Platysma sign in high cervical lesion
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《神经病学神经外科学杂志》
Department of Neurology, Chiba University, Chiba, Japan
Correspondence to:
Ryuji Sakakibara
Department of Neurology Chiba University, 1-8-1 Inohana Chuo-ku, Chiba 260-8670 Japan; sakakibara@faculty.chiba-u.jp
Platysma weakness has been acknowledged as a sign of central hemiparesis, particularly when facial paresis is not obvious. A 71 year old man—who had no history of Bell’s palsy or stroke—had an acute onset of right side dominant tetraparesis, decreased superficial sensation below C3 segment, and micturitional disturbance. He also had platysma weakness on the right side (fig 1), though cranial nerves were normal. Magnetic resonance imaging (MRI) scans of the cervical cord disclosed a high signal intensity in the right side dominant central cord at C3-4 segments on T2-weighted image (fig 2), suggestive of the cervical cord infarction. Platysma muscles are innervated by both the facial nucleus and high cervical cord in mammals,1 which are spared in C4 tetraplegic patients2 but involved in this patient with C3 lesion.
Figure 1 Platysma sign in high cervical lesion.
Figure 2 MRI scan of the patient.
References
Chickering JG, Sokoloff AJ. Innervation of propatagial musculature in a flying squirrel, Glaucomys volans (Rodentia Sciuridae). Brain Behavior Evolution 1996;47:1–7.
Pollock D, Sell H. Myoelectric control sites in the high-level quadriplegic patient. Arch Phys Med Rehab 1978;59:217–20.(Y Ogawa and R Sakakibara)
Correspondence to:
Ryuji Sakakibara
Department of Neurology Chiba University, 1-8-1 Inohana Chuo-ku, Chiba 260-8670 Japan; sakakibara@faculty.chiba-u.jp
Platysma weakness has been acknowledged as a sign of central hemiparesis, particularly when facial paresis is not obvious. A 71 year old man—who had no history of Bell’s palsy or stroke—had an acute onset of right side dominant tetraparesis, decreased superficial sensation below C3 segment, and micturitional disturbance. He also had platysma weakness on the right side (fig 1), though cranial nerves were normal. Magnetic resonance imaging (MRI) scans of the cervical cord disclosed a high signal intensity in the right side dominant central cord at C3-4 segments on T2-weighted image (fig 2), suggestive of the cervical cord infarction. Platysma muscles are innervated by both the facial nucleus and high cervical cord in mammals,1 which are spared in C4 tetraplegic patients2 but involved in this patient with C3 lesion.
Figure 1 Platysma sign in high cervical lesion.
Figure 2 MRI scan of the patient.
References
Chickering JG, Sokoloff AJ. Innervation of propatagial musculature in a flying squirrel, Glaucomys volans (Rodentia Sciuridae). Brain Behavior Evolution 1996;47:1–7.
Pollock D, Sell H. Myoelectric control sites in the high-level quadriplegic patient. Arch Phys Med Rehab 1978;59:217–20.(Y Ogawa and R Sakakibara)