1/35. toxoplasma gondii myelitis in a patient with adult T-cell leukemia-lymphoma.adult T cell leukemia-lymphoma (ATL) caused by HTLV-I may be associated with severe immunosupression and several opportunistic infections. Toxoplasmic encephalitis is a common central nervous system opportunistic infection in severely immunosupressed patients, however spinal cord involvement by this parasite is rare. In this paper, we report a case of toxoplasmic myelitis in a patient with ATL.- - - - - - - - - - ranking = 1keywords = nervous system (Clic here for more details about this article) |
2/35. Non-progressive viral myelitis in X-linked agammaglobulinemia.We report a 14-year-old boy with X-linked agammaglobulinemia (XLA) complicated by isolated non-progressive myelitis caused by Coxsackie virus B1. Despite the absence of immunoglobulin supplement and persistence of the virus for the initial 2 years, motor impairment did not show any progression for 3 years. This report shows that the prognosis of central nervous system infection in XLA is not determined by immunoglobulin levels alone, and that it is not always progressive or fatal. The balance between host immunity and the virulence of the causative virus may be involved in the prognosis of meningoencephalitis in XLA.- - - - - - - - - - ranking = 1keywords = nervous system (Clic here for more details about this article) |
3/35. radiation myelitis in a 5-year-old girl.Myelopathy is an uncommon complication of radiotherapy, particularly in the pediatric age group. A 5-year-old girl with acute lymphoblastic leukemia developed a severe but transient radiculopathy after intrathecal administration of methotrexate and cytarabine for an isolated central nervous system relapse. Chemotherapy was then given through an intraventricular catheter. Owing to a second central nervous system recurrence, she was treated with craniospinal radiation. The whole brain down to the level of C2 received a dose of 2400 cGy. Two months after completion of radiation, the child developed a progressive tetraparesis, and magnetic resonance imaging revealed an enhancing lesion involving the medulla and upper cervical cord. A biopsy was consistent with a treatment-related necrotizing leukoencephalopathy. This case suggests that patients who develop neurologic dysfunction when treated with methotrexate can also be particularly susceptible to radiation-related injury.- - - - - - - - - - ranking = 2keywords = nervous system (Clic here for more details about this article) |
4/35. magnetic resonance imaging of meningoradiculomyelitis in early disseminated Lyme disease.lyme disease, a multisystem illness caused by the spirochete borrelia burgdorferi, is the most common vector-borne disease in the united states. There are 3 clinical stages of lyme disease: early localized, early disseminated, and late persistent disease. Neuroborreliosis, infection of the nervous system by B. burgdorferi, may occur during early disseminated or late persistent disease. spinal cord involvement in early disseminated disease is extremely rare. In patients with early disseminated neuroborreliosis, treatment with antibiotics often leads to rapid recovery and may prevent further complications of lyme disease. The authors present the clinical and radiographic findings, both before and after treatment, in a patient with meningoradiculomyelitis due to early disseminated lyme disease.- - - - - - - - - - ranking = 1keywords = nervous system (Clic here for more details about this article) |
5/35. Acute flaccid paralysis associated with west nile virus: motor and functional improvement in 4 patients.OBJECTIVE: To describe motor and functional recovery in 4 patients with acute flaccid paralysis associated with west nile virus (WNV) infection. DESIGN: A case series describing patient clinical features at admission to rehabilitation through 6-month follow-up. SETTING: Academic acute free-standing inpatient rehabilitation hospital. PARTICIPANTS: The patients (3 men, 1 woman; age range, 29-72 y) with central nervous system WNV infection presented on rehabilitation admission, 18 to 112 days after onset of symptoms, with severe flaccid asymmetric weakness without sensory loss, and decreased functional independence. Electrodiagnostic studies demonstrated a severe diffuse motor axonopathy consistent with an anterior myelitis. INTERVENTION: Acute inpatient rehabilitation program over a period of 35 to 106 days. MAIN OUTCOME MEASURES: Motor and FIM instrument scores at admission to rehabilitation, discharge, and 6-month follow-up. RESULTS: All patients showed modest improvements in strength and function; no patient made full recovery of strength or became ambulatory by 6-month follow-up. CONCLUSIONS: Little is known about recovery in patients with WNV-associated anterior myelitis. It will be important to document any further improvements in strength and function in such patients over a longer follow-up period.- - - - - - - - - - ranking = 1keywords = nervous system (Clic here for more details about this article) |
