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Trombone tongue: a new clinical sign for significant medullary compression at the craniovertebral junction
- Source :
- Journal of Neurosurgery: Spine. 5:550-553
- Publication Year :
- 2006
- Publisher :
- Journal of Neurosurgery Publishing Group (JNSPG), 2006.
-
Abstract
- ✓The authors describe a previously unreported clinical sign that may indicate the onset of significant compression of the medulla oblongata in cases of craniovertebral junction abnormalities. This 17-year-old boy presented with mild bilateral leg weakness. Imaging studies revealed severe basilar invagination and a marked Chiari malformation. While awaiting surgery, his tongue developed an involuntary constant protrusion–intrusion repetitive motion. The onset of this so-named “trombone tongue” sign was followed shortly afterward by rapidly progressive spastic tetraparesis. After the authors performed a transmaxillary clivectomy, foramen magnum decompression, and occipitocervical fusion, they noted that the abnormal tongue motion promptly resolved and the tetraparesis gradually improved. The authors discuss their current understanding of the central control of tongue movements and present a hypothesis on the pathogenesis of trombone tongue based on the neuroanatomical basis of another abnormal tongue movement sign, lingual myoclonus.
- Subjects :
- Male
Myoclonus
Adolescent
Tetraparesis
Basilar invagination
Tongue
Humans
Medicine
Chiari malformation
Medulla Oblongata
Foramen magnum
Movement Disorders
business.industry
General Medicine
Anatomy
medicine.disease
Magnetic Resonance Imaging
Cervicomedullary Junction
Arnold-Chiari Malformation
medicine.anatomical_structure
Cervical Vertebrae
Spastic tetraparesis
medicine.symptom
business
Subjects
Details
- ISSN :
- 15475654
- Volume :
- 5
- Database :
- OpenAIRE
- Journal :
- Journal of Neurosurgery: Spine
- Accession number :
- edsair.doi.dedup.....10ff4f352ecebf1390a0981bb2a65927
- Full Text :
- https://doi.org/10.3171/spi.2006.5.6.550