Mrs.Siddique

History:

The patient, a middle-aged adult, presented with progressive weakness and power loss in the upper limb, primarily affecting grip strength and arm movement. The condition had been gradually worsening, interfering with daily activities such as lifting objects, dressing, and performing routine tasks. Along with muscle weakness, the patient reported persistent neck pain, radiating into the arms, as well as tingling, numbness, and stiffness, symptoms characteristic of cervical nerve root compression.

The severity of the symptoms indicated early signs of cervical paralysis, a condition where nerve signals between the brain and arms become disrupted due to pressure on the spinal cord or nerve roots in the cervical spine. Conservative management (medications, physiotherapy, rest) had failed to yield significant improvement, necessitating a surgical solution.

Clinical Examination & Diagnosis:

Upon clinical evaluation, the patient demonstrated:

  • Motor weakness (Grade 3–4/5) in one or both upper limbs

  • Diminished reflexes and sensory disturbances

  • Difficulty in maintaining posture due to pain and stiffness

MRI of the cervical spine revealed:

  • Prolapsed intervertebral disc (slip-disc) at C4-C5 or C5-C6

  • Significant compression of the spinal cord and/or nerve roots

  • Early myelopathic changes (inflammation or indentation on the spinal cord)

Diagnosis:

Cervical Disc Prolapse with Nerve Root and Spinal Cord Compression
(A case of Cervical Myeloradiculopathy with Progressive Motor Deficit)