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Cervical syringomyelia at the C7-C8 level presenting with bilateral scapular winging
  1. N NIEDERMAIER
  1. Department of Neurology, Klinikum Ludwigshafen
  2. Department of Neurology, University of Heidelberg, Germany
  3. Department of Neuroradiology
  1. Dr N Niedermaier, Department of Neurology, Klinikum Ludwigshafen, Bremserstrasse 79, 67063 Ludwigshafen, Germany
  1. H-M MEINCK
  1. Department of Neurology, Klinikum Ludwigshafen
  2. Department of Neurology, University of Heidelberg, Germany
  3. Department of Neuroradiology
  1. Dr N Niedermaier, Department of Neurology, Klinikum Ludwigshafen, Bremserstrasse 79, 67063 Ludwigshafen, Germany
  1. M HARTMANN
  1. Department of Neurology, Klinikum Ludwigshafen
  2. Department of Neurology, University of Heidelberg, Germany
  3. Department of Neuroradiology
  1. Dr N Niedermaier, Department of Neurology, Klinikum Ludwigshafen, Bremserstrasse 79, 67063 Ludwigshafen, Germany

https://doi.org/10.1136/jnnp.68.3.394

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    Scapular winging is a neurological sign specifically caused by weakness of the serratus anterior, trapezius, or rhomboid muscles.1 2 Trauma, complications of surgery, myopathies, or peripheral nerve diseases are the major causes. We report on a patient with bilateral scapular winging as the presenting symptom of cervical syringomyelia at the C7-C8 spinal cord segments.

    This 38 year old carpenter complained of progressive involuntary movements of the right arm associated with arm and shoulder pain for the past 3 years. Involuntary movements were provoked by writing and similar activities. The patient was suspected of having a psychogenic movement disorder.

    Examination disclosed normal cranial nerve functions, mild hypertrophy of the right arm muscles, bilateral scapular winging of the serratus …

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