A Case of Man-in-the-Barrel Syndrome Induced by Cervical Spinal Cord Ischemia

Byeol A Yoon; Jong Juk Kim; Dong Ho Ha

doi:10.14253/kjcn.2013.15.2.59

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Yoon, Kim, and Ha: A Case of Man-in-the-Barrel Syndrome Induced by Cervical Spinal Cord Ischemia

Case Report

Korean J Community Nutr 2013;15(2):59-62.

Published online: 19 January 2013

DOI: https://doi.org/10.14253/kjcn.2013.15.2.59

A Case of Man-in-the-Barrel Syndrome Induced by Cervical Spinal Cord Ischemia

Byeol A Yoon¹, Jong Juk Kim¹, Dong Ho Ha²

¹Departments of Neurology and Dong-A University College of Medicine, Busan, Korea

²Departments of Radiology, Dong-A University College of Medicine, Busan, Korea

Address for correspondence; Jong Kuk Kim Department of Neurology, Dong-A University College of Medicine, 26 Daesingongwon-ro, Seo-gu, Busan 602-715, Korea Tel: +82-51-240-5260 Fax: +82-51-244-8338 E-mail: advania9@chol.com

Received 17 October 201215 April 2013 Accepted 10 December 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Man-in-the-barrel syndrome (MIBS) is a clinical syndrome of bilateral upper limb weakness with normal lower extremity function. It can be caused by various neurological conditions such as bilateral cerebral hypoperfusion, syringomyelia, motor neuron disease, or cervical myelopathies. We report a patient with MIBS after cervical spinal cord ischemia. It is postulated to be caused by ischemic insults of anterior spinal artery from repeated and prolonged neck extension.

Keywords: Man-in-the-barrel syndrome, Spinal cord ischemia, Neck

REFERENCES

1.Orsini M., Catharino AM., Catharino FM., Mello MP., Freitas MR., Leite MA, et al. Man-in-the-barrel syndrome, a symmetrical proximal brachial amyotrophic diplegia related to motor neuron diseases: a survey of nine cases. Rev Assoc Med Bras. 2009. 55:712–715.

2.Crisostomo EA., Suslavich FJ. Man-in-the-barrel syndrome associated with closed head injury. J Neuroimaging. 1994. 4:116–117.

3.Vainstein G., Gordon CR., Gadoth N. HTLV-1 associated motor neuron disease mimicking “Man-in-the-Barrel” syndrome. J Clin Neuromuscul Dis. 2005. 6:127–131.

4.Sage JI., Van Uitert RL. Man-in-the-barrel syndrome. Neurology. 1986. 36:1102–1103.

5.Berg D., Mullges W., Koltzenburg M., Bendszus M., Reiners K. Man-in-the-barrel syndrome caused by cervical spinal cord infarction. Acta Neurol Scand. 1998. 97:417–419.

6.Schneider RC., Cherry G., Pantek H. The syndrome of acute central cervical spinal cord injury; with special reference to the mechanisms involved in hyperextension injuries of cervical spine. J Neurosurg. 1954. 11:546–577.

7.Ben Sassi S., El Euch G., Regaieg A., Mabrouk T., Zouari M., Ben Romdhane N, et al. Man-in-the-barrel syndrome with combination of infarctions in the anterior spinal artery and posterior inferior cerebellar artery territories. Cerebrovasc Dis. 2009. 27:201–202.

8.Piao YS., Lu DH., Su YY., Yang XP. Anterior spinal cord infarction caused by fibrocartilaginous embolism. Neuropathology. 2009. 29:172–175.

9.Han JJ., Massagli TL., Jaffe KM. Fibrocartilaginous embolism-an uncommon cause of spinal cord infarction: a case report and review of the literature. Arch Phys Med Rehabil. 2004. 85:153–157.

Figure 1.

Cervical spinal MRI one day after the onset shows compressed cord at C3-4 and C4-5 by bulging disc without prominent signal changes in T2-weighted (A and C) and T1-weighted enhanced images (B and D).

Figure 2.

Follow up cervical cord MRI 17 days after the onset shows increased signal intensities in T2-weighted images (A and C, arrow heads) as “eyes of owl” pattern (D, arrows).

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