scholarly journals Neurological Manifestations of Mycetoma

2021 ◽  
Author(s):  
Elkhansa.A.Ali ◽  
Khabab Abbasher Hussien Mohamed Ahmed ◽  
Radi Tofaha Alhusseini ◽  
Abdallah M. Abdallah ◽  
Muaz A. Ibrahim ◽  
...  
Keyword(s):  
Cord Compression ◽  
Lower Limbs ◽  
Neurological Involvement ◽  
Cervical Cord ◽  
Sensory Level ◽  
Neurological Manifestations ◽  
Spastic Paraplegia ◽  
Community Based ◽  
Cross Sectional ◽  
White Nile

Abstract Introduction: Mycetoma is a chronic specific granulomatous progressive and disfiguring subcutaneous inflammatory disease. It is caused by true fungi (Euomycetoma) or by higher bacteria (Actinomycetoma).Mycetoma mainly affects lower limbs, followed by upper limbs, back and rarely head and neck. Mycetoma is mainly transmitted through trauma with infected sharp objects. Objectives: To determine the neurological manifestations of mycetoma. Methodology: A descriptive cross-sectional community based study included 160 patients with mycetoma seen in White Nile state. Results: Almost 160 patients were included in the study, 90% of them were male. Two patients presented with entrapment neuropathy, one presented with proximal neuropathy, one has peripheral neuropathy, one has dorsal spine involvement presented with spastic paraplegia with sensory level, one has cervical cord compression, and one patient has repeated attacks of convulsion. Conclusion: Although it is rare, clinicians should highly suspect neurological involvement in mycetoma patients.

scholarly journals Walk and Run Test in Patients with Degenerative Compression of the Cervical Spinal Cord

2021 ◽  
Vol 10 (5) ◽  
pp. 927
Author(s):  
Zdenek Kadanka ◽  
Zdenek Kadanka ◽  
Tomas Skutil ◽  
Eva Vlckova ◽  
Josef Bednarik
Keyword(s):  
Cervical Spinal Cord ◽  
Japanese Orthopaedic Association ◽  
Cord Compression ◽  
Cervical Cord ◽  
Cross Sectional ◽  
Severity Of Disability ◽  
Degree Of Disability ◽  
Degenerative Cervical Myelopathy ◽  
Cardinal Symptoms ◽  
Run Test

Impaired gait is one of the cardinal symptoms of degenerative cervical myelopathy (DCM) and frequently its initial presentation. Quantitative gait analysis is therefore a promising objective tool in the disclosure of early cervical cord impairment in patients with degenerative cervical compression. The aim of this cross-sectional observational cohort study was to verify whether an objective and easily-used walk and run test is capable of detecting early gait impairment in a practical proportion of non-myelopathic degenerative cervical cord compression (NMDCC) patients and of revealing any correlation with severity of disability in DCM. The study group consisted of 45 DCM patients (median age 58 years), 126 NMDCC subjects (59 years), and 100 healthy controls (HC) (55.5 years), all of whom performed a standardized 10-m walk and run test. Walking/running time/velocity, number of steps and cadence of walking/running were recorded; analysis disclosed abnormalities in 66.7% of NMDCC subjects. The DCM group exhibited significantly more pronounced abnormalities in all walk/run parameters when compared with the NMDCC group. These were apparent in 84.4% of the DCM group and correlated closely with disability as quantified by the modified Japanese Orthopaedic Association scale. A standardized 10-m walk/run test has the capacity to disclose locomotion abnormalities in NMDCC subjects who lack other clear myelopathic signs and may provide a means of classifying DCM patients according to their degree of disability.

scholarly journals Cervical Cord Compression With Lower Limbs Sensory Disturbance Presentation: Three Case Reports and Literature Review

2021 ◽  
Author(s):  
Yafei Cao ◽  
Yihong Wu ◽  
Weiji Yu ◽  
Weidong Liu ◽  
Shufen Sun ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Lower Limb ◽  
Cord Compression ◽  
Lower Limbs ◽  
Anterior Cervical Discectomy ◽  
Cervical Cord ◽  
Sensory Disturbance ◽  
Cervical Discectomy ◽  
Sensory Disturbances

