Cervical spondylotic amyotrophy mimicking amyotrophic lateral sclerosis

Cervical spondylotic myelopathy refers to compressive myelopathy resulting from degenerative changes of the spine. Some patients present with “myelopathic hand” characterized by loss of motor strength, sensory changes, and spasticity. However, cervical spondylosis with muscle atrophy of the upper extremities without sensory disturbance or pyramidal signs is called cervical spondylotic amyotrophy. Cervical spondylotic amyotrophy is a rare condition, usually reported as unilateral disorder, though occasionally, it may be bilateral. Due to the gross wasting and absence of sensory signs, it may be mistakenly diagnosed as amyotrophic lateral sclerosis. Since cervical spondylotic amyotrophy is similar to motor neuron disease, and yet is treatable, it is important to recognize and treat this condition.