-
Neurology India 2018
Topics: Basal Ganglia; Child, Preschool; Group VI Phospholipases A2; Humans; Magnetic Resonance Imaging; Male; Mutation; Neuroaxonal Dystrophies; Paraparesis, Spastic
PubMed: 29323006
DOI: 10.4103/0028-3886.222887 -
Internal Medicine (Tokyo, Japan) 2015Acute aortic syndrome complicated by both ST-segment elevation myocardial infarction (STEMI) and spinal ischemia is exceedingly rare. We herein report the case of a...
Paraparesis after Primary Percutaneous Coronary Intervention for ST-segment Elevation Myocardial Infarction: Combined Uncommon Complications of Acute Aortic Syndrome in a Patient.
Acute aortic syndrome complicated by both ST-segment elevation myocardial infarction (STEMI) and spinal ischemia is exceedingly rare. We herein report the case of a 66-year-old man who presented with paraparesis after primary percutaneous coronary intervention for STEMI. He was found to have an intramural hematoma of the ascending aorta and a severe dissection in the descending aorta, which led to both STEMI and paraparesis.
Topics: Acute Disease; Aged; Angioplasty, Balloon, Coronary; Aorta; Aorta, Thoracic; Aortic Arch Syndromes; Follow-Up Studies; Heart Conduction System; Humans; Ischemia; Magnetic Resonance Imaging; Male; Myocardial Infarction; Paraparesis; Spine; Treatment Outcome
PubMed: 26328645
DOI: 10.2169/internalmedicine.54.4508 -
Zhurnal Nevrologii I Psikhiatrii Imeni... 2023A familial case of a rare autosomal dominant Alzheimer's disease (AD), related to gene (AD3, OMIM 607822), differing from common multifactorial form by earlier onset...
A familial case of a rare autosomal dominant Alzheimer's disease (AD), related to gene (AD3, OMIM 607822), differing from common multifactorial form by earlier onset and, in part of cases, by accompanying neurological signs, spastic paraparesis particularly, is presented. The first sign in a female proband and in her son was paraparesis manifested at the age of 29 and 21 years, respectively. Cognitive disturbances developed soon; the former diagnosis was hereditary spastic paraplegia with cognitive impairment, In the proband examined in 2008 at 33 years old the diagnosis was not established. In the son examined in 2022 at 27 years old whole-exome sequencing detected a novel missense mutation p.Thr421Ala. The mutation was confirmed by Sanger sequencing in him, found out in the proband (who was severely disabled by that time) and excluded in her unaffected mother. Except for different age of onset, AD3 in two patients was similar, though in whole it is variable, also in relatives. The variability and rareness of the disease hampers clinical diagnostics. Massive parallel sequencing is a most reliable diagnostic method.
Topics: Adult; Female; Humans; Male; Age of Onset; Alzheimer Disease; Mothers; Mutation; Paraparesis, Spastic; Pedigree; Presenilin-1; Young Adult
PubMed: 37994898
DOI: 10.17116/jnevro2023123111120 -
Journal of Neurosurgery Sep 2005This 16-year-old boy with Proteus syndrome suffered acute spinal cord compression secondary to hemorrhage into an extradural paraspinal angiolipomatous hamartoma. A...
This 16-year-old boy with Proteus syndrome suffered acute spinal cord compression secondary to hemorrhage into an extradural paraspinal angiolipomatous hamartoma. A magnetic resonance (MR) imaging study performed 12 years earlier had revealed the presence of this tumor at the apex of a mild thoracic scoliosis, which had been stable during the intervening decade. Spinal cord neurological deficit in Proteus syndrome is rare. It can arise either from vertebral abnormalities and kyphoscoliotic deformities or from tumor encroachment. The authors describe the temporal evolution of scoliosis and acute spinal cord compression caused by a paraspinal angiolipomatous hamartoma over a period of 12 years. A review of the literature suggests that regular follow up, including serial MR imaging, is indicated in children with Proteus syndrome and scoliosis. Earlier resection of extradural tumor mass encroaching on the cord is warranted in the treatment of these children.
Topics: Adolescent; Angiolipoma; Hamartoma; Hemorrhage; Humans; Magnetic Resonance Imaging; Male; Paraparesis; Proteus Syndrome; Scoliosis; Spinal Cord Compression
PubMed: 16238085
DOI: 10.3171/ped.2005.103.3.0282 -
Child's Nervous System : ChNS :... Oct 2021Primary spinal hydatid cyst is a rare but serious condition which occurs in about 1% of patients with hydatid disease. This disease may result in severe spinal cord...
BACKGROUND
Primary spinal hydatid cyst is a rare but serious condition which occurs in about 1% of patients with hydatid disease. This disease may result in severe spinal cord compression presenting with various neurological deficits.
CASE REPORT
A 3-year-old boy was referred to our center with progressive weakness of lower limbs, frequency, and urinary incontinence. His parents did not report back pain during child's illness. Lumbar magnetic resonance imaging (MRI) revealed an extradural well-defined thin-walled cystic lesion at L4 to S3 vertebral levels without enhancement. The cyst had compressed the thecal sac associated with bone scalloping of vertebral bodies and posterior elements. Osteoplastic laminectomy of L4-L5 and laminectomy of S1-S3 was done. Intraoperative and histopathological findings indicated an epidural hydatid cyst.
CONCLUSION
Although spinal hydatid cysts are rare but might be considered in the differential diagnosis of any patient with signs and symptoms of spinal cord compression. The pathophysiology, clinical manifestations, epidemiology, diagnosis, and surgical treatment of extradural hydatid cyst are discussed.
