Korean J Clin Neurophysiol.  2013 Dec;15(2):59-62. 10.14253/kjcn.2013.15.2.59.

A Case of Man-in-the-Barrel Syndrome Induced by Cervical Spinal Cord Ischemia

• Yoon BA
• Kim JJ
• Ha DH

• KMID: 1863275
• DOI: http://doi.org/10.14253/kjcn.2013.15.2.59

Abstract

Man-in-the-barrel syndrome (MIBS) is a clinical syndrome of bilateral upper limb weakness with normal lower extremity function. It can be caused by various neurological conditions such as bilateral cerebral hypoperfusion, syringomyelia, motor neuron disease, or cervical myelopathies. We report a patient with MIBS after cervical spinal cord ischemia. It is postulated to be caused by ischemic insults of anterior spinal artery from repeated and prolonged neck extension.

Keyword

Man-in-the-barrel syndrome; Spinal cord ischemia; Neck

MeSH Terms

Arteries
Humans
Lower Extremity
Motor Neuron Disease
Neck
Spinal Cord Diseases
Spinal Cord Ischemia*
Spinal Cord*
Syringomyelia
Upper Extremity

Figure

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  Figure 1. Cervical spinal MRI one day after the onset shows compressed cord at C3-4 and C4-5 by bulging disc without prominent signal changes in T2-weighted (A and C) and T1-weighted enhanced images (B and D).

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  Figure 2. Follow up cervical cord MRI 17 days after the onset shows increased signal intensities in T2-weighted images (A and C, arrow heads) as “eyes of owl” pattern (D, arrows).

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