Bilateral upper limb weakness
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Hirayama disease is a form of muscular dystrophy seen in 2nd-3rd decade. It is thought to be due to disproportionate growth between canal contents and bony spinal canal resulting in a lax dura in extension and vice versa.
Contrast MRI may be done to demonstrate findings better but is not essential. A dynamic MRI should definitely be done in every suspected case.
- Jakhere S, Wagh V. Hirayama's disease: the importance of flexion magnetic resonance imaging. J Postgrad Med. 2011;57 (1): 48-50. J Postgrad Med (full text) - doi:10.4103/0022-3859.74289 - Pubmed citation
- Hassan KM, Sahni H, Jha A. Clinical and radiological profile of Hirayama disease: A flexion myelopathy due to tight cervical dural canal amenable to collar therapy. Ann Indian Acad Neurol. 2012;15 (2): 106-12. Ann Indian Acad Neurol (full text) - doi:10.4103/0972-2327.94993 - Free text at pubmed - Pubmed citation