Myelopathy

Cervical Myelopathy Tests

Individuals with cervical myelopathy typically present with a cluster of upper motor neuron signs such as:

  • Unsteady gait
  • Reflexes > 2+
  • Hoffmann’s Sign: Tap the nail of the 3rd or 4th digit with the thumb and index finger relaxed but not touching. A + test is involuntary flexing of the thumb and index finger.
  • Babinski Sign: a blunt instrument is rubbed along the lateral aspect of the heel to the toes. A + test is dorsiflexion of the big toe and fanning of the other toes.
  • wasting of the hands, loss of dexterity, nonspecific weakness
An example of a positive Hoffmann sign
[youtube=http://www.youtube.com/watch?v=QjtiasgMgwY]
An example of a positive Babinski sign
[youtube=http://www.youtube.com/watch?v=bWKTrUjxkqs]

If a patient presents with signs and symptoms of cervical myelopathy, it is important to refer to a physician for further assessment.  MRI, CT scan or myelography is necessary for confirmation.

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