An Autopsy Case of Respiratory Failure Induced by Repetitive Cervical Spinal Cord Damage due to Abnormal Movement of the Neck in Athetoid Cerebral Palsy

Intern Med. 2017;56(11):1425-1430. doi: 10.2169/internalmedicine.56.7411. Epub 2017 Jun 1.

Abstract

We herein report the clinical and autopsy findings of a 48-year-old right-handed man with athetoid cerebral palsy who suffered from cervical myelopathy due to abnormal neck movement, and who died of respiratory failure. Pathologically, the external appearance of the ventral surface of the cervical spinal cord revealed a linear indentation running obliquely at the level between the C4 and C5 segments. In the most severely compressed lesion, the gray matter was predominantly affected and severely atrophic. Microscopically, clusters of oligodendrocytes associated with thinly myelinated axons were also observed in the lateral funiculus. The latter findings are unique, and could be interpreted as regenerative and/or restorative phenomena of the central nervous system following chronic repetitive spinal cord compression.

Keywords: athetoid cerebral palsy; cervical spondylosis; myelopathy; neuropathological finding; oligodendrocyte; respiratory failure.

Publication types

  • Case Reports

MeSH terms

  • Autopsy
  • Cerebral Palsy / complications*
  • Cervical Vertebrae / pathology*
  • Dyskinesias / complications*
  • Humans
  • Male
  • Middle Aged
  • Neck
  • Respiratory Insufficiency / etiology*
  • Spinal Cord Compression / complications*