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 Iatrogenic transverse myelitis in a patient with rheumatoid arthritis

2019 ◽  
Vol 12 (3) ◽  
pp. e227584 ◽  
Author(s):  
Pournamy Sarathchandran ◽  
Ayman Alboudi ◽  
Reem AlSuwaidi ◽  
Abubaker AbdulRahman Almadani
Keyword(s):  
Rheumatoid Arthritis ◽  
Transverse Myelitis ◽  
Complete Recovery ◽  
Acute Onset ◽  
Lower Limbs ◽  
Sensory Level ◽  
Hyperintense Lesion ◽  
The Past ◽  
Thoracic Spinal ◽  
Fluid Attenuated Inversion Recovery

We report the case of a 59-year-old Arab woman who was presented with acute onset of neck pain followed by quadriparesis, paraesthesias of lower limbs and incontinence of urine. Examination revealed asymmetric sensorimotor quadriparesis with sensory level at T1, establishing a clinical diagnosis of transverse myelitis. Cervical and thoracic spinal MRI showed enhancing T2/fluid attenuated inversion recovery (FLAIR) hyperintense lesion extending from C4 to C7 level in addition to long-segment lesion extending the whole of the spinal cord. She was known to have rheumatoid arthritis for the past 20 years and has been on etanercept for the past 8 years and methotrexate since past 3 years. Etanercept was stopped and she was treated with methylprednisolone followed by oral steroids and physiotherapy with which she had near complete recovery.

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 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

Ayurvedic Management of Dry Eye Sydrome - A Case Study

2017 ◽  
Vol 2 (4) ◽  
Author(s):  
Hemalatha S. ◽  
Rati S.
Keyword(s):  
Dry Eye ◽  
Treatment Modality ◽  
Similar Condition ◽  
Symptomatic Relief ◽  
Tear Film ◽  
Modern Medicine ◽  
Common Condition ◽  
Dry Out ◽  
Tear Substitute

Dry eye syndrome is a common condition that results from reduced tear production or excessive tear evaporation or an abnormality in the production of mucus or lipids normally found in the tear layer or combination of these. If blinking is decreased or if the eyelids cannot be closed, they may dry out leading to dry eye. It is accompanied by increased osmolarity of the tear film and inflammation on the surface of the eye may occur of left untreated leading to pain, ulcers or scars on the cornea and loss of vision. Prevalence of dry eye range from 5% to 35% worldwide while in India it is 29.25%. Tear substitute are the only treatment modality with modern medicine, only providing symptomatic relief. Ayurveda describes similar condition called Sushkakshi Paka and this patient was treated with Tarpana and Nasya with Jeevantyadi Ghrita.

scholarly journals A Japanese hereditary spastic paraplegia family with a rare nonsynonymous variant in the SPAST gene

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Takuya Morikawa ◽  
Shiroh Miura ◽  
Takahisa Tateishi ◽  
Kazuhito Noda ◽  
Hiroki Shibata
Keyword(s):  
Molecular Diagnosis ◽  
Hereditary Spastic Paraplegia ◽  
Autosomal Dominant ◽  
Family Members ◽  
Pathogenic Variant ◽  
Lower Limbs ◽  
Spastic Paraplegia ◽  
Nonsynonymous Variant ◽  
Japanese Family ◽  
Functional Variants

AbstractSpastic paraplegia (SPG) type 4 is an autosomal dominant SPG caused by functional variants in the SPAST gene. We examined a Japanese family with three autosomal dominant SPG patients. These patients presented with typical symptoms of SPG, such as spasticity of the lower limbs. We identified a rare nonsynonymous variant, NM_014946.4:c.1252G>A [p.Glu418Lys], in all three family members. This variant has previously been reported in a Russian SPG family as a “likely pathogenic” variant.5 Ascertainment of additional patients carrying this variant in an unrelated Japanese SPG family further supports its pathogenicity. Molecular diagnosis of SPG4 in this family with hereditary spastic paraplegia is confirmed.

scholarly journals Disseminated Cryptococcosis revealed by transverse myelitis in Immunocompetent patient: a case report and review of the literature

BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Fangfang Qu ◽  
Zhenzhen Qu ◽  
Yingqian Lv ◽  
Bo Song ◽  
Bailin Wu
Keyword(s):  
Spinal Cord ◽  
Amphotericin B ◽  
Transverse Myelitis ◽  
Immunocompetent Patient ◽  
Lower Limbs ◽  
Coxsackie Virus ◽  
Gadolinium Contrast ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal ◽  
Cord Injury

Abstract Background Transverse myelitis (TM) is due to inflammatory spinal cord injury with bilateral neurologic involvement, which is sensory, motor, or autonomic in nature. It may be associated with autoimmune disease, vaccination, intoxication and infections. The most common infection cause of TM is Coxsackie virus and Mycoplasma pneumoniae. The cryptococcosis is rare. We present the case of disseminated cryptococcosis revealed by transverse myelitis in an immunocompetent 55-year-old male patient. The literature review is also stated. Case presentation The 55-year-old man suffered from gradual numbness, weakness in both lower limbs and finally paralyzed in the bed. The thoracic spine Computed tomography (CT) was normal, but multiple nodules in the lung were accidentally discovered. Thoracic Magnetic Resonance Imaging (MRI) showed diffused thoracic spinal cord thickening and extensively intramedullary T2 hyper intensity areas. Gadolinium contrast enhanced T1WI showed an intramedullary circle-enhanced nodule at 9th thoracic level. Diagnosis was made by histological examination of the bilateral lung biopsy. The patient was treated successfully with systemic amphotericin B liposome and fluconazole and intrathecal dexamethasone and amphotericin B liposome. Conclusions This is a patient with disseminated cryptococcosis involving the lung, spinal cord and adrenal glands, which is rare in the absence of immunodeficiency.

scholarly journals Predictors of outcome in a large retrospective cohort of patients with transverse myelitis

2017 ◽  
Vol 24 (13) ◽  
pp. 1743-1752 ◽  
Author(s):  
Matteo Gastaldi ◽  
Enrico Marchioni ◽  
Paola Banfi ◽  
Valeria Mariani ◽  
Laura Di Lodovico ◽  
...  
Keyword(s):  
Nervous System ◽  
Connective Tissue ◽  
Autoimmune Diseases ◽  
Inflammatory Diseases ◽  
Univariate Analysis ◽  
Transverse Myelitis ◽  
Inflammatory Disorder ◽  
Prognostic Assessment ◽  
Lumbar Mri ◽  
Post Infectious

Background: Transverse myelitis (TM) is an inflammatory disorder that can be idiopathic or associated with central nervous system autoimmune/dysimmune inflammatory diseases, connective tissue autoimmune diseases, or post-infectious neurological syndromes. Prognosis of initial TM presentations is uncertain. Objective: To identify outcome predictors in TM. Methods: Retrospective study on isolated TM at onset. Scores ⩾3 on the modified Rankin scale (mRS) marked high disability. Results: A total of 159 patients were identified. TM was classified as follows: idiopathic (I-TM, n = 53), post-infectious (PI-TM, n = 48), associated with multiple sclerosis (MS-TM, n = 51), or neuromyelitis optica spectrum disorders/connective tissue autoimmune diseases/neurosarcoidosis ( n = 7). At follow-up (median, 55 months; interquartile range, 32–80), 42 patients were severely disabled, and patients with I-TM or PI-TM showed the worst outcomes. Predictors of disability were infectious antecedents, sphincter and pyramidal symptoms, high mRS scores, blood–cerebrospinal fluid barrier damage, lumbar magnetic resonance imaging (MRI) lesions on univariate analysis, and older age (odds ratio (OR), 1.1; 95% confidence interval (CI), 1.0–1.1), overt/subclinical involvement of the peripheral nervous system (PNS) (OR, 9.4; 95% CI, 2.2–41.0), complete TM (OR, 10.8; 95% CI, 3.4–34.5) on multivariate analysis. Conclusion: Our findings help define prognosis and therapies in TM at onset. Infectious antecedents and PNS involvement associate with severe prognosis. Nerve conduction studies and lumbar MRI could improve the prognostic assessment of this condition.

scholarly journals Covid-19 post-infectious acute transverse myelitis responsive to corticosteroid therapy: report of two clinical cases