Abstract Background: Lower limb sensory disturbance presentation can be a false localizing cervical cord compressive myelopathy (CSM). It may lead to delayed or missed diagnosis, resulting in the wrong management plan, especially in the presence of concurrent lumbar lesions.Case presentation:Three Asian patients with lower limb sensory disturbances presentation were treated ineffectively in the lumbar. Magnetic resonance imaging (MRI) showed cervical disc herniation and cervical level spinal cord compression. Anterior cervical discectomy surgery and zero-p interbody fusion were performed. After operations, imagings showed that the spinal cord compression were relieved, and the lower limbs sensory disturbances were also relieved. Three-months follow-up after operation showed good recovery.Conclusions:These three cervical cord compression cases of lower limb sensory disturbance presentation were easily misdiagnosed with lumbar spondylosis. Anterior cervical discectomy and fusion operation had a good therapeutic effect. Therefore, cases that present with lower limb sensory disturbance, but in a non-radicular classical pattern, should always alert a suspicion of a possible cord compression cause at a higher level.

scholarly journals CLINICAL EVALUATION OF PANCHKARMA MANAGEMENT ALONG WITH PHYSIOTHERAPY IN TRANSVERSE MYELITIS - A CASE STUDY

2020 ◽  
Vol p4 (05) ◽  
pp. 2453-2457
Author(s):  
Mishra Meenu ◽  
Shivhare Shwetal
Keyword(s):  
Involuntary Movement ◽  
Symptomatic Relief ◽  
Transverse Myelitis ◽  
Lower Limbs ◽  
Sensory Level ◽  
Spastic Paraplegia ◽  
Demyelinating Disorder ◽  
Bowel Movements ◽  
Post Infectious

Introduction: Transverse Myelitis is an acute, usually monophasic, demyelinating disorder affecting the spinal cord. It is usually thought to be post infectious in origin. It occurs at any age and present with a subacute paraparesis with a sensory level, accompanied by severe pain in the neck or back at the onset. The annual incidence of Transverse Myelitis ranges from 1.34 to 4.60 cases per million. In Ayurveda there is no description of a single disease which can exactly resemble with Transverse Myelitis. It can be correlated with Adhrangghata, which comes under Vatavyadhi. Aim: To study the effect of Panchkarma management with Physiotherapy in Transverse Myelitis and to find out effective Panchkarma management in Transverse Myelitis. Material & Methods: A 30-year-old male patient Vikas Dubey was visited unit OPD 31767 Kayachikitsa Govt. Ayurveda Hospital Bhopal. On 3rd June 2019 presented with Spastic Paraplegia, had involuntary movement in bilateral lower limbs along with moderate pain off and on and irregular bladder bowel movements. The patient was treated with Panchkarma along with Physiotherapy for 76 days. Assessment was done on the basis of symptomatic relief. Observation: The Panchkarma procedures along with physiotherapy yielded improvement in sensory & motor functions of patient. Conclusion: On the basis of result obtained, it can be concluded that Panchkarma along with physiotherapy can be used as effective treatment in management of Transverse Myelitis.

scholarly journals nCoV-2019 infection induced neurological outcome and manifestation, linking its historical ancestor SARS-CoV and MERS-CoV: a systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ajay Prakash ◽  
Harvinder Singh ◽  
Phulen Sarma ◽  
Anusuya Bhattacharyya ◽  
Deba Prasad Dhibar ◽  
...  
Keyword(s):  
Systematic Review ◽  
Neurological Outcome ◽  
Case Reports ◽  
Meta Analysis ◽  
Signs And Symptoms ◽  
Neurological Involvement ◽  
Neurological Manifestations ◽  
Cross Sectional ◽  
Early Management ◽  
Neurological Signs

