Cysticercosis of the nervous system: less frequent clinical forms III- spinal cord forms

The spinal forms of cysticercosis are rather rare (2.7% of 296 cases of neurocysticercosis recorded in the Department of Neurology of the University of São Paulo Medical School). In a survey of the literature only 42 cases were found, most of them associated with cerebral symptoms. The reasons for this low incidence, as well as the possible routes followed by the parasite in its approach to the spinal cord, are discussed. After a review of the first cases reported in the literature, the authors refer the main syndromes (meningomyelitides, tabetiform pictures and spinal cord compressions) and some of the clinico-pathologic features of spinal cysticercosis. Nine cases of spinal cysticercosis are reported. The diagnosis was based on laboratorial data (mainly the complement fixation test for cysticercosis in the cerebrospinal fluid) or in the results of surgical therapy. Other cerebrospinal fluid findings (presence of eosinophile cells, protein contents, and the results of the manometric tests) are discussed. Myelographic block was demonstrated in 5 cases. Three of these patients were submitted to laminectomy, with variable results. The prevailing neurological picture was that of spinal cord and/or root compression (4 cases). Two patients showed a dorsal funiculi syndrome closely simulating tabes dorsalis. Two other patients presented a picture of meningomyelitis with no systematization. One patient had a syndrome suggestive of subacute combined degeneration of the spinal cord, but the presence of cerebral symptoms and the laboratorial data pointed to cysti-cercosis as the main disease process.

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CULTIVATION OF NERVOUS TISSUE IN THE CEREBROSPINAL FLUID OF PATIENTS SUFFERING FROM MEGALOBLASTIC ANEMIA WITH SUBACUTE COMBINED DEGENERATION OF THE SPINAL CORD

Acta Psychiatrica Scandinavica ◽

10.1111/j.1600-0447.1956.tb04717.x ◽

1956 ◽

Vol 31 (1) ◽

pp. 9-20 ◽

Cited By ~ 1

Author(s):

P. Ermala ◽

M. Siurala ◽

L. Siimes ◽

P. Reissell

Keyword(s):

Spinal Cord ◽

Cerebrospinal Fluid ◽

Nervous Tissue ◽

Megaloblastic Anemia ◽

Subacute Combined Degeneration

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John Goodsir (1814–1867) and his neurological illness

Journal of Medical Biography ◽

10.1177/09677720211021573 ◽

2021 ◽

pp. 096777202110215

Author(s):

Iain Macintyre ◽

Christopher Gardner-Thorpe ◽

Andreas K Demetriades

Keyword(s):

Subacute Combined Degeneration ◽

Retrospective Diagnosis ◽

Neurological Illness ◽

Tabes Dorsalis ◽

University Of Edinburgh ◽

The University

John Goodsir, conservator and professor of anatomy at the University of Edinburgh, suffered an unidentified illness described by experts after his death as tabes. The features that led to this diagnosis, the understanding of tabes at that time and its relationship in some cases to syphilis, are discussed. It is concluded that the most likely diagnoses are subacute combined degeneration of the cord as a result of malnutrition or tabes dorsalis resulting from earlier syphilis. The presence of ‘lightning pains’ leans towards the latter diagnosis but evidence for a means of acquisition of syphilis is lacking. The disadvantages of retrospective diagnosis are discussed.

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A case report on Subacute Combined Degeneration of spinal cord in children – A rare neurological manifestation in Vitamin B12 deficiencies

International Journal of Bioassays ◽

10.21746/ijbio.2017.6.12.2 ◽

2017 ◽

Vol 6 (12) ◽

pp. 5562

Author(s):

Tiana Mary Alexander ◽

Vineeta Pande ◽

Sharad Agarkhedkar ◽

Dnyaneshwar Upase

Keyword(s):

Spinal Cord ◽

Case Report ◽

Vitamin B12 ◽

Pernicious Anemia ◽

Chronic Diarrhea ◽

Megaloblastic Anemia ◽

Vegetarian Diet ◽

Malabsorption Syndrome ◽

Subacute Combined Degeneration ◽

B12 Deficiency

Megaloblastic anemia is a common feature between 6 months – 2 years and rarely occurs after 5 years of age, especially in a child consuming non-vegetarian diet. B12 deficiency may occur after 5 years of age because of chronic diarrhea, malabsorption syndrome, or intestinal surgical causes. Pernicious anemia causes B12 deficiency, but nutritional B12 deficiency with subacute combined degeneration causing ataxia is rare.

