Abstract Details

Title Acute Hyperextension “Surfer’s” Myelopathy in a Gymnast: Bending over Backwards for Diagnosis

Topic Child Neurology and Developmental Neurology

Presentation(s) P13 - Poster Session 13 (5:30 PM-6:30 PM)

Poster/Presentation
Number 5-002

Objective not applicable - case report

Background Acute hyperextension or surfer's myelopathy is a clinical diagnosis made in the setting of acute onset weakness without frank trauma but often after small, repetitive flexion and extension spine movements in athletes during sports practice. There may be radiology correlate in a non-vascular distribution. The pathophysiology is unknown but hypothesized to be due to transient occlusion of spinal arteries. Pediatric case reports are rare, thus we present a case that adds to the clinical spectrum of this disorder.

Design/Methods not applicable - case report

Results We report a healthy school-aged girl presenting with leg weakness after doing a handstand. She hyper-extended her back to touch the wall and then flexed forward to recover. Initially, she was able to walk, however a few hours later she was crawling due to weakness and back pain. She developed urinary retention with overflow incontinence and constipation. Exam revealed diffuse mild leg weakness, right more than left, a slow, wide-based gait, lower extremity hyper-reflexia, and normal sensation. CSF analysis was normal, including autoantibodies and oligoclonal bands. MRI findings were typical of this myelopathy. She improved over weeks with physical therapy. MRI spine demonstrated hyperintense T2 signal abnormality with cord expansion through the distal spinal cord seen on both sagittal and axial planes. MRI findings completely resolved on follow-up imaging approximately 6 weeks later.

Conclusions While rare, acute hyperextension myelopathy can affect children. There may be radiologic findings, which normalize rapidly. These patients do not require steroids or surgical intervention and they recover rapidly back to baseline.

Authors/Disclosures
Rebecca J. Levy, MD (Stanford LPCH Child Neurology) PRESENTER	Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Stoke. An immediate family member of Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for SRB Hawaii Law LLC. An immediate family member of Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Wisner Baum LLP. The institution of Dr. Levy has received research support from CNCDP-K12. The institution of Dr. Levy has received research support from NINDS.
	No disclosure on file
Sonia Partap, MD, F�鶹��ýӳ�� (Stanford University)	The institution of Dr. Partap has received research support from NIH.

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