AbstractThe first systematic review and meta-analysis to help clinician to identify early signs and symptoms of neurological manifestation in COVID-19 positive patients which will further help in early management of patients. Present systematic review and meta-analysis aimed to discuss the prevalence of neurological involvement of the 2019-nCoV patients and assess the symptomatic trend of events as compared to the 2002 “SARS” and 2012 “MERS” pandemics. The articles were systematically screened through several search engine and databases. The articles published or in preprint were included in the study till 15th May 2020. The systematic review done as per the published literatures which included 31 cross sectional, observational studies and case reports which revealed neurological signs and symptoms in SARS-COV-2 disease. For meta-analysis, we included 09 observational and cross-sectional studies which included COVID-19 positive patients and assessed the predominance of various neurological signs and symptoms in COVID-19 patients with relation to SARS-2002 and MERS-2012. Data was analyzed by using the “MedCalc” Statistical Software version 19.2.6 and reported as pooled prevalence. Standard I2 test was used to analyze the heterogeneity. We have collected and screened about a total 2615articles, finally we have included 31articles for the systematic review and 09 for meta-analysis as per the inclusion/exclusion criteria. The analysis was made as per the prevalence rate of neurological symptoms in COVID-19 positive patients. The cumulative neurological outcome of SARS-2002 and MERS-2012 was assessed to get the trends which was further tried to correlate the events with the current pandemic. During the analysis severity and outcome of neurological manifestations range from simple headache to vague non-focal complaints to severe neurologic impairment associated with seizure or meningitis. Central and peripheral nervous system (CNS/PNS) manifestations were seen during the SARS-2002, MERS-2012 and COVID-19. However, none of the publication had primary or secondary objectives of searching neurological manifestations in the COVID-19 patients and the pathogenic mechanism which will subsequently strengthen the importance to start more prospective clinical trials. The prevalence of neurological signs and symptoms were taken as primary objective. Thereafter, the prevalence of each CNS/PNS symptoms was categorized and their prevalence studied. The selection of Bagheri et al., 2020 may be discussed because they have done the cross-sectional study with the neurological finding and correlated the data with prevalence of the COVID-19 positive patients. The proportion of patients presenting with neurological outcome and clinical/PCR positivity were done. We had searched and followed all the possible online/web source, still the data collection process may remain a limitation of work due to addition of several publications on COVID-19 every day. Due to lack of data of SARS-CoV and MERS-CoV, we have included the case reports, MERS and COVID-19 in CNS/PNS manifestations.

CIDP PRESENTING AS MYELORADICULOPATHY

2021 ◽  
pp. 50-51
Author(s):  
Sundarachary. N.V ◽  
Mythri. A.
Keyword(s):  
Peripheral Nerves ◽  
Urge Incontinence ◽  
Cauda Equina ◽  
Cord Compression ◽  
Nerve Conduction Studies ◽  
Lower Limbs ◽  
Sensory Level ◽  
Nerve Roots ◽  
Sensory Disturbances ◽  
Progressive Disorder

Chronic inammatory demyelinating polyradiculoneuropathy (CIDP) is a relapsing or chronic progressive disorder which is one of the causes of hypertrophic neuropathy. Enlarged nerve roots were identied in few patients. We now report a case of CIDP with highly thickened or enlarged nerve roots severe enough to cause cord compression and myelopathy. A 38 year old woman presented with weakness and sensory disturbances in lower limbs with sensory level at L1 and bladder disturbances in form of urgency and urge incontinence . MRI showed a non enhancing isointense mass lesion from L1 to S1 causing compression over conus . During surgery the cauda equina nerve roots were found to be thickened , entangled with ' bag of worms' appearance. Nerve conduction studies showed all her peripheral nerves to be inexcitable. Her CSF protein was mildly elevated. Diagnosis of CIDP with thickened nerve roots was considered and she was started on steroids and subsequently showed improvement. Thus, CIDP may present with symptoms of myeloradiculopathy due to thickened nerve roots causing cord compression.

scholarly journals Neurological Manifestations in Leprosy: A Study in Tribal Community of Hill Tracts

2016 ◽  
Vol 6 (1) ◽  
pp. 10-14
Author(s):  
Ahmed Tanjimul Islam ◽  
Shamrin Sultana ◽  
Matiur Rahman ◽  
Md Azizul Hoque
Keyword(s):  
Health Care ◽  
Early Stage ◽  
Correct Diagnosis ◽  
Cranial Nerves ◽  
Care Facility ◽  
Health Care Facility ◽  
Neurological Involvement ◽  
Neurological Manifestations ◽  
Tribal Community ◽  
Cross Sectional

