# A Case Report and Review of Literature on Hirayama Disease

## TL;DR

This paper presents a case of Hirayama disease in a young man and reviews the literature on this rare neurological condition.

## Contribution

The paper contributes a new case report of Hirayama disease from a non-Asian region.

## Key findings

- The patient exhibited bilateral upper limb weakness and wasting, consistent with HD.
- Imaging and nerve conduction studies confirmed the diagnosis.
- HD remains underreported due to mild symptoms and lack of awareness.

## Abstract

Hirayama disease (HD) is a rare, benign, self-limiting condition that typically affects individuals in their 20s. Although the disease is self-limiting, it can result in functional impairment in those affected. The most common presentation is an asymmetrical, unilateral, or bilateral upper limb weakness with wasting. With an interesting pathogenesis and lack of definitive treatment, HD is an interesting neurological conundrum. Mild symptoms in patients often lead to underreporting of the disease, as individuals may not seek medical attention or may not recognize their symptoms. Most case reports in the literature are from Asia and the Middle East. We report a case of HD in a male patient in his 20s with gradual bilateral upper limb weakness and wasting, confirmed by imaging and nerve conduction studies.