Ventral Cervical Spinal Schwannoma Presenting as Progressive Myelopathy.

PRESENTATION: A male patient in his 20s presented with a two-year history of progressive paraparesis and new-onset urinary incontinence. Neurological examination revealed bilateral ankle clonus, reduced lower-limb power, spastic gait and a positive Hoffmann's sign.

DIAGNOSIS: MRI of the cervical spine demonstrated an intradural extramedullary lesion extending from C4 to C5-C6 disc level, causing severe cord compression. Histopathology confirmed schwannoma.

TREATMENT: The patient underwent surgical resection via anterior cervical corpectomy of C4 and C5. Postoperatively, his lower-limb strength improved, and bladder control had returned by 6 weeks.

DISCUSSION: This case highlights an unusual lower-limb-predominant presentation of cervical schwannoma, emphasising the role of neurological examination in accurate lesion localisation.