1/67. poliomyelitis-like syndrome associated with Epstein-Barr virus infection.A 20-month-old male presented with an acute clinical syndrome resembling poliomyelitis, characterized by a flaccid monoplegia, areflexia of the involved limb, and preserved sensation. Electrophysiologic studies supported a neuronopathic localization involving the anterior horn cells. Although laboratory evidence for a poliovirus infection was absent, serologic and polymerase chain reaction studies documented an active central nervous system infection with Epstein-Barr virus, indicating that a poliomyelitis-like syndrome may be produced by infectious agents other than enteroviruses.- - - - - - - - - - ranking = 1keywords = nervous system (Clic here for more details about this article) |
2/67. Anaesthetic management of a woman who became paraplegic at 22 weeks' gestation after a spontaneous spinal cord haemorrhage secondary to a presumed arteriovenous malformation.A 19-yr-old woman developed a paraplegia with a T10 sensory level at 22 weeks' gestation. The spinal injury was caused by spontaneous bleed of a presumed arteriovenous malformation in the spinal cord. She presented for Caesarean section at term because of the breech position of her fetus. The successful use of a combined spinal epidural-regional anaesthetic is described and the risks of general and regional anaesthesia are discussed.- - - - - - - - - - ranking = 1.9430292199623keywords = malformation (Clic here for more details about this article) |
3/67. Virtual reality in paraplegia: a VR-enhanced orthopaedic appliance for walking and rehabilitation.spinal cord injuries (SCIs) have a profound physical, social and emotional cost to patients and their families. Obviously SCIs severely disrupt normal patterns of interaction with the environment. Firstly, the opportunities for active interaction are inevitably diminished due to motor or sensory impairment. Moreover, such problems may increase as the time since injury lengthens and the patient becomes more withdrawn and isolated in all spheres of activity. However, advances in Information technology are providing new opportunities for rehabilitation technology. These advances are helping people to overcome the physical limitations affecting their mobility or their ability to hear, see or speak. In this chapter an overview is given of the design issues of a VR-enhanced orthopaedic appliance to be used in SCI rehabilitation. The basis for this approach is that physical therapy and motivation are crucial for maintaining flexibility and muscle strength and for reorganizing the nervous system after SCIs. First some design considerations are described and an outline of aims which the tool should pursue given. Finally, the design issues are described focusing both on the development of a test-bed rehabilitation device and on the description of a preliminary study detailing the use of the device with a long-term SCI patient.- - - - - - - - - - ranking = 1keywords = nervous system (Clic here for more details about this article) |
4/67. Our surgical approach towards the treatment of urethrocele and urethral fistula.A new technique, described in the text, has been elaborated inspired by that of Monseur (1968) for urethral techniques. It has been performed with success in three paraplegics and in one incomplete tetraparesis. The plastic reconstruction of the diseased part of the urethra after excision of the stenosis and a fistula or diverticula by rotation and fixation to the subcavernal groove creates, in fact, an enlarged neo-urethra rendering the recurrence of the primary lesion practically impossible. This technique, first applied to spinal cord injuries, has been extended with permanent success to other lesions, such as tuberculosis stenosis and malformations.- - - - - - - - - - ranking = 0.38860584399246keywords = malformation (Clic here for more details about this article) |
5/67. Acute flank pain: an unusual presentation of a spinal AVM.The authors report the case of a 6-year-old boy with a spinal cord arteriovenous malformation (AVM) who presented with acute flank pain and a delayed onset of paraplegia. An early diagnosis of a spinal cord AVM was made difficult by the absence of neurological findings on initial evaluation. Included is a description of his clinical course, and the presentation of spinal AVMs to the emergency physician is discussed.- - - - - - - - - - ranking = 0.38860584399246keywords = malformation (Clic here for more details about this article) |
