scholarly journals Serological screening for syphilis in non-compressive spinal injuries

2021 ◽  
Author(s):  
Bianca Frigo Pires ◽  
Osmi Hamamoto
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Transverse Myelitis ◽  
Rare Condition ◽  
Signs And Symptoms ◽  
Lower Limbs ◽  
Intramedullary Tumors ◽  
Serological Screening ◽  
Chronic Myelopathy ◽  
Syphilis Serology

Background: Syphilis is an infectious disease that can present systemic symptoms during its progression, reaching the central nervous system, causing neurosyphilis, combined include involvement of the meninges and spinal cord. Objectives: to review information on meningomyelitis in patients with positive syphilis serology, assessing the need for serological screening for syphilis knowledge and the importance of the clinician for an accurate diagnosis, preventing major sequelae or fatalities Methods: We analyzed 14 clinical cases of syphilitic myelitis from January 2000 to January 2021. Documents were resolved to determine clinical issues, apparent symptoms, radiological findings, penal treatment and complications. Results: 85.7% suffered from chronic myelopathy and 14.3% revealed subacute transverse myelitis. The most common clinical condition of chronic myelopathy was tabes dorsalis, present in 50%, afterwards it was syphilitic meningomyelite, present in 33.3%. Conclusion: Syphilitic myelitis is a rare condition, but there are studies that prove an increase in cases of myelopathy in patients with positive syphilis serology. The condition manifests itself with weakness of the lower limbs, sensory disturbance and urinary and fecal incontinence, in addition to long spinal cord injuries and abnormal enhancement, predominantly in the superficial parts of the spinal cord, in imaging exams. There is a differential diagnosis with multiple pathologies, such as intramedullary tumors, herniated intervertebral disc, myelopathy caused by HIV, among others. Therefore, it is important to know the signs and symptoms and an approach to serological screening for syphilis in patients with neurological disorders and non-compressive medical injuries.

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 Development of a Rehabilitation Game for Individuals With Spinal Cord Injury Using a User-Centered Design Process

2018 ◽  
Author(s):  
Stuart R. Fairhurst ◽  
Logan C. McCool ◽  
Kristin M. Scheel ◽  
Crystal L. Stien ◽  
Charlotte M. Brenteson ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Video Game ◽  
Perceived Exertion ◽  
Interactive Video ◽  
Spinal Cord Injuries ◽  
Lower Limbs ◽  
User Centered Design ◽  
Cord Injury ◽  
Interactive Video Game

The use of video games during exercise, exergaming, has been shown to increase energy expenditure without increasing perceived exertion [1]. This suggests that exergaming may be an effective way to engage a patient during rehabilitation and increase adherence to a rehabilitation regime. Existing exergame systems are designed with able bodied users in mind and often combine hand controlled game play while using lower limbs for aerobic exertion, making current systems inaccessible to individuals with spinal cord injuries and others without lower limb function. Our earlier work on increasing exercise accessibility includes developing an ergometer for supine use for patients who have recently had a flap procedure [2]. The goal of the present project was to create an engaging, interactive video game designed for use during arm ergometry by individuals with spinal cord injury (SCI) in either the supine or seated position.

CASE REPORT ON A RARE NEUROLOGICAL COMPLICATION OF MYCOBACTERIUM TUBERCULOSIS INFECTION IN HIV PATIENT

2021 ◽  
pp. 1-2
Author(s):  
K. Shivaraju ◽  
Mandhala Saikrishna
Keyword(s):  
Spinal Cord ◽  
Mycobacterium Tuberculosis ◽  
Case Report ◽  
Neurological Complication ◽  
Transverse Myelitis ◽  
Sudden Onset ◽  
Lower Limbs ◽  
Tuberculosis Infection ◽  
Mycobacterium Tuberculosis Infection ◽  
History Of

LETM is rarely caused by tuberculosis infection. LETM is a contiguous immune-mediated inammatory lesion of the spinal cord that extends to three or more segments of spinal cord. Here we presenting a case of 55 years old female patient with known HIV infection and no history of tuberculosis infection admitted in the hospital with complains of sudden onset of asymmetrical weakness of lower limbs and urinary incontinence from four days. on evaluation she was underwent some series of investigations, in that nally diagnosed with longitudinally extensive transverse myelitis due to tuberculosis infection. Then patient was treated with ART and ATT with steroids and supportive treatment along with physiotherapy. after some days patient condition was gradually improving with treatment and discharged, advised physiotherapy daily and followup on OPD basis. So based on this case report, we recommend that clinicians should suspect mycobacterium tuberculosis infection when patient diagnosed with transverse myelitis

scholarly journals Neurobrucellosis with ischemic stroke and spinal cord involvement: a case report

