"I am not delusional!" Sensory dysaesthesia secondary to degenerative cervical myelopathy

BMJ Case Rep. 2019 Apr 11;12(4):e229033. doi: 10.1136/bcr-2018-229033.

Abstract

Degenerative cervical myelopathy (DCM) is the most common cause of adult spinal cord dysfunction, most classically presenting with a broad-based gait and clumsy hands. Limb sensory loss and paraesthesia are considered common symptoms of DCM. However, we report an unusual case of a patient presenting with prominent and atypical sensory symptoms. The patient repeatedly presented to accident and emergency complaining of her body resembling a wet gel-like substance that she attributed to the use of olive oil moisturising cream. The patient was found to have myelopathic signs on examination and MRI consistent with severe cervical myelopathy. She subsequently underwent successful decompressive anterior cervical discectomy, as recommended by international guidelines. This case serves to remind health professionals of uncommon presentations of common disease and the importance of maintaining a wide initial differential diagnosis.

Keywords: neurological injury; neurology; pain (neurology); spinal cord.

Publication types

  • Case Reports

MeSH terms

  • Cervical Vertebrae*
  • Decompression, Surgical
  • Delusions
  • Diagnosis, Differential
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Middle Aged
  • Paresthesia / diagnosis*
  • Paresthesia / etiology
  • Paresthesia / psychology
  • Spinal Cord Compression / complications
  • Spinal Cord Compression / diagnostic imaging
  • Spinal Cord Compression / surgery*