6/67. Spinal dural arteriovenous malformation: a cause of myelopathy.Spinal vascular malformation is an uncommon but potentially treatable cause of myelopathy. We describe two cases of angiographically proven spinal vascular malformation in malaysia. The first case is a 47-year-old man who had a progressive myelopathy and the second a 60-year-old man with intermittent attacks of transient paraparesis leading to paraplegia. As the clinical presentation of spinal vascular malformation is variable, it should be considered as a cause of patients with myelopathy.- - - - - - - - - - ranking = 2.7202409079472keywords = malformation (Clic here for more details about this article) |
7/67. Functional recovery from paraplegia caused by syphilitic meningomyelitis.BACKGROUND: Syphilitic involvement of the nervous system can present in many different ways. We report a patient who presented with rapidly evolving paraparesis secondary to syphilitic meningomyelitis. methods: Case report. FINDINGS: cerebrospinal fluid (CSF) studies confirmed the diagnosis of neurosyphilis. Spinal magnetic resonance imaging (MRI) studies were indicative of leptomeningeal and thoracic spinal cord disease. Treatment with IV penicillin resulted in marked clinical, radiologic, and CSF improvement. MRI imaging provided documentation of spinal cord involvement and was useful in monitoring recovery. This patient's progressive neurologic improvement was monitored for 2 years and documented by periodic Functional Independence Measure scores. CONCLUSION: Recognition of this unusual complication of secondary neurosyphilis is important, because it is a treatable cause of paraparesis with potential for good recovery.- - - - - - - - - - ranking = 1keywords = nervous system (Clic here for more details about this article) |
8/67. Intramedullary neurenteric cyst presenting as infantile paraplegia: a case and review.The authors report a case of a 3-month-old male child with paraplegia in whom magnetic resonance imaging (MRI) revealed a nonenhancing intramedullary cystic lesion extending from the level of D1 to D7 without any other associated anomaly. Intraoperatively, these findings were confirmed and the spinal cord was found to have splayed circumferentially into a papery thin rim. The patient underwent marsupialization of the cyst with subtotal excision of the cyst wall. Histopathological examination revealed ciliated pseudostratified columnar epithelium consistent with the diagnosis of a neurenteric cyst. Intramedullary neurenteric cysts are rare developmental malformations, and out of the 13 previously reported cases, only 3 were evaluated by MRI. This is the first case report in the literature of an intramedullary neurenteric cyst presenting as infantile paraplegia. In the present report, the embryology, etiopathogenesis, radiological imaging and management of this rare clinical entity are discussed and a detailed literature review is presented.- - - - - - - - - - ranking = 0.38860584399246keywords = malformation (Clic here for more details about this article) |
9/67. Intraspinal extramedullary haematopoiesis in a patient with myelofibrosis.A 54-year-old patient with myelofibrosis developed paresis of the legs, and bladder dysfunction due to extramedullary haematopoiesis in the spinal channel. He was given palliative radiotherapy but died shortly afterwards. Although rare, the possibility of extramedullary haematopoiesis in the central nervous system should be considered when neurological symptoms appear in a patient with myelofibrosis, because good palliation is possible with timely radiotherapy.- - - - - - - - - - ranking = 1keywords = nervous system (Clic here for more details about this article) |
10/67. lymphoma-induced polyradiculopathy in AIDS: two cases.Progressive polyradiculopathy is a rare, well-documented complication of the acquired immunodeficiency syndrome in man. It has been commonly attributed to a cytomegalovirus (CMV) infection. We report two hiv-infected patients with clinical and electrophysiological features of a unique, subacute, progressive polyradiculopathy. Post-mortem examination in case 1 disclosed an infiltration of the leptomeninges, the lumbar spinal cord, and the anterior and posterior roots by a B-cell immunoblastic lymphoma. immunochemistry for HIV1 and CMV was negative in the peripheral and the central nervous system. Case 2 showed bone-marrow involvement by a Burkitt type lymphoma. Specific chemotherapy was followed by both clinical improvement of the polyradiculopathy and complete remission on a second bone-marrow biopsy. These findings may indicate that a lymphoma must also be considered a possible cause of polyradiculopathy in AIDS.- - - - - - - - - - ranking = 1keywords = nervous system (Clic here for more details about this article) |
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