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Case of intermittent claudication as a result of cervical myelopathy presenting with ankle clonus induced by the gait loading test
Author(s) -
Sawamura Masanori,
Murata Oki,
Ogawa Masafumi
Publication year - 2016
Publication title -
neurology and clinical neuroscience
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.125
0ISSN - 2049-4173
DOI - 10.1111/ncn3.12059
Subject(s) - medicine , neurogenic claudication , clonus , intermittent claudication , hyperreflexia , claudication , myelopathy , spinal stenosis , lumbar spinal stenosis , weakness , surgery , lumbar , spinal cord , vascular disease , arterial disease , psychiatry , epilepsy
Spinal lesions can cause intermittent claudication. A 67‐year‐old man was referred to our department with a 3‐year history of progressive intermittent claudication. Spinal magnetic resonance imaging showed only moderate cervical canal stenosis, but not severe lumbar canal stenosis, which could cause intermittent claudication. The gait loading test reproduced tightness and weakness in the lower extremities, as well as an induced pyramidal tract sign that included Achilles tendon hyperreflexia and right ankle clonus. He was therefore diagnosed with spinal intermittent claudication. Two weeks later, sudden lower limb paralysis with urinary retention appeared without a traumatic event. After cervical spine surgery, the intermittent claudication disappeared. Spinal claudication is rare, and a relatively unknown symptom. As such, it is therefore a diagnostic challenge. Here, we highlight the importance of a full clinical report and the usefulness of the gait loading test for determining the clinical diagnosis.