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Potential Virus Involvement in Alzheimer’s Disease: Results from a Phase IIa Trial Evaluating Apovir, an Antiviral Drug Combination

Journal of Alzheimer s Disease Reports ◽

10.3233/adr-210301 ◽

2021 ◽

pp. 1-19

Author(s):

Nina Lindblom ◽

Lars Lindquist ◽

Jacob Westman ◽

Mikael Åström ◽

Roger Bullock ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cerebrospinal Fluid ◽

Drug Combination ◽

Antiviral Treatment ◽

Antiviral Drug ◽

Disease Process ◽

Drop Out ◽

Large Drop ◽

Drop Out Rate

Background: Accumulating data suggest infectious agents are involved in Alzheimer’s disease (AD). The two primary aims of this trial were to assess safety and efficacy of an antiviral drug combination on AD progression. Objective: The trial evaluated whether Apovir, a combination of two antiviral agents, pleconaril (active on enteroviruses) and ribavirin (active on several viruses), could slow AD progression. Methods: Sixty-nine patients 60–85 years were treated with Apovir or placebo for 9 months and followed until 12 months after end of treatment. Cognitive tests, safety, biomarkers, drug plasma, and cerebrospinal fluid concentrations were assessed. Results: The tolerability of Apovir was compromised as demonstrated by the large drop-out rate and increased frequency and severity of adverse events. The primary endpoint, demonstrating a difference in change from baseline to 9 months between groups in ADAS-cog total score, was not met (p = 0.1809). However, there were observations indicating potential effects on both ADAS-cog and CDR-SB but these effects need to be verified. Also, there was a decrease in cerebrospinal fluid amyloid-β in Apovir at 9 months (p = 0.0330) but no change in placebo. Conclusion: This was the first randomized, placebo controlled clinical trial exploring antiviral treatment on AD progression. The trial is considered inconclusive due to the large drop-out rate. New trials are needed to verify if the indications of effect observed can be confirmed and which component(s) in Apovir contributed to such effects. Pleconaril alone may be studied to improve the tolerability and to verify if enterovirus is involved in the disease process.

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Some Points in the Histology of Lymphogenous and Hæmatogenous Toxic Lesions of the Spinal Cord

Journal of Mental Science ◽

10.1192/bjp.54.226.560 ◽

1908 ◽

Vol 54 (226) ◽

pp. 560-561

Author(s):

David Orr ◽

R. G. Rows

Keyword(s):

Spinal Cord ◽

Central Nervous System ◽

Nervous System ◽

Sciatic Nerve ◽

Morphological Type ◽

Broth Culture ◽

Anatomical Distribution ◽

Tabes Dorsalis ◽

The Central Nervous System ◽

The Brain

At a quarterly meeting of this Association held last year at Nottingham, we showed the results of our experiments with toxins upon the spinal cord and brain of rabbits. Our main conclusion was, that the central nervous system could be infected by toxins passing up along the lymph channels of the perineural sheath. The method we employed in our experiments consisted in placing a celloidin capsule filled with a broth culture of an organism under the sciatic nerve or under the skin of the cheek; and we invariably found a resulting degeneration in the spinal cord or brain, according to the situation of the capsule. These lesions we found to be identical in morphological type and anatomical distribution with those found in the cord of early tabes dorsalis and in the brain and cord of general paralysis of the insane. The conclusion suggested by our work was that these two diseases, if toxic, were most probably infections of lymphogenous origin.

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Subacute Combined Degeneration of the Spinal Cord

The Journal of Nervous and Mental Disease ◽

10.1097/00005053-190510000-00024 ◽

1905 ◽

Vol 32 (10) ◽

pp. 677

Author(s):

J. A. Ormerod

Keyword(s):

Spinal Cord ◽

Subacute Combined Degeneration

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Clinical Features and Outcomes of a Racially Diverse Population with Fibrillary Glomerulonephritis

American Journal of Nephrology ◽

10.1159/000455390 ◽

2017 ◽

Vol 45 (3) ◽

pp. 248-256 ◽

Cited By ~ 13

Author(s):

Fernanda Payan Schober ◽

Meghan A. Jobson ◽

Caroline J. Poulton ◽

Harsharan K. Singh ◽

Volker Nickeleit ◽

...

Keyword(s):

Clinical Characteristics ◽

Disease Process ◽

Signs And Symptoms ◽

Patient Characteristics ◽

Underlying Disease ◽

Fibrillary Glomerulonephritis ◽

Black Patients ◽

End Stage ◽

20 Nm ◽

The University

Background: Fibrillary glomerulonephritis is characterized by randomly arranged fibrils, approximately 20 nm in diameter by electron microscopy. Patients present with proteinuria, hematuria and kidney insufficiency, and about half of the reported patients progress to end-stage kidney disease within 4 years. The dependence of patient characteristics and outcomes on race has not been explored. In this study, we describe a cohort of patients with fibrillary glomerulonephritis and compare their clinical characteristics and outcomes with those of patients previously described. Methods: The University of North Carolina (UNC) Nephropathology Database was used to retrospectively identify patients diagnosed with fibrillary glomerulonephritis between 1985 and 2015. Of these patients, those treated at UNC were selected. Their demographic and clinical characteristics - including signs and symptoms, comorbidities, laboratory values, treatments and outcomes - were compared with those of patients described earlier. Results: Among the 287 patients identified, 42 were treated at the UNC Kidney Center. When compared to earlier cohorts, a higher frequency of black race, hepatitis C virus (HCV) infection and use of hemodialysis were noted in both black and HCV-positive patients. Autoimmune diseases, infections and malignancies were frequently observed, present in over half of all cases. Conclusion: According to this study, fibrillary glomerulonephritis represents a secondary glomerular disease process (associated with autoimmune disease, infection or malignancy) in many cases and hence screening is essential. As the screening for comorbidities increased over time, more underlying causes were identified. We noted a high frequency of HCV among black patients, suggesting a possible causative association. Treatment of underlying disease is essential for patients for the best outcome.

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