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hongfeng Wen ◽  
Di Jin ◽  
Lina Cai ◽  
Tao Wu ◽  
Haichao Liu
Keyword(s):  
Spinal Cord ◽  
Ischemic Stroke ◽  
Clinical Manifestations ◽  
Transverse Myelitis ◽  
Lower Limbs ◽  
Spinal Cord Atrophy ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Next Generation Sequencing Ngs

Abstract Background Brucellosis is a common zoonotic disease that may have a variety of clinical manifestations when it affects the nervous system. Ischemic stroke is a rare clinical symptom, but if it is not diagnosed and treated early, it may cause more severe consequences. Case presentation We report a 38-year-old man presenting with hearing impairment for four years and sudden weakness of the right limb for two years, recurrent aphasia, and gradual weakness of bilateral lower limbs for nine months. He had bilateral positive Babinski’s sign. Cerebrospinal fluid (CSF) showed raised protein and pleocytosis. Magnetic resonance imaging (MRI) showed ischemic infarcts in the pons and extensive enhancement of spinal meninges combined with spinal cord atrophy and ischemia. The tests revealed Brucella Rose Bengal positive in serum and CSF. Brucella culture in CSF was also positive. Next-generation sequencing (NGS) of CSF revealed positive for Brucella with 105 species were detected. He showed significant improvement with antibiotics at five months follow-up. Conclusions Neurobrucellosis may mimic stroke and transverse myelitis like syndromes. NB is a treatable infectious condition and should always be considered in the differentials, especially if there are risk factors, as in our case.

scholarly journals Meningitis retention syndrome caused by varicella zoster virus in a patient without a rash: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tsuneaki Kenzaka ◽  
Ken Goda ◽  
Ayako Kumabe
Keyword(s):  
Varicella Zoster Virus ◽  
Urinary Retention ◽  
Aseptic Meningitis ◽  
Acute Urinary Retention ◽  
Rare Condition ◽  
Signs And Symptoms ◽  
Lower Limbs ◽  
Viral Origin ◽  
Varicella Zoster ◽  
Intravenous Acyclovir

Abstract Background Meningitis retention syndrome (MRS) is a rare condition that presents with acute urinary retention as a complication of aseptic meningitis. Cases of MRS due to varicella zoster virus (VZV) infection without a rash are rare. We report the case of a patient who had no signs of meningitis or VZV infection, including a rash. Case presentation A 58-year-old man presented with dysesthesia of the lower limbs and acute urinary retention. He had fever but no rash and no signs of meningitis. He was diagnosed to have VZV infection based on the detection of VZV DNA in the cerebrospinal fluid. He responded satisfactorily to a course of intravenous acyclovir and experienced no sequelae during a 2-year follow-up period. Conclusion MRS due to aseptic meningitis of viral origin should be considered in the differential diagnosis of acute urinary retention even in the absence of specific signs and symptoms of meningitis or a suggestive rash.

scholarly journals Intramedullary Cavernoma: Case Report and Literature Review

2019 ◽  
Vol 2 (1) ◽  
Keyword(s):  
Spinal Cord ◽  
Vascular Malformations ◽  
Cord Compression ◽  
Lower Limbs ◽  
Low Flow ◽  
Vascular Lesions ◽  
Spinal Vascular Malformations ◽  
Patient Reported ◽  
Spinal Cord Compression Syndrome ◽  
Chronic Myelopathy

Introduction: Cavernomas are benign vascular anomalies consisting of cavities where the blood circulates at low flow and at low pressure. Intramedullary localization is unusual, represents approximately 5 to 12% of spinal vascular malformations and 3% of intra-dural vascular malformations (5% of medullary vascular lesions). Observation: A patient, aged 59, consulted for the abrupt installation of moderate back pain followed by predominant muscle weakness in the two lower limb of progressive worsening, responsible for gait disorders. The patient reported thermal hypoesthesia and heaviness of the two lower limbs that had been evolving for two years. The examination found a dorsal spinal cord compression syndrome. On the MRI, there were abnormalities of intramedullary signal of the dorsal (D11) spinal cord with bleeding stigmas suggestive of intramedullary cavernomas. Conclusion: The management of the medullary cavernoma is essentially neurosurgical with complete microsurgical resection of the malformation. In the absence of surgical treatment, evolution can be to chronic myelopathy or neurological aggravation.