Background: Leprosy is a chronic granulomatous infectious disease having major burden on humans over thousands of years. If untreated, it results in permanent damage to various systems and organs. So we designed this study to evaluate the neurological complications in early stage in adult leprosy patients.Objective: The aim of this study was to find out the pattern of neurological manifestations among adult leprosy patients.Materials  and  Methods: This cross-sectional hospital-based study on 85 adult tribal leprosy patients was conducted in a district level health care facility from January to December 2014 using simple, direct, standardized questionnaire including history and neurological examinations.Results: The commonest age group affected was 18–30 years (62.4%). Male group was predominant (68.2%). Majority cases (66%) had multibacillary leprosy. At first visit 72.7% cases with neurological findings could not be diagnosed correctly by primary health care personnel. More than six months were required for correct diagnosis in 61.2% cases. Numbness was the commonest (74.5%) neurological symptom. In upper limb, motor findings were predominant with wasting in 50.9% cases. In lower limb, sensory findings were predominant with stock pattern sensory impairment being the commonest (56.4%). Ulnar nerve was the commonest peripheral nerve to enlarge with tenderness. Facial nerve was the commonest cranial nerve involved. All cases with multiple cranial nerves involvement were of multibacillary type. Due to physical disability 92.7% cases lost their jobs.Conclusion: In this study neurological involvement was found associated with severe disability.J Enam Med Col 2016; 6(1): 10-14

scholarly journals Compressive Dorsal Myelopathy Secondary to Extramedullary Hematopoiesis in a Thalassemic Patient

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Ismail Ibrahim Ismail ◽  
Fathi Massoud ◽  
K. J. Alexander ◽  
Jasem Youssef Al-Hashel
Keyword(s):  
Extramedullary Hematopoiesis ◽  
Cord Compression ◽  
Lower Limbs ◽  
Beta Thalassemia ◽  
Sensory Level ◽  
Compensatory Mechanism ◽  
Hematopoietic Tissue ◽  
Thalassemic Patient ◽  
Low Dose Radiotherapy ◽  
Magnetic Resonance Imaging Mri

Background. Extramedullary hematopoiesis (EMH) is one of the rare causes of spinal cord compression (SCC). It results from noncancerous proliferation of hematopoietic tissue outside the bone marrow as a compensatory mechanism for ineffective erythropoiesis. It occurs in the paraspinal area in 11–15% of thalassemic patients in intermediate and severe cases causing a paraspinal compressive mass. We present a rare case of spinal EMH with thoracic cord compression in a 22-year-old female with beta thalassemia who presented with paraparesis and we provide a review of literature. Case Report. A 22-year-old female patient with a known history of beta thalassemia presented with subacute onset of weakness and numbness of both lower limbs with a sensory level at T6. Magnetic resonance imaging (MRI) of the dorsal spine showed cord compression secondary to paraspinal EMH from T2 to T9 with most prominent compression over T5. She was managed with blood transfusion and low-dose radiotherapy. Conclusion. Although rare, EMH should be suspected in thalassemic patients presenting with paraplegia. Treatment with blood transfusions is usually effective. Other options include radiotherapy, surgery, hydroxyurea or a combination of these modalities.

scholarly journals Histoplasmosis - An Unusual Cause of Spastic Paraplegia in an Immunocompetent Host in Bangladesh

2014 ◽  
Vol 14 (2) ◽  
pp. 201-203
Author(s):  
Chayan Kumar Singha ◽  
Eshita Biswas ◽  
Ferdous Jahan ◽  
Prodip Kumar Biswas
Keyword(s):  
Pulmonary Involvement ◽  
Lower Limbs ◽  
Sensory Level ◽  
Spastic Paraplegia ◽  
Immunocompetent Host ◽  
Healthy Male ◽  
Disseminated Histoplasmosis ◽  
Local Tenderness ◽  
Generalized Lymphadenopathy ◽  
Physical Findings

A case of disseminated histoplasmosis in a 62-year immunocompetent healthy male presenting as compressive myelopahty without any pulmonary involvement or travel to endemic zone is described. The patient presented with fever, dull ache pain in the back of the lower chest, weakness of both lower limbs with impairment of emptying of bowel and bladder, physical findings include raised temperature, generalized lymphadenopathy, nontender mild hepatomegaly, spastic paraplegia with sensory level up to D8 and local tenderness over D7 vertebra without any gibbus. Diagnosis was confirmed by presence of histoplasmacapsulatum in the lymph node and soft tissue from the spine. The particular interest of this paper is to present a case of disseminated histoplasmosis especially presenting as spastic paraplegia in an immunocompetent host without pulmonary involvement and illustrates the importance of recognizing the possibility of histoplasmosis in Bangladesh where mimickers of histoplasmosis like tuberculosis is extremely common.DOI: http://dx.doi.org/10.3329/jom.v14i2.19688 J Medicine 2013, 14(2): 201-203

