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Klinische und diagnostische Charakteristika des Wurzelsyndroms Th1

Clinical and diagnostic characteristics of T1 root syndrome

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Zusammenfassung

Hintergrund

Unter den radikulären Läsionen sind Läsionen der Wurzel Th1 eine Rarität. Seltenes Auftreten und eine dem deutlich häufiger anzutreffenden C8-Syndrom-ähnelnde Symptomatik erschweren die Diagnose einer Radikulopathie Th1. Anhand von drei Fallbeispielen soll auf die klinischen und diagnostischen Besonderheiten eines Th1-Syndroms eingegangen werden.

Material und Ergebnisse

Wir berichten über drei Patienten mit einem Th1-Syndrom. In der Diagnostik (klinische Untersuchung, Elektrophysiologie, MRT) zeigte sich in zwei Fällen ein lateraler intraforaminaler Bandscheibenvorfall auf Höhe BWK1/2, im dritten Fall die Metastase eines Zervixkarzinoms als Ursache der Radikulopathie. In allen Fällen erfolgte die Operation. Die beiden Patienten mit einem Bandscheibenvorfall waren postoperativ sofort schmerzfrei, im dritten Fall waren Schmerzen und die neurologischen Symptome regredient.

Schlussfolgerung

Anhand von drei Fallbeispielen konnte gezeigt werden, dass bei gründlicher Analyse von klinischer Symptomatik und funktioneller (Elektrophysiologie) und morphologischer (Bildgebung) Diagnostik eine Radikulopathie Th1 sicher von einer C8-Läsion zu differenzieren ist. Von der dekompressiven operativen Therapie profitierten alle drei Patienten.

Summary

Background

Among radicular lesions, those affecting the T1 root are rare. Together with the similarity of symptoms to C8 syndrome, which is more common, this makes the diagnosis of T1 radiculopathy complicated. The clinical and diagnostic specifics of T1 syndrome are shown here based on three cases.

Materials and Results

We report on three patients with T1 syndrome. Clinical diagnostics (clinical investigation, electrophysiology, MRI) showed in two cases lateral intraforaminal disc herniae at the T1–2 level, and the third patient had metastasis of a cervix carcinoma being responsible for the radiculopathy. In all cases surgery was performed. The patients with disc herniae were immediately pain-free after surgery; in the third patient the neurological symptoms and pain clearly improved.

Conclusions

These three cases show that by thorough analysis of clinical symptoms and functional (electrophysiology) and morphological (MRI) diagnostics, T1 radiculopathy can be differentiated from C8 lesions. All of the patients benefited from decompressive surgery.

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Authors and Affiliations

  1. Neurochirurgische Klinik und Poliklinik, Klinikum Großhadern, Marchioninistraße 15, 81377, München, ?Country?

    A. Ardeshiri, A. Ardeshiri, J.-C. Tonn &  T.N. Witt

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  1. A. Ardeshiri
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  2. A. Ardeshiri
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  3. J.-C. Tonn
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  4. T.N. Witt
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Correspondence to T.N. Witt.

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Ardeshiri, A., Ardeshiri, A., Tonn, JC. et al. Klinische und diagnostische Charakteristika des Wurzelsyndroms Th1. Nervenarzt 78, 931–936 (2007). https://doi.org/10.1007/s00115-007-2270-8

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  • DOI: https://doi.org/10.1007/s00115-007-2270-8

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