Abstract

SILVA, Ana Ribeiro da et al. When an alteration of the gait reveals cervical pathology: a challenging diagnosis. Rev Port Med Geral Fam [online]. 2020, vol.36, n.1, pp.81-84. ISSN 2182-5173.  https://doi.org/10.32385/rpmgf.v36i1.12386.

Introduction: Degenerative cervical disease is an age-related condition, presenting signs and/or symptoms in a minority of cases. This case report aims to highlight the importance of recognizing cervical spondylolytic myelopathy as a differential diagnosis in the case of a progressive decrease in the muscular strength of the lower limbs and changes in gait pattern. Case description: A 64-year-old male patient, seen at a consultation programmed for a change in the usual walking pattern with about three years of evolution. On physical examination, the patient presented a broad base gait and signs compatible with upper motor neuron attainment: spastic paraparesis with hyperreflexia of the lower limbs and a bilaterally positive Babinski signal. From the imaging study, the presence of degenerative spondylodiscal changes of the cervical spine with spinal cord involvement was highlighted, evidencing the presence of a cervical spondylotic myelopathy. Subjected to cervical decompression laminectomy, it is currently inserted in a physiotherapy rehabilitation program with an almost total recovery of its gait pattern. Comment: Cervical spondylosis myelopathy is the clinical condition that represents the main cause of myelopathy in adults. It may represent a diagnostic challenge, either because of the absence of specific findings or because of the high number of differential diagnoses. Their suspicion increases in the presence of progressive gait changes associated with sensory or motor complaints in the upper limbs in individuals over 55 years of age.

Keywords : Cervical spondylosis; Myelopathy; Cervical spondylotic myelopathy.

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