A Case of Cervical Radiculopathy Presenting as Dystonic Tremor.

BACKGROUND

To our knowledge, this is the first case report of a cervical disc prolapse and foraminal stenosis presenting with dystonic tremor in addition to brachialgia.

CASE DESCRIPTION: A 54-year-old, right-handed man presented with a dystonic tremor and aching throughout his right upper limb. Magnetic resonance imaging of the cervical spine revealed a disc osteophyte complex at C5/6 causing C6 foraminal impingement bilaterally in addition to a disc osteophyte complex at C6/C7 causing severe bilateral foraminal narrowing. Electromyography showed neurogenic changes consistent with chronic C6/7 radiculopathy. There was no response to numerous medical treatments for his dystonia or brachialgia. Computed tomography-guided right C6 and C7 root block led to complete but temporary resolution of all symptoms, including the dystonic tremor. Definitive treatment consisting of a C5/6 and C6/7 anterior cervical discectomy and fusion led to a complete, immediate, and continued resolution of his right-sided brachialgia and dystonic tremor.

CONCLUSIONS

This case highlights the potential of cervical disc prolapse to present with dystonic tremor with the likely mechanism being secondary to the painful radiculopathy and highlights the potential benefits of surgical decompression with this atypical presentation.