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Suffering from hirayama. Fingers get stiff in cold. Will it be cured completely?

Nov 2013
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Practicing since : 1994
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My son 20 yrs old is suffering from hirayama since Aug-2010.
His right hand palm is most effected one. Fingers of right hand stiffen in cold.
Will it be cured?
Posted Thu, 21 Feb 2013 in Brain and Spine
Answered by Dr. Sudhir Kumar 40 minutes later

Thank you for posting your query.

First of all, I would like to tell you that unfortunately, Hirayama disease can not be cured. However, one should not lose hope, as several treatment methods can help your son (as mentioned below).

In this condition, there is atrophy (shrinkage) of spinal cord in the neck region. This is where the nerves of hands come from.

Effective treatment options are:

1. Using soft cervical collar- this limits the neck movements, which are supposed to worsen this condition.

2. Regular physiotherapy and exercises.

3. Use of nerve vitamins such as methycobal and vitamin E.

In some cases, cervical spine surgery may be useful. This can be decided after doing an MRI scan of cervical spine in flexion and extension views.

Please discuss these issues with your neurologist.

You may get back if you have any more queries.

Best wishes,
Dr Sudhir Kumar MD (CMC Vellore), DM Neurology (CMC Vellore) XXXXXXX Consultant Neurologist
Apollo Hospitals, Hyderabad
Above answer was peer-reviewed by
Follow-up: Suffering from hirayama. Fingers get stiff in cold. Will it be cured completely? 44 hours later
Dear Sir, Thank You for your response. I have also uploaded his MRI and NCV report.
I have certain querries:
1. Mythlcobal is being given since begining. Should we start vitamin E as it was not prescribed ealier.
2. Since April 11 the shrinkage is stopped or we are not in a postion to visualised it. Does slow progression will continue or it will stop. Will faster shrinkage start again?
3. If cervical spine surgery is done his wasted mussles will regain or not. If surgical surgery is done how much time the pateint need rest from the day of surgery?
Answered by Dr. Sudhir Kumar 32 minutes later
Thank you for getting back with more details.

I have gone through Ambuj's reports of MRI and NCV studies.

Regarding your queries, following are the responses:

1. You can start EVION 400 mg capsules once daily now.

2. It is sometimes not possible to visualize shrinkage on the MRI. Shrinkage may stop in some cases.

3. Wasted muscles will not regain after surgery. However, further wasting can be prevented. 1-2 week rest may be required after surgery.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
Follow-up: Suffering from hirayama. Fingers get stiff in cold. Will it be cured completely? 2 days later
Thank you Sir for promt reply.
Last, I would like to know the approx cost of nerve compression surgery and how frequenctly it is done at CMC Vellore.
Answered by Dr. Sudhir Kumar 18 minutes later
Thank you for getting back.

I may not be accurate, however, cervical spine surgery may cost between 1-2 lakhs.

It is a commonly done surgery at CMC Vellore, though not for Hirayama disease. The same surgery is also done for disc prolapse, etc.

Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
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