6/35. Meningeal hematopoiesis following radiation myelitis in a hematopoietic stem-cell transplant recipient.Extramedullary meningeal hematopoiesis (EMH) represents an uncommon finding after stem-cell transplantation. We describe the case of an allogeneic bone marrow transplantation (BMT) recipient who developed EMH 1 month after radiation myelitis had been diagnosed. A 39-year-old man with multiple myeloma underwent matched unrelated BMT following a myeloablative conditioning regimen of cyclophosphamide and total-body irradiation (200 cGyx6). This was followed by delivery of 40 Gy of involved-field radiation to an extramedullary plasmacytoma compressing the spinal cord. Although transplantation went extremely well, the patient developed radiation myelitis 7 months after transplantation, and EMH ensued 1 month later. Because the patient was not in a disease state known to cause EMH, it is tempting to speculate that radiation-related neural injuries might cause donor cells to migrate to the central nervous system.- - - - - - - - - - ranking = 1keywords = nervous system (Clic here for more details about this article) |
7/35. Enlargement of the spinal cord: inflammation or neoplasm?Intramedullary spinal tumours are uncommon lesions that can cause significant difficulties in the differential diagnosis between inflammatory diseases such as multiple sclerosis and acute disseminated encephalomyelitis, and vascular malformations or neoplasms. We report five cases in which the history and the clinical symptoms suggested an inflammatory process of the spinal cord but the MRI characteristics were those of neoplastic lesions. Both non-neoplastic and neoplastic intramedullary lesion may have very similar symptoms, and even CSF abnormalities, but in every one of our cases, a more detailed history and longer observation of the clinical course would have led to the correct diagnosis; in such problem cases, empirical treatment and a follow-up MRI after a month's observation would be a more prudent approach providing that the patient is not rapidly deteriorating.- - - - - - - - - - ranking = 0.0085162301906585keywords = malformation (Clic here for more details about this article) |
8/35. dengue infection: neurological manifestations and cerebrospinal fluid (CSF) analysis.Neurological manifestation is considered a rare complication of dengue infection. Neurological and cerebrospinal fluid (CSF) findings of 13 patients with dengue infection were studied. Seven patients had encephalitis, two had myelitis and four showed guillain-barre syndrome (GBS). No alteration in CSF was found from 57% of those with encephalitis. patients with GBS and myelitis showed a CSF-blood barrier dysfunction. The differences in the CSF may be related to the location of the lesion and multiple mechanisms of the disease in the nervous system.- - - - - - - - - - ranking = 1keywords = nervous system (Clic here for more details about this article) |
9/35. A comparison of myelopathy associated with megavoltage irradiation and remote cancer.Two middle-aged women with malignancy of the aerodigestive tract were treated by megavoltage irradiation. Both subsequently developed transverse myelopathy. The diagnosis of radiation myelitis was rendered in one. The other was thought to have metastatic compression of the spinal cord; in this case, evidence was such that radiation myelopathy also was appropriate. The irradiation dose-time relationships in both patients were biologically low compared to published isoeffect curves available in the literature. The first patient had injury within the irradiated region and the main neurological damage was found there. In the second patient the entire spinal cord was necrotic, clearly placing the second case outside the radiation myelopathy syndrome. Gross and microscopic examinations of the tissues of these two patients show that the remote effects of malignancy upon the central nervous system can imitate the clinical picture of radiation myelitis.- - - - - - - - - - ranking = 1keywords = nervous system (Clic here for more details about this article) |
10/35. Transient intrathecal IgG synthesis in herpes zoster myelitis: 2 case reports.Alterations in cerebrospinal fluid in 2 cases of viral myelopathy associated with herpes zoster infection are reported. Viral myelopathy is a rare complication of herpes zoster. Quantitatively there was a slight increase in IgG production and oligoclonal IgG bands were detected by isoelectric focusing. These parameters returned to normal after 1 year suggesting a transient involvement of the central nervous system.- - - - - - - - - - ranking = 1keywords = nervous system (Clic here for more details about this article) |
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