Peripheral motor deficit and three vertebral artery dissections.

Ti,ree cases of extracranial vertebral artery dissections with upper limb p eripheral motor deficit (C5-C6) are reported. Six similar cases were also f ound in the literature. Central neurological symptoms occurred in five of t hese nine cases, suggesting the diagnosis of dissection. The peripheral mot or or sensorial deficit was strictly isolated in the four other cases, simu lating radicular nevralgia due to discopathy or foraminal compression. In c ase of dissections, a precise analysis of pain is helpful to guide diagnosi s; sharp, unbearable, continuous and extended neck pain without nocturnal p aroxysms and posterior neck stiffness is typical, Analgesics or anti-inflam matory drugs are ineffective. Peripheral motor deficit is more common than sensory deficit. Recovery was complete in this serie. In most cases, the ra diculopathy appears to be due to cervical root compression in its extrafora minal course due to the dissection hematoma and rarely to radicular ischemi a.