2021 ◽  
Author(s):  
Thaís de Maria Frota Vasconcelos ◽  
Danilo Nunes Oliveira ◽  
Glauber de Menezes Ferreira ◽  
Fabrícia Carneiro Torres ◽  
José Daniel Vieira de Castro ◽  
...  
Keyword(s):  
Corticosteroid Therapy ◽  
Transverse Myelitis ◽  
Acute Transverse Myelitis ◽  
Post Infectious ◽  
Clinical Cases

scholarly journals A rare case of post COVID-19 hemophagocytic lymphohistiocytosis in a pediatric patient

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S93-S93
Author(s):  
A Rjoop ◽  
M Barukba ◽  
O Al Rusan
Keyword(s):  
Bone Marrow ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Bone Marrow Aspirate ◽  
Viral Infections ◽  
Nk Cell ◽  
T Cell Response ◽  
Lower Limbs ◽  
Inflammatory Conditions ◽  
Special Stain

Abstract Introduction/Objective Hemophagocytic Syndromes are a cluster of disorders related to cytotoxic dysfunction of T/NK-cells and are mainly subdivided into Primary (familial) and Secondary (acquired) forms, with the latter usually linked to patients with viral infections; including EBV, CMV among many others. A myriad of other causes have been associated with hemophagocytic lymphohistiocytosis (HLH), most notably systemic inflammatory conditions; especially Juvenile Rheumatoid Arthritis and hematolymphoid malignancies particularly T/NK-cell lymphomas. Methods/Case Report A previously healthy 7-year-old boy, presented to the ER with fever and a skin rash over both lower limbs of 1 week duration. Two weeks prior he was tested for COVID-19 and was found to be positive. Physical examination further revealed slightly palpable liver and spleen. CBC was done and exhibited pancytopenia, further testing showed elevated LDH, hyperferritinemia and hypertriglyceridemia. However, serological testing for rheumatological conditions was unremarkable. Imaging studies were done and were noncontributory. Subsequently, a bone marrow aspirate and biopsy were done. The bone marrow aspirate showed afew histiocytes engulfing red blood cells and nuclear debris (hemophagocytic cells), complete trilineage maturation and normal M:E ratio of 3:1. Trephine biopsy was hypocellular for age and estimated at about 70%, composed of myeloid and erythroid precursors with various degrees of maturation. Megakaryocytes were adequate in number and showed normal morphology. Extensive histiocytic infiltration as highlighted by CD68 immunostain and focal phagocytosis were identified. CD34 highlighted <5% blasts, PAS special stain showed no fungal elements and no fibrosis was evident by Reticulin special stain. The background was devoid of lymphoid aggregates or granulomas. Stainable iron stores were depleted. No sideroblasts were identified. The patient was treated with corticosteroid and showed marked improvement and was discharged after 3 days. Results (if a Case Study enter NA) NA Conclusion Hemophagocytic lymphohistiocytosis can be a critical sequela of COVID-19 infection. Suggested mechanisms include impaired/delayed T-cell response and elevated levels of several inflammatory cytokines. Clinical suspesion is important in the diagnosis of these cases. Further study of this correlation is needed as we explore clinical sequelae of COVID-19 infection.

scholarly journals Acute myelitis after SARS-CoV-2 infection: a case report

2020 ◽  
Author(s):  
Kang Zhao ◽  
Jucun Huang ◽  
Dan Dai ◽  
Yuwei Feng ◽  
Liming Liu ◽  
...  
Keyword(s):  
Acute Flaccid Paralysis ◽  
Clinical Findings ◽  
Lower Limbs ◽  
Nasopharyngeal Swab ◽  
Comprehensive Treatment ◽  
Nucleic Acid Testing ◽  
Test Results ◽  
Microbiological Test ◽  
Novel Coronavirus ◽  
Post Infectious

AbstractWe report a case of acute myelitis in a patient infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A 66-year-old man with coronavirus disease 2019 was admitted with acute flaccid paralysis of the bilateral lower limbs and urinary and bowel incontinence. All serum microbiological test results were negative, except for SARS-CoV-2 nucleic acid testing. Clinical findings indicated post-infectious acute myelitis. He received treatment containing ganciclovir, lopinavir/ritonavir, moxifloxacin, dexamethasone, human immunoglobulin, and mecobalamin. With a diagnosis of post-infectious acute myelitis and comprehensive treatment, paralysis of the bilateral lower extremities ameliorated. After two negative novel coronavirus RNA nasopharyngeal swab tests, he was discharged and transferred to a designated hospital for isolation and rehabilitation therapy.

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