1/11. Multifocal relapsing-remitting myelitis in a patient with atopic dermatitis: multiple sclerosis or atopic myelitis?We describe a patient with multifocal relapsing-remitting myelitis. This case had abnormal high intensity lesions in the spinal cord at the cervical and thoracic levels on magnetic resonance imaging (MRI). She had complicated atopic dermatitis and high serum IgE levels, which showed strong sensitivity to mite antigen. These features closely resemble those of atopic myelitis, suggesting that atopic myelitis may develop a relapse with multifocal involvement of the spinal cord, which can mimic multiple sclerosis.- - - - - - - - - - ranking = 1keywords = multiple sclerosis, sclerosis (Clic here for more details about this article) |
2/11. Paroxysmal kinesigenic choreoathetosis because of cryptogenic myelitis. Remission with carbamazepine and the pathogenetic role of altered sodium channels.Lesions of the spinal cord causing paroxysmal kinesigenic choreoathetosis are rare and most of the reported cases have been because of multiple sclerosis. We now describe this movement disorder occurring in a patient who developed a myelitis of unknown aetiology. A typically striking remission followed treatment with carbamazepine. It is suggested that the effect of the drug and the disorder itself may both be explained on the basis of altered sodium channels.- - - - - - - - - - ranking = 0.2keywords = multiple sclerosis, sclerosis (Clic here for more details about this article) |
3/11. 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 = 0.2keywords = multiple sclerosis, sclerosis (Clic here for more details about this article) |
4/11. Acute myelitis in a child: current hypotheses.This report presents the case of a child with atopic dermatitis, who developed progressive muscular weakness and hypotonia of the four limbs. The cervical spinal cord magnetic resonance imaging revealed a C(4) lesion (T(2)-weighted images); the cerebrospinal fluid findings were normal. Treatment with intravenous immunoglobulins and methylprednisolone obtained rapid clinical improvement, and approximately 1 month later the small C(4) lesion disappeared. Various diagnostic hypotheses are discussed: acute myelitis by infective agents, acute disseminated encephalomyelitis, multiphasic disseminated encephalomyelitis, multiple sclerosis, and isolated postinfective myelitis. Another hypothesis relates to atopic myelitis, a form recently described in the Japanese literature, associated with atopic dermatitis, hyperIgEemia, and high levels of specific immunoglobulin E to dermatophagoides farinae and dermatophagoides pteronyssinus. This diagnosis is difficult to confirm without biopsy evidence of eosinophilic inflammation.- - - - - - - - - - ranking = 0.2keywords = multiple sclerosis, sclerosis (Clic here for more details about this article) |
5/11. magnetic resonance imaging in asymptomatic disseminated vasculomyelinopathy.Two cases of disseminated vasculomyelinopathy (one of acute disseminated encephalomyelitis (ADEM), the other of acute transverse myelitis), are reported because of the persistence, 3 years and 5 months respectively, of abnormalities of magnetic resonance imaging (MRI). These abnormalities remained although in the first case the disease had been essentially asymptomatic from the onset except for one seizure, the patient remaining neurologically intact, whereas in the second case, the patient had made a complete recovery from very serious neurologic dysfunction. The first case illustrates the fact that ADEM may rarely occur without any symptoms, even in the presence of severe imaging abnormalities in both CT and MRI. Neither the persistence of a blood-brain barrier permeability alteration nor gliosis can satisfactorily explain the MRI changes, and thus the pathological significance of areas of increased signal intensity in MRI remains poorly understood and a matter of uncertainty. This report emphasizes the futility of attempting to correlate any kind of clinical observation, laboratory parameter, or effect of therapeutic regimens with changes, or lack thereof, in the MRI in multiple sclerosis and disseminated vasculomyelinopathy.- - - - - - - - - - ranking = 0.2keywords = multiple sclerosis, sclerosis (Clic here for more details about this article) |
6/11. Linear scleroderma: a response to neurologic injury? Report and literature review.A 28-year-old white man presented with neurologic symptoms and skin changes. Subsequent evaluation led to the diagnosis of transverse myelitis of the cervical spine (C8) and linear scleroderma. The progression of neurologic abnormalities prompted treatment with corticosteroids. Neurologic symptoms diminished and the progression of linear skin lesions halted. A review of the literature uncovered considerable evidence for underlying abnormalities of the spine and spinal cord in many patents with linear scleroderma and a paucity of immunologic abnormalities characteristic of progressive systemic sclerosis. patients presenting with new onset linear scleroderma should be evaluated for underlying neurologic causes.- - - - - - - - - - ranking = 0.012884437420526keywords = sclerosis (Clic here for more details about this article) |
7/11. spinal cord seizures in transverse myelopathy: report of two cases.Paroxysmal sensorimotor phenomena of spinal cord origin are well documented in the literature dealing with multiple sclerosis, but have seldom been identified in other conditions. These seizures are characterized by tonic spasm in the extremities, often accompanied by painful dysesthesias, and are fleeting, usually lasting no more than two minutes. Although they may occur spontaneously, they are commonly precipitated by tactile stimulation or movement of the extremity. These episodes must be clinically differentiated from spasticity as they have been shown to be responsive to anticonvulsants such as carbamazepine (Tegretol). We present two patients admitted to our rehabilitation facility with a diagnosis of idiopathic transverse myelopathy. Clinical and diagnostic evaluation revealed no evidence of multiple sclerosis and follow-up studies for two and one-half years in case 1 and one year in case 2 continued to support the admitting diagnoses. Each patient developed focal sensorimotor phenomena relatively early in the course of the disease which interfered with rehabilitation. Effective treatment was obtained with administration of carbamazepine. Subsequently, both patients developed signs and symptoms of multiple sclerosis. The complication of spinal cord seizures may become a limiting factor in the rehabilitation of patients with idiopathic transverse myelopathy unless the disorder is recognized and appropriate anticonvulsant therapy initiated. It may also be the first indicator that multiple sclerosis rather than "idiopathic" transverse myelopathy is present.- - - - - - - - - - ranking = 0.8keywords = multiple sclerosis, sclerosis (Clic here for more details about this article) |
8/11. Possible beneficial effect of high-dose intravenous steroid therapy in acute demyelinating disease and transverse myelitis.Intravenous steroid followed by oral prednisone was administered to patients with guillain-barre syndrome (five), acute transverse myelitis (three), and multiple sclerosis in acute relapse (seven). Preliminary experience with each of these disorders revealed prompt clinical improvement in some patients. The approach used in this uncontrolled study deserves further investigation.- - - - - - - - - - ranking = 0.2keywords = multiple sclerosis, sclerosis (Clic here for more details about this article) |
9/11. spinal cord swelling in multiple sclerosis.Three cases of subacutely progressive spinal paraparesis had myelographic evidence of spinal cord swelling suggesting the diagnosis of intramedullary tumour. The diagnosis of multiple sclerosis (MS) was made in each case with the aid of CSF protein electrophoresis, evoked responses and CT scan. Because acute MS may produce cord swelling simulating tumor or syrinx, these additional investigations may be necessary to make a correct diagnosis.- - - - - - - - - - ranking = 1keywords = multiple sclerosis, sclerosis (Clic here for more details about this article) |
10/11. Acute urinary retention due to sacral myeloradiculitis.Three cases of acute urinary retention without local urological causes are described. A diagnosis of sacral myeloradiculitis of viral origin appeared more likely than a first episode of multiple sclerosis. The literature is reviewed and a protocol for the investigation of such patients is suggested.- - - - - - - - - - ranking = 0.2keywords = multiple sclerosis, sclerosis (Clic here for more details about this article) |
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