Journal of Clinical Case Reports

Bilateral Involvement in Three Patients with Hirayama Disease

Abstract

Koichi Okamoto, Masakuni Amari, Haruhiko Shimada and Masamitsu Takatama

We report three patients with Hirayama disease with bilateral involvement. Case 1 developed weakness and wasting of bilateral hands at the age of 15 years. Case 2 developed unilateral weakness and wasting of the hand at the age of 18 years, and gradually exhibited progression to the other side within 1 year. Case 3 was a female who developed weakness and wasting of one hand at the age of 17 years, and showed dysesthesia and weakness in the other side, with pyramidal tract signs 31 years after the onset of the disease; she was diagnosed with complication of cervical disc hernia. We notice that bilateral involvement represents a severe form of this disease. We also need to differentiate incidental complications when the patients show worsening after a long stationary period.