case_images: PMC9977207_01
case_images: Prominent thenar and hypothenar atrophy of left hand (yellow arrows).
case_images: cureus-0015-00000034396-i01.jpg
case_images: PMC9977207_01_cureus-0015-00000034396-i01.jpg
case_images: FIG1
case_images: Examination of the upper limbs revealed forearm, interosseous, thenar, and hypothenar muscular atrophy and weakness (Figures 1-3).
case_images: Prominent thenar and hypothenar atrophy of right hand (yellow arrows).
case_images: cureus-0015-00000034396-i02.jpg
case_images: PMC9977207_01_cureus-0015-00000034396-i02.jpg
case_images: FIG2
case_images: Examination of the upper limbs revealed forearm, interosseous, thenar, and hypothenar muscular atrophy and weakness (Figures 1-3).
case_images: Prominent bilateral forearm muscle atrophy (yellow arrows), selective sparing of brachioradialis (green arrows).
case_images: cureus-0015-00000034396-i03.jpg
case_images: PMC9977207_01_cureus-0015-00000034396-i03.jpg
case_images: FIG3
case_images: Examination of the upper limbs revealed forearm, interosseous, thenar, and hypothenar muscular atrophy and weakness (Figures 1-3).
case_images: Atrophy of bilateral lower limb muscles, more marked in the calf muscles. Foot showing bilateral Hallux valgus deformity and clawing.
case_images: cureus-0015-00000034396-i04.jpg
case_images: PMC9977207_01_cureus-0015-00000034396-i04.jpg
case_images: FIG4
case_images: Clawing with the Hallux Valgus deformity was observed on both feet (Figure 4).
case_images: Normal appearing MRI sequence of the cervical region with a mild extension of the neck.
case_images: cureus-0015-00000034396-i05.jpg
case_images: PMC9977207_01_cureus-0015-00000034396-i05.jpg
case_images: FIG5
case_images: MRI of the cervical spine with screening of other regions was normal (Figure 5 and Figure 6), but a cervico-thoracic flexion MRI revealed forward migration of the posterior wall of the dura mater indenting the spinal cord from C7-D7 levels with prominent posterior epidural space with fat and flow voids.
case_images: Normal appearing MRI sequence of the cervical region with neck flexion.
case_images: cureus-0015-00000034396-i06.jpg
case_images: PMC9977207_01_cureus-0015-00000034396-i06.jpg
case_images: FIG6
case_images: MRI of the cervical spine with screening of other regions was normal (Figure 5 and Figure 6), but a cervico-thoracic flexion MRI revealed forward migration of the posterior wall of the dura mater indenting the spinal cord from C7-D7 levels with prominent posterior epidural space with fat and flow voids.
case_images: Flexion MRI sequence of thoracic spine showing increased posterior epidural space, further confirmed by contrast MRI showing increased venous prominence and posterior void (yellow arrows).
case_images: cureus-0015-00000034396-i07.jpg
case_images: PMC9977207_01_cureus-0015-00000034396-i07.jpg
case_images: FIG7
case_images: On contrast MRI there was prominent homogenous posterior epidural enhancement (Figure 7).