord
myelopathy
sensory
localization

Authors

Hung-Sheng Lin
Hsin-Ling Yin
Chi-Chui
Chun-Chung Lui
Wei-Hsi Chen

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