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Anterior cysts of the spine

A difficult differential diagnosis to amyotrophic lateral sclerosis

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Abstract

We describe three patients referred to our ALS/MND clinic with suspected diagnosis of amyotrophic lateral sclerosis (ALS). The patients were all male, middle aged, and their initial symptoms were weakness and fasciculations in upper limb muscles. Results of clinical and electrophysiological examination in all cases were in accordance with possible ALS according to the revised El Escorial criteria. Other conditions mimicking ALS appeared to be excluded by extensive technical examinations and laboratory tests. Only repeated MRI examinations revealed anterior spinal cysts several years after symptom onset. This report intends to highlight this rare and difficult differential diagnosis of ALS and underlines the value of the revised El Escorial criteria in conjunction with electrophysiology to asses the certainty of the diagnosis ALS.

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Abbreviations

ALS:

amyotrophic lateral sclerosis

CSF:

cerebrospinal fluid

CMAP:

compound muscle action potential

CT:

computer tomography

MND:

motoneuron disease

MRC:

medical research council

MRI:

magnetic resonance imaging

TMS:

transcranial magnetic stimulation

MEP:

motor evoked potential

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Authors and Affiliations

  1. Dept. of Neurology and Clinical Neurophysiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany

    S. Schmalbach, S. Petri, R. Dengler & K. Krampfl

  2. Dept. of Neuroradiology, Hannover Medical School, Hannover, Germany

    F. Götz

Authors
  1. S. Schmalbach
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  2. S. Petri
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  3. F. Götz
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  4. R. Dengler
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  5. K. Krampfl
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Correspondence to S. Schmalbach.

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Schmalbach, S., Petri, S., Götz, F. et al. Anterior cysts of the spine. J Neurol 255, 1662–1669 (2008). https://doi.org/10.1007/s00415-008-0951-2

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  • DOI: https://doi.org/10.1007/s00415-008-0951-2

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