Diplegia of upper limbs [344.2], Reason for Study: ^Reason: Bilateral upper extremity palsy most consistent with lower motor neuron injury, please evaluate for lesions that would explain such clinical presentation (eg. Anterior horn lesions) Brain MRINo evidence of acute ischemic or hemorrhagic lesion.The ventricles, sulci and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, or restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.C-SpineHigh signal intensity lesion on T2 weighted and STIR images bilateral anterior horn cell from C34 to C67 spinal cord. Since there is no evidence of associated spinal cord edema, these findings could be related to prior incident. Gad enhancement may be helpful for evaluation of active inflammation.The cranial-cervical junction is normal. There is normal cervical lordosis. The cervical spine alignment is anatomic. The vertebral body height is preserved. The bone marrow and end plates demonstrate a normal MR appearance. The epidural space, thecal sac, and spinal cord are preserved with no evidence of spinal canal/neural foraminal narrowing or myelopathy. The intervertebral discs demonstrate normal T2 intensity and height with no evidence of disc herniation. The paraspinal soft tissues are unremarkable.
1. Anterior horn of cervical spinal cord high signal intensity lesions, differential diagnosis include infectious origin such as Poliomyelitis, prior inflammatory or demyelination, or prior infarct.2. Normal brain MRI.