Do longer necks predispose to Hirayama disease? A comparison with mimics and controls

Patients with HD had longer cervical segments as compared to the non-HD group and age matched controls [p = 0.001]. The longer cervical segment, in combination with dural changes probably contributes to the pathophysiology of dynamic flexion hypothesis of HD and the onset around the growth spurt. Patients with HD had cold paresis and finger extensors were consistently weaker than flexors. Apart from longer necks, cold paresis and pattern of weakness may help to differentiate HD from its mimics.