Hirayama Disease - A Fresh Look into an Old Disease

Hirayama disease is insidious onset gradually progressive, unilateral or asymmetric atrophy of the hand and forearm seen frequently in young males especially from the Asian continent. Pathophysiologically, it is now known that Hirayama disease is not likely to be a motor neuron disease as it was once thought to be, but as a result of ‘Cervical flexion induced Myelopathy.’ MRI with flexion contrast studies for prompt recognition and early institution of cervical therapy to prevent progression are very important to limit disability in these individuals.