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Trombone tongue: a new clinical sign for significant medullary compression at the craniovertebral junction

Authors :
James Allibone
Ramesh Chelvarajah
Adrian T. H. Casey
Cheong H Lee
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.

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