ROSAI-DORFMAN DISEASE CAUSING SPINAL CORD COMPRESSION

Neurosurgery ◽  
2008 ◽  
Vol 62 (4) ◽  
pp. E977-E978 ◽  
Author(s):  
Grégory Dran ◽  
David Rasendrarijao ◽  
Fanny Vandenbos ◽  
Philippe Paquis
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Central Nervous System Involvement ◽  
Cervical Lymphadenopathy ◽  
Cord Compression ◽  
Lower Limbs ◽  
Pathological Examination ◽  
Magnetic Resonance Imaging Scan ◽  
Sensory Level ◽  
Rosai Dorfman Disease

Abstract OBJECTIVE Rosai-Dorfman disease is a rare idiopathic, histiocytic, proliferative disease characterized by massive, painless cervical lymphadenopathy. Extranodal involvement is rare and central nervous system involvement is unusual. We present a patient with Rosai-Dorfman disease with spinal cord compression. Very few cases have been reported in the literature. CLINICAL PRESENTATION A 17-year-old man presented with a 1-month history of progressive fatigue of the legs. His medical history was significant for Rosai-Dorfman disease diagnosed 7 months earlier. Clinical examination was consistent with a pyramidal syndrome and proprioceptive disturbances on his lower limbs without sensory level. A magnetic resonance imaging scan revealed an intradural extramedullary space-occupying lesion at the T1-T4 level with dural insertion and spinal cord compression. INTERVENTION A T1–T4 laminotomy was performed. Upon opening the dura, a reddish-gray mass was encountered, which encased the dorsal and lateral arachnoidal membrane. The lesion was relatively well circumscribed and was easily dissected from the underlying arachnoid. Pathological examination of the compressive soft tissue was consistent with Rosai-Dorfman disease. Postoperatively, the patient showed substantial improvement in neurological function. He was followed for 18 months with no complaints and no recurrence. CONCLUSION Neurosurgeons should consider this rare etiology of spinal cord compression. They must be aware that this lesion can occur in front of an intraspinal lesion, mimic meningiomas, occur in young people, and can potentially be associated with other locations of disease, including intracranial lesions. Surgery is the treatment of choice.

Lipophilic Statin Use and Suicidal Ideation in a Sample of Adults With Mood Disorders

Crisis ◽  
2014 ◽  
Vol 35 (4) ◽  
pp. 278-282 ◽  
Author(s):  
Karen M. Davison ◽  
Bonnie J. Kaplan
Keyword(s):  
Suicidal Ideation ◽  
Mood Disorders ◽  
Prevalence Ratio ◽  
Cross Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Symptom Scores ◽  
Unit Increase ◽  
Predominantly Female ◽  
Lipophilic Statin

Background: Mood disorders are associated with a high risk of suicide. Statin therapy has been implicated in this relationship. Aims: To further clarify reported associations between suicide and cholesterol in mental health conditions, we conducted an analysis of dietary, clinical, and suicidal ideation measures in community-living adults with mood disorders. Method: Data were used from a cross-sectional study of a randomly selected community-based sample (> 18 years; n = 97) with verified mood disorders. Dietary (e.g., fat, iron, vitamin intakes), clinical (e.g., current depression and mania symptoms, medications), and sociodemographic (age, sex, and income) measures were analyzed using bivariate statistics and Poisson regression with robust variance. Results: Participants were predominantly female (71.1%) with bipolar disorder (59.8%); almost one-third (28.9%) were taking lipophilic statins. The prevalence of suicidal ideation was more than 2.5 times in those taking statins, PR = 2.59, 95% CI 1.27–5.31, p < .05. The prevalence ratio for suicidal ideation was 1.10, 95% CI 1.06–1.15, p < .001, for each unit increase in mania symptom scores. No associations between suicidal ideation and dietary intake measures were identified. Conclusion: Individuals with mood disorders may be susceptible to neuropsychiatric effects of cholesterol-lowering drugs, which warrants further research.

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