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Journal of the Neurological Sciences Nov 2014Adult-onset, chronic progressive spastic paraparesis may be due to a large number of causes and poses a diagnostic challenge. There are no recent evidence-based... (Review)
Review
Adult-onset, chronic progressive spastic paraparesis may be due to a large number of causes and poses a diagnostic challenge. There are no recent evidence-based guidelines or comprehensive reviews to help guide diagnostic work-up. We survey the literature on chronic progressive spastic paraparesis, with special emphasis on myelopathies, and propose a practical, MRI-based approach to facilitate the diagnostic process. Building on neuro-anatomic and radiographic conventions, we classify spinal MRI findings into six patterns: extradural; intradural/extramedullary; Intramedullary; Intramedullary-Tract specific; Spinal Cord Atrophy; and Normal Appearing Spinal Cord. A comprehensive differential diagnosis of chronic progressive myelopathy for each of the six patterns is generated. We highlight some of the more common and/or treatable causes of progressive spastic paraparesis and provide clinical pointers that may assist clinicians in arriving at the diagnosis. We outline a practical, comprehensive MRI-based algorithm to diagnosing adult-onset chronic progressive myelopathy.
Topics: Diagnosis, Differential; Humans; Image Processing, Computer-Assisted; Magnetic Resonance Imaging; Paraparesis, Spastic; Spinal Cord Diseases
PubMed: 25263600
DOI: 10.1016/j.jns.2014.09.015 -
Journal of the American Veterinary... Nov 2023
Topics: Dogs; Animals; Low Back Pain; Lumbosacral Region; Paraparesis; Magnetic Resonance Imaging; Dog Diseases
PubMed: 37468125
DOI: 10.2460/javma.23.05.0278 -
Journal of the American Veterinary... Jul 2023
Topics: Cats; Animals; Urination; Defecation; Behavior, Animal; Paraparesis; Cat Diseases
PubMed: 36735502
DOI: 10.2460/javma.22.12.0564 -
Ortopedia, Traumatologia, Rehabilitacja Oct 2019Traumatic injury to the spinal cord during spinal or epidural anesthesia is usually secondary to either direct needle penetration or intra-neural injection of local... (Comparative Study)
Comparative Study
Traumatic injury to the spinal cord during spinal or epidural anesthesia is usually secondary to either direct needle penetration or intra-neural injection of local anesthetics. Two women were admitted to a rehabilitation department with paraparesis and hypoesthesia after delivery. One had undergone a lower segment cesarean section under spinal anesthesia and the other, a spontaneous delivery under epidural anesthesia. After discharge from the rehabilitation treatment, they both experienced some weakness in the lower limbs. The patho-physiological basis of this complication seems to be either direct damage to the spinal cord by intra-neural injection of local anesthetics, or local ischemia.
Topics: Adult; Anesthesia, Epidural; Anesthesia, Spinal; Cesarean Section; Female; Humans; Paraparesis; Pregnancy; Treatment Outcome
PubMed: 31774065
DOI: No ID Found -
Journal of Inherited Metabolic Disease Nov 2007Spastic paraparesis is a general term describing progressive stiffness and weakness in the lower limbs caused by pyramidal tract lesions. This clinical situation is... (Review)
Review
Spastic paraparesis is a general term describing progressive stiffness and weakness in the lower limbs caused by pyramidal tract lesions. This clinical situation is frequently encountered in adult neurology. The diagnostic survey is usually limited to searching for acquired causes (spinal cord compression, inflammatory, metabolic, infectious diseases) and the so-called 'hereditary spastic paraparesis'. Although poorly recognized by neurologists, spastic paraparesis is also one of the multiple presentations of inborn errors of metabolism (IEMs) in children and adults. Pyramidal signs are usually included in a diffuse neurological or systemic clinical picture; however, in some cases spastic paraparesis remains the only symptom for years. Since these metabolic causes are often treatable, it is essential to include them in the general diagnostic approach to spastic paraparesis. Here we review IEMs causing paraparesis in adults.
Topics: Age of Onset; Decision Trees; Female; Genetic Diseases, Inborn; Humans; Male; Metabolism, Inborn Errors; Methylation; Motor Neurons; Paraparesis, Spastic; Spinal Cord; Syndrome
PubMed: 17957490
DOI: 10.1007/s10545-007-0745-1 -
Indian Journal of Pediatrics Sep 2021
Topics: Acute Disease; Child, Preschool; Humans; Muscle Hypotonia; Paraparesis
PubMed: 32986158
DOI: 10.1007/s12098-020-03507-5 -
Rheumatology (Oxford, England) Feb 2024
Topics: Humans; Gout; Paraparesis
PubMed: 37610321
DOI: 10.1093/rheumatology/kead433 -
Arthritis & Rheumatology (Hoboken, N.J.) Jun 2018
Topics: Aged; Gout; Humans; Male; Paraparesis
PubMed: 29409109
DOI: 10.1002/art.40434 -
The Israel Medical Association Journal... Jun 2013
Topics: Compartment Syndromes; Humans; Paraparesis; Posture; Rhabdomyolysis; Sleep
PubMed: 23882908
DOI: No ID Found -
QJM : Monthly Journal of the... Sep 2022
Topics: Humans; Lymphoma, Large B-Cell, Diffuse; Paraparesis
PubMed: 35608308
DOI: 10.1093/qjmed/hcac132