Cases reported "Myelitis, Transverse"

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1/206. 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. ( info)

2/206. MR imaging of acute transverse myelitis.

    magnetic resonance imaging has proven to be useful in the diagnosis of spinal cord pathology. Little has been written in the literature concerning magnetic resonance imaging of acute transverse myelitis. A case of magnetic resonance imaging of acute transverse myelitis in a young man with known systemic lupus erythematosus is presented along with a review of the radiographic approach to transverse myelitis. ( info)

3/206. Rapid onset transverse myelitis in adolescence: implications for pathogenesis and prognosis.

    Five adolescents with transverse myelitis were reviewed. All presented with a rapid onset paralysis of the lower limbs and impairment of bladder control. The maximum disability developed between 10 minutes and six hours. There was no history of trauma, asthma, or prodromal illness. Investigations failed to demonstrate a vascular cause. Extensive spinal cord abnormalities were observed on magnetic resonance imaging. Electrophysiological investigations, performed in four cases, were all consistent with anterior horn cell damage. In all five adolescents there was poor recovery. The underlying pathogenesis of this rapid onset condition remains a subject of debate. Similarities with both transverse myelitis and fibrocartilaginous emboli are evident, widening the spectrum of conditions within the transverse myelitis umbrella. These observations suggest that in rapid onset "transverse myelitis" the combination of extensive hyperintensity on spinal cord neuroimaging with electrophysiological evidence of anterior horn cell involvement might have adverse prognostic significance. ( info)

4/206. cytomegalovirus-associated transverse myelitis in a non-immunocompromised patient.

    cytomegalovirus (CMV)-associated transverse myelitis is rare in immunocompetent patients. The case of a 54-year-old man is reported here who developed acute transverse myelitis with cerebrospinal fluid (CSF) alterations, suggesting a central nervous system infection. CMV-IgM positivity in serum and CMV isolated from blood, positive CMV PCR and positivity for pp65 antigen in blood, without viral antigens in the CSF and a positive response to therapy with ganciclovir (followed by progressive improvement) supported the diagnosis. ( info)

5/206. Efficacy of spinal cord stimulation for neuropathic pain following idiopathic acute transverse myelitis: a case report.

    spinal cord stimulation (SCS) involves the electrical stimulation of dorsal structures within the spinal cord, and is the most widespread application of neurostimulation for the relief of chronic pain. Idiopathic acute transverse myelitis (IATM) is an acute monophasic lesion of the spinal cord that presents with symptoms associated with loss of cord function. The incidence of chronic pain secondary to this condition is unknown, but is considered rare. We report the efficacy of SCS for relief of severe neuropathic pain in both lower limbs secondary to IATM, which had failed to respond to conventional pain therapies. ( info)

6/206. Spontaneous expulsion of large vesicle calculi in a woman with paraparesis.

    INTRODUCTION: urolithiasis is a common but preventable complication of Spinal Cord Disorders (SCD). CASE REPORT: We report a 25-year-old woman with paraparesis who spontaneously passed two large calculi perurethra without pain and developed urethral scarring. Detrusor hyperreflexia, absence of sensations and lack of sphincter tone could have contributed to painless expulsion of the large calculi in this patient. CONCLUSION: dysuria, a prominent symptom of urolithiasis may not be present in subjects with SCD. awareness about urolithiasis among health professionals involved in the care of SCD patients is necessary for prevention and early intervention. ( info)

7/206. Successful treatment of Epstein-Barr virus-induced transverse myelitis with ganciclovir and cytomegalovirus hyperimmune globulin following unrelated bone marrow transplantation.

    We report a patient who developed Epstein-Barr virus (EBV)-induced transverse myelitis 19 months after unrelated bone marrow transplantation (BMT). The disease was diagnosed by physical examination, serologic determinations, EBV-specific polymerase chain reaction in peripheral blood lymphocytes and cerebrospinal fluid, and characteristic magnetic resonance imaging scan of the spine. The patient was treated with ganciclovir and cytomegalovirus (CMV) hyperimmune globulin. He gradually improved and recovered completely within 4 weeks. This case suggests that ganciclovir and CMV hyperimmune globulin appear to be effective for the treatment of EBV-induced transverse myelitis in immunocompromised patients following BMT. ( info)

8/206. Transient absence of F-waves in acute myelopathy: a potential source of diagnostic error.

    BACKGROUND: The frequent absence of F-waves in lesions of the nerve roots and proximal nerve is well known, with absence of F-waves occasionally the only electrophysiologic manifestation of early guillain-barre syndrome. It is less well known that acute central nervous system lesions can cause disappearance of F-waves. CASE DESCRIPTION: A 25 year old woman presented with quadriparesis and sensory loss progressive over several days. Hyporeflexia and hypotonia were present. Imaging studies were initially negative. Electrophysiologic testing was normal apart from the diffuse absence of F-waves. This led to strong consideration of the diagnosis of guillain-barre syndrome, and treatment for this diagnosis. However, imaging studies ultimately revealed the diagnosis to be transverse myelitis. F responses normalized 6 weeks after the initial study. CONCLUSIONS: F responses are significantly modulated by central nervous system factors. The relevant experimental and clinical literature is reviewed. The relevance of this to the diagnosis of guillain-barre syndrome has not been previously emphasized, but our experience confirms that the absence of F-waves in a patient with acute weakness accompanied by hyporeflexia and hypotonia does not distinguish between peripheral nerve and central nervous system lesions. ( info)

9/206. Repeated subarachnoid catheter displacement as a complication of spinal infusion using an internal infusion pump.

    OBJECTIVE: To present and analyze the case of a woman receiving chronic spinal opioid therapy using an implanted infusion pump who experienced repeated displacement of the subarachnoid catheter despite the use of standard techniques for anchoring the catheter. The solution devised to avoid the problem is described. CASE REPORT: A 53-year-old woman was diagnosed with transverse myelitis 10 years earlier and she developed T7-T10 spinal cord atrophy, and pain below the T7 segment. After unsuccessful noninvasive pharmacological treatment, a spinal opioid infusion protocol was begun. On 3 occasions during the course of therapy, despite the use of standard measures for anchoring the system, catheter displacement into the subcutaneous pouch of the pump occurred. After the last such episode, a specially designed technique was used, anchoring the catheter by means of a silicone piece, and the injection of 2.5 mL of fibrin glue in the epidural space. CONCLUSIONS: The application of fibrin glue (Tissucol; Immuno AG, Vienna, austria) may be considered as an adjuvant for the fixation of subarachnoid catheters used for intraspinal infusions. ( info)

10/206. sjogren's syndrome with primary biliary cirrhosis, complicated by transverse myelitis and malignant lymphoma.

    A 53-year-old woman with sjogren's syndrome (SS) and primary biliary cirrhosis (PBC) complicated by transverse myelitis (TM) and malignant lymphoma (ML) is reported. TM has been described only in seven cases of primary SS, including three with PBC and four without PBC. The features of SS associated with PBC and complicated by TM were less typical compared with those seen in SS without PBC complicated by TM. This case is the first report of a case with SS, PBC, TM and ML. SS in association with PBC is, in general, overlooked, but such cases must be investigated with great caution for extraglandular complications. ( info)
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