In 1960, this 65-year-old woman became instantly paralyzed from the neck down after a diving accident when she hit the bottom of a pool. Two days later, she had an emergency cervical laminectomy. She was then placed on tongs and gradually improved her sensation and movements, more in the arms than in her legs. However, she subsequently developed a motor deficit on the right side of her body and a sensory deficit on the left side of her body, particularly to pain and temperature.

Several years after sustaining a serious high cervical spinal cord injury that initially rendered her quadriplegic, and following a very satisfactory recovery after emergency cervical laminectomy, our patient developed a progressive neurologic syndrome characterized by decreased mobility on the right side of her body, particularly affecting the intrinsic muscles of her right hand. She also lost the sensation of pain, heat, and cold on the left side.

Examination was remarkable for contractures, impaired dexterity, and muscular atrophy of her right hand causing a clawhand (main en griffe) appearance, right-sided long-tract signs, and loss of pain and temperature appreciation on the left side (not shown on
the tape) without a classical cape or hemicape distribution. There was no right-sided segmental anesthesia, facial analgesia, or thermal hypesthesia. She had preservation of light-touch sensation, position sense, and vibration sense. There was no Horner syndrome, brainstem findings, scoliosis, digital ulcerations, or Charcot joints.