Topics: Child; Child, Preschool; Echinococcosis; Epidural Space; Humans; Laminectomy; Male; Paraparesis; Spinal Cord Compression
PubMed: 33683421
DOI: 10.1007/s00381-021-05100-3 -
Acta Neurologica Belgica Dec 2014
Topics: Adult; Hematopoiesis, Extramedullary; Humans; Magnetic Resonance Imaging; Male; Paraparesis; Spinal Cord
PubMed: 24104868
DOI: 10.1007/s13760-013-0254-y -
Journal of Zoo and Wildlife Medicine :... Sep 2009A polar bear (Ursus maritimus) housed at the Toronto Zoo presented with acute-onset, nonambulatory paraparesis. Physical examination 24 hr after onset was otherwise...
A polar bear (Ursus maritimus) housed at the Toronto Zoo presented with acute-onset, nonambulatory paraparesis. Physical examination 24 hr after onset was otherwise unremarkable, spinal radiographs looked normal, and blood tests indicated mild dehydration. With continued deterioration in its general condition, euthanasia was elected a day later. Necropsy did not reveal a cause for the major presenting clinical signs. Serum collected at the time of initial examination was positive for West Nile virus (WNV) antibodies in a serum neutralization assay and at the time of euthanasia was positive in both a competitive enzyme-linked immunosorbent assay and in a plaque reduction neutralization assay. The major microscopic finding was a mild-to-moderate nonsuppurative meningoencephalomyelitis. WNV was not detected by immunohistochemistry in brain or spinal cord or by real-time reverse transcription-polymerase chain reaction (RT-PCR) and cell culture of brain and kidney, but it was isolated and identified by RT-PCR in second passage cell culture of spleen. Retrospective immunohistochemistry on spleen revealed rare antigen-positive cells, probably macrophages. Prevention of exposure to potentially WNV-infected mosquitoes or vaccination of captive bears against WNV should be considered.
Topics: Animals; Animals, Zoo; Antibodies, Viral; Fatal Outcome; Immunohistochemistry; Male; Neutralization Tests; Paraparesis; Reverse Transcriptase Polymerase Chain Reaction; Ursidae; West Nile Fever; West Nile virus
PubMed: 19746875
DOI: 10.1638/2008-0121.1 -
BMC Research Notes Feb 2016Extramedullary haemopoiesis is a common compensatory phenomenon in most haemolytic anaemias. However, spinal cord compression due to extramedullary spinal epidural...
BACKGROUND
Extramedullary haemopoiesis is a common compensatory phenomenon in most haemolytic anaemias. However, spinal cord compression due to extramedullary spinal epidural haemopoiesis is an extremely rare complication of thalassemia. In such situation patients present with paraplegia with a sensory level. Usual treatment options are surgery and/or radiotherapy.
CASE PRESENTATION
Here we report a 27 year old Sri Lankan Muslim male with haemoglobin E-Beta thalassaemia presented with episodic spastic paraparesis when he was anaemic which was dramatically responded to blood transfusion therapy.
CONCLUSION
Most of the reported cases with paraplegia have been treated with surgery with or without radiation therapy or radiation therapy alone. Our patient makes dramatic recovery after blood transfusion in each presentation.
Topics: Adult; Blood Transfusion; Epidural Space; Humans; Male; Paraparesis, Spastic; Spinal Cord Compression; Treatment Outcome; beta-Thalassemia
PubMed: 26915434
DOI: 10.1186/s13104-016-1918-5 -
The Canadian Journal of Neurological... Sep 2014
Topics: Adult; Diagnosis, Differential; Female; Friedreich Ataxia; Humans; Paraparesis, Spastic
PubMed: 25373823
DOI: 10.1017/cjn.2014.28 -
Neurology Feb 2022We present the case of a 57-year-old man with protein S deficiency and left leg deep vein thrombosis (DVT) 5 years earlier, who developed stepwise progressive bilateral...
We present the case of a 57-year-old man with protein S deficiency and left leg deep vein thrombosis (DVT) 5 years earlier, who developed stepwise progressive bilateral lower limb weakness, numbness/paresthesia, gait imbalance, hesitancy of micturition, and constipation in the setting of recurrent left common femoral DVT treated with apixaban. Symptoms amplified with Valsalva, corticosteroids, and postlumbar puncture, with longitudinally extensive midthoracic T2-hyperintense lesion extending to the conus associated with hazy holocord enhancement on magnetic resonance imaging (MRI), raising suspicion for spinal dural arteriovenous fistula (sDAVF). Initial digital subtraction angiography (DSA) was negative for sDAVF. However, cerebral spinal fluid (CSF) was herpes simplex virus (HSV)-2 positive, and he was treated with antiviral therapy. Unfortunately, he continued to worsen despite treatment. Repeat neuroimaging 12 months after initial presentation demonstrated persistent lower thoracic/conus lesion in addition to cauda equina enhancement and subtle dorsal T2-hypointense flow voids. We raised red flags (e.g., lack of clinical prodrome, no herpetic rash, no CSF pleocytosis, and rostral extent of the lesion) that suggested the HSV2 nucleic acid detection was perhaps unrelated to the neurologic syndrome. Given the high index of suspicion for sDAVF, we repeated spinal vascular imaging. Spinal MRA demonstrated dilated right dorsal perimedullary veins from T10 to T11. Repeat DSA revealed a right T10 sDAVF. Microsurgical treatment rather than embolization of the fistula was successful without complication, with significant improvement in motor, sphincter, and to a lesser extent sensory function, with residual gait imbalance after inpatient rehabilitation 3 weeks postoperatively.
Topics: Central Nervous System Vascular Malformations; Clinical Reasoning; Constipation; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Paraparesis; Spinal Cord; Urinary Retention
PubMed: 34799458
DOI: 10.1212/WNL.0000000000013090