REVIEW

Amyotrophic Lateral Sclerosis and Cervical Myelopathy overlap: a concise review for the spine surgeon

Sobreposição de Esclerose Lateral Amiotrófica e Mielopatia Cervical: uma revisão concisa para o cirurgião de coluna

  • Clara Sasse Scherer (1)
  • Emily Stefhani Keil (1)
  • Marco Antônio Machado Schlindwein (1)
  • Carlos Fernando Pereira da Silva Herrero (2)
  • Marcus Vinicius Magno Gonçalves (3)
  Views: 832
  Downloads: 41

Resumo

A esclerose lateral amiotrófica é uma condição progressiva causada pela deterioração do neurônio motor na medula espinhal e no cérebro. A mielopatia espondilótica cervical é uma disfunção medular secundária, não traumática e progressiva. Devido aos sintomas iniciais semelhantes e maior incidência em indivíduos mais velhos, não é incomum a sobreposição de esclerose lateral amiotrófica e mielopatia espondilótica cervical. O objetivo deste trabalho é diferenciar a esclerose lateral amiotrófica da mielopatia espondilótica cervical e elucidar, se possível, a apresentação sobreposta destas. Em resumo, a esclerose lateral amiotrófica e a mielopatia espondilótica cervical ocorrem em pacientes com epidemiologia semelhante e podem coexistir em quase metade dos pacientes com esclerose lateral amiotrófica. O diagnóstico deve considerar os exames de imagem, sintomas e alertas clínicos que ajudam a diferenciar essas duas condições evitando, assim, iatrogenias e erros de diagnóstico, que estão associados a pior prognóstico, cirurgias inadequadas e maiores custos no atendimento.

Palavras-chave

Esclerose lateral amiotrófica; Cirurgia na coluna; Mielopatia cervical

Abstract

Amyotrophic Lateral Sclerosis is a progressive condition caused by motor neuron deterioration in the spinal cord and brain. Cervical spondylotic myelopathy is a secondary spinal cord dysfunction, non-traumatic and progressive. Due to their similar initial symptoms and higher incidence in older individuals, it is not uncommon for an overlap of amyotrophic lateral sclerosis and cervical spondylotic myelopathy. The purpose of this paper is to differentiate amyotrophic lateral sclerosis of cervical spondylotic myelopathy and to elucidate, if possible, the overlap presentation of them. In summary, the amyotrophic lateral sclerosis and the cervical spondylotic myelopathy occur in similar epidemiology and can co-occur in almost half of amyotrophic lateral sclerosis patients. Their diagnosis must consider imaging exams, symptoms and clinical red flags that help to differentiate these two conditions, thus avoiding iatrogenic issues and misdiagnosis, which are associated with worse prognosis, inappropriate surgeries, and higher costs in healthcare.

Keywords

Amyotrophic lateral sclerosis; Spine surgery; Cervical myelopathy

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1 Medical student, University of the Region of Joinville – UNIVILLE, Joinville, SC, Brazil.

2 MD, University of Sao Paulo, USP, Ribeirão Preto, SP, Brazil.

3 MD, PhD, Neurologist, Department of Medicine, University of the Region of Joinville, UNIVILLE, Joinville, SC, Brazil.

 

Received Apr 17, 2022

Accepted May 15, 2022

JBNC  Brazilian Journal of Neurosurgery

  •   ISSN (print version): 0103-5118
  •   e-ISSN (online version): 2446-6786

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