Poster 490 Acute Nontraumatic Cervical Myelopathy with Upper and Lower Limb Weakness Caused by Pseudogout: A Case Report

PM&R ◽  
2012 ◽  
Vol 4 ◽  
pp. S357-S358
Author(s):  
Jamie L. Schmeer ◽  
Ernesto S. Cruz
Keyword(s):  
Case Report ◽  
Lower Limb ◽  
Cervical Myelopathy ◽  
Limb Weakness ◽  
Lower Limb Weakness

scholarly journals Degenerative cervical myelopathy presenting as subjective lower limb weakness could be a trap towards misdiagnosis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Chi-An Luo ◽  
Meng-Ling Lu ◽  
Arun-Kumar Kaliya-Perumal ◽  
Lih-Huei Chen ◽  
Wen-Jer Chen ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Functional Recovery ◽  
Lower Limb ◽  
Cervical Myelopathy ◽  
Cord Compression ◽  
Surgical Decompression ◽  
Limb Weakness ◽  
Lower Limb Weakness ◽  
Tandem Spinal Stenosis ◽  
Degenerative Cervical Myelopathy

AbstractWhen patients presenting with subjective lower limb weakness (SLLW) are encountered, it is natural to suspect a lumbar pathology and proceed with related clinical examination, investigations and management. However, SLLW could be a sign of degenerative cervical myelopathy (DCM) due to an evolving cord compression. In such circumstances, if symptoms are not correlated to myelopathy at the earliest, there could be potential complications over time. In this study, we intend to analyse the outcomes after surgical management of the cervical or thoracic cord compression in patients with SLLW. Retrospectively, patients who presented to our center during the years 2010–2016 with sole complaint of bilateral SLLW but radiologically diagnosed to have a solitary cervical or thoracic stenosis, or tandem spinal stenosis and underwent surgical decompression procedures were selected. Their clinical presentation was categorised into three types, myelopathy was graded using Nurick’s grading and JOA scoring; in addition, their lower limb functional status was assessed using the lower extremity functional scale (LEFS). Functional recovery following surgery was assessed at 6 weeks, 3 months, 6 months, one year, and two years. Selected patients (n = 24; Age, 56.4 ± 10.1 years; range 32–78 years) had SLLW for a period of 6.4 ± 3.2 months (range 2–13 months). Their preoperative JOA score was 11.3 ± 1.8 (range 7–15), and LEFS was 34.4 ± 7.7 (range 20–46). Radiological evidence of a solitary cervical lesion and tandem spinal stenosis was found in 6 and 18 patients respectively. Patients gradually recovered after surgical decompression with LEFS 59.8 ± 2.7 (range 56–65) at 1 year and JOA score 13.6 ± 2.7 (range − 17 to 100) at 2 years. The recovery rate at final follow up was 47.5%. Our results indicate the importance of clinically suspecting SLLW as an early non-specific sign of DCM to avoid misdiagnosis, especially in patients without conventional upper motor neuron signs. In such cases, surgical management of the cord compression resulted in significant functional recovery and halted the progression towards permanent disability.

scholarly journals A Case Report of Alcoholic Liver Disease with Lower Limb Weakness

2017 ◽  
Vol 38 (6) ◽  
pp. 1068-1075 ◽  
Author(s):  
Tae-ryun Kim ◽  
Hyun-chan Lim ◽  
Da-eun Lee ◽  
Yeo-jin Jang ◽  
Sang-yun Jeon
Keyword(s):  
Case Report ◽  
Liver Disease ◽  
Alcoholic Liver Disease ◽  
Lower Limb ◽  
Limb Weakness ◽  
Lower Limb Weakness

scholarly journals Tuberculous lumbar spinal epidural abscess in a young adult (case report)

SICOT-J ◽  
2018 ◽  
Vol 4 ◽  
pp. 5
Author(s):  
Ghazwan Abdulla Hasan ◽  
Saif Mohammed Kani ◽  
Ahmed Alqatub
Keyword(s):  
Case Report ◽  
Lower Limb ◽  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Mri Scan ◽  
Limb Weakness ◽  
Lower Limb Weakness ◽  
Lumbar Spinal ◽  
Spinal Epidural

Introduction: Spinal Epidural abscess (SEA) is an uncommon pathology that needs an urgent intervention to decompress the pressure on the spinal epidural sac, cord, and roots. The authors report a rare case of a young adult with lumbar spinal epidural tuberculous abscess occupying the spinal canal from L2–L5 vertebrae with extesion to the posterior paraspinal muscles and presenting with bilateral progressive lower limb weakness.   Case report: A 42 years old male teacher presented with a 15-day history of progressive difficulty to walking and bilateral lower limb weakness associated with fever, malaise and later on urinary incontinence. A magnetic resonance imaging (MRI) scan revealed a paraspinal intermuscular abscess and an abscess occupying the spinal canal compressing the dural sac from L2–L4/5, without any signs of vertebral involvement. Surgery was done by a posterior midline incision. Pus was evacuated from multiple pockets through the paraspinal muscle layers. Laminectomy for L3/4, and hemilaminectomy for L2/3, and L4/5 were performed. Pus and bone specimens were negative for acid-fast bacilli. However, both histopathological studies and Polymerase Chain Reaction (PCR) testing confirmed the presence of tuberculosis (TB). The patient received TB antibiotics, and a follow-up MRI scan at 2 months showed complete evacuation of the abscess. However, signs of L5 spondylitis were evident. No further surgery was needed as there was no vertebral collapse or neural compression and the patient's clinical condition was improving. He had normal right lower limb power and sensation and grade 4+ motor power of the left lower limb. Bowels and bladder function was normal. Conclusion: Isolated tuberculous spinal epidural abscess is a rare disease and should be treated urgently with evacuation and decompression. Signs of spondylitis or spondylodiscitis may appear later and therefore long follow up is recommended in tuberculous cases presenting with an isolated epidural abscess.

Poster 163 Acute Lower Limb Weakness Due to Herpes Zoster: A Case Report

PM&R ◽  
2014 ◽  
Vol 6 (9) ◽  
pp. S241-S242
Author(s):  
Morgan Brubaker ◽  
Eric Sorenson
Keyword(s):  
Case Report ◽  
Herpes Zoster ◽  
Lower Limb ◽  
Limb Weakness ◽  
Lower Limb Weakness

scholarly journals Postpartum femoral neuropathy: managing the next pregnancy

2019 ◽  
Vol 12 (12) ◽  
pp. e232967 ◽  
Author(s):  
Cathy Rowland ◽  
Daniel Kane ◽  
Maeve Eogan
Keyword(s):  
Caesarean Section ◽  
Motor Function ◽  
Lower Limb ◽  
Elective Caesarean Section ◽  
Mode Of Delivery ◽  
Primiparous Woman ◽  
Limb Weakness ◽  
Femoral Neuropathy ◽  
Lower Limb Weakness ◽  
Spontaneous Labour

A 34-year-old primiparous woman presented in spontaneous labour and had an unassisted vaginal birth of a 3.5 kg infant. Postnatally, the patient experienced lower limb weakness and was unable to mobilise unassisted. A diagnosis of postpartum femoral neuropathy was made. Full recovery of normal motor function was not achieved until 5 months postpartum. She returned in her next pregnancy, seeking advice on how to avoid this complication from reoccurring. It was decided that an elective caesarean section was an appropriate mode of delivery, which she underwent at 39 weeks without complication and without recurrence of the femoral neuropathy.

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