Cervical myelopathy secondary to cervical disc protrusion in patient with dystonic cerebral palsy--A case report

Abstract

Cervical myelopathy had been noted in patients with involuntary neck movement, especially in individuals with athetoid-dystonic cerebral palsy(CP). The excessive and repeated neck motions were considered to be responsible for the premature spondylosis, which might be the cause of myelopathy. The exact pathophysiology and managements were still controversial. Here we present a rare case who was a male patient with long-lasting dystonic neck movement developing cervical myelopathy due to protrusion of disc in his relatively young age. Magnetic resonance imaging (MRI) showed the protrusion of cervical disc at the level of C3-4, which was correlated well with his clinical symptoms. Anterior diskectomy and bony fusion were done for decompression. Halo-vest immobilization was applied to prevent the instability coming from dystonic neck movement after surgery. There was partial neurologic recovery after surgery. It is a rare clinical condition and may be easily overlooked. Therefore we recommended that MRI should be done as early as possible for cases with similar presentations, in order to establish an early correct diagnosis and early intervention.