Description
A 97 year old female presented with a tetraparesis after sustaining a hyperextension injury of the neck from a fall. Neurological examination showed f laccid weakness (2/5) in the upper limbs which was greater distally affecting C7, C8 and T1 bilaterally. There was a less pronounced global weakness of the lower limbs. Pinprick sensation was diminished to the level of C6. Proprioception was absent to the right ankle but preserved in the left leg. There was a global reduction in tendon ref lexes with bilateral extensor plantar responses. She was incontinent of urine. An MRI of the cervical spine was performed (figure 1).