scholarly journals Case report: “an unexpected origin of coma in a young adult”

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Ranjana Chandrikasing ◽  
Sudeshkoemar Ramnarain ◽  
Rakesh Bansie ◽  
Harvey Yang ◽  
Huibert Ponssen ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Transverse Myelitis ◽  
Respiratory Acidosis ◽  
Sudden Onset ◽  
Lower Limbs ◽  
Traumatic Spinal Cord Injury ◽  
Cord Injury ◽  
Hypoventilation Syndrome ◽  
Diaphragmatic Weakness

AbstractWe report a peculiar case of acute non-traumatic coma due to neuromuscular hypoventilation syndrome caused by a non-traumatic spinal cord injury (NTSCI). A 21-year-old patient presented to the emergency room complaining of sudden onset weakness in his lower limbs and shortness of breath. While in the ER, he briefly became comatose and labs revealed an acute respiratory acidosis. Detailed neurologic examination ultimately revealed upper motor neuron signs and quadriplegia. He was ultimately diagnosed with a non-traumatic spinal cord injury, in particular, a cervical transverse myelitis which had caused acute diaphragmatic weakness. Although a very rare cause of coma, emergency medicine physicians need to be aware of transverse myelitis, a disorder that may result in rapidly progressive neurologic decline and is treated with immunomodulation.

scholarly journals Rethinking the Body in the Brain after Spinal Cord Injury

2022 ◽  
Vol 11 (2) ◽  
pp. 388
Author(s):  
Erik Leemhuis ◽  
Valentina Giuffrida ◽  
Maria Luisa De Martino ◽  
Giuseppe Forte ◽  
Anna Pecchinenda ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spatial Organization ◽  
Spinal Cord Injuries ◽  
The Body ◽  
Lower Limbs ◽  
Body Regions ◽  
Cord Injury ◽  
The Central Nervous System ◽  
Clinical Resource ◽  
The Brain

Spinal cord injuries (SCI) are disruptive neurological events that severly affect the body leading to the interruption of sensorimotor and autonomic pathways. Recent research highlighted SCI-related alterations extend beyond than the expected network, involving most of the central nervous system and goes far beyond primary sensorimotor cortices. The present perspective offers an alternative, useful way to interpret conflicting findings by focusing on the deafferented and deefferented body as the central object of interest. After an introduction to the main processes involved in reorganization according to SCI, we will focus separately on the body regions of the head, upper limbs, and lower limbs in complete, incomplete, and deafferent SCI participants. On one hand, the imprinting of the body’s spatial organization is entrenched in the brain such that its representation likely lasts for the entire lifetime of patients, independent of the severity of the SCI. However, neural activity is extremely adaptable, even over short time scales, and is modulated by changing conditions or different compensative strategies. Therefore, a better understanding of both aspects is an invaluable clinical resource for rehabilitation and the successful use of modern robotic technologies.

Spinal cord ischaemic injury while playing in a playground

2021 ◽  
Vol 14 (7) ◽  
pp. e242155
Author(s):  
Joana de Brito Chagas ◽  
Candida Cancelinha ◽  
Rui Pedro Pais ◽  
Carmen Costa
Keyword(s):  
Spinal Cord ◽  
Emergency Department ◽  
Acute Flaccid Paralysis ◽  
Bladder Dysfunction ◽  
Treatment Guidelines ◽  
Rare Condition ◽  
Lower Limbs ◽  
Extensive Investigation ◽  
Imaging Diagnosis ◽  
Ischaemic Injury

Spinal cord ischaemia is a rare condition in children in which imaging diagnosis can be difficult and treatment guidelines are not well established. We describe a case of a previously healthy 13-year-old girl admitted to the emergency department with an acute flaccid paralysis of the lower limbs, abdominal and dorsal pain, and bladder dysfunction. A few hours earlier, she had been playing on a swing with hyperextension and an arched back position. Spinal cord MRI was normal in the first hours, but ischaemic signs were described in a second examination performed some hours later. We discuss the extensive investigation for differential diagnosis and the management of this case.

scholarly journals Acute spinal cord infarction syndrome unusually mimicking Transverse myelitis: A case report

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Aliyu Ibrahim ◽  
Aisha Shuaibu ◽  
Usman Adamu Nuhu ◽  
Hauwa A. Aliyu
Keyword(s):  
Spinal Cord ◽  
Transverse Myelitis ◽  
Sudden Onset ◽  
Dorsal Column ◽  
Lower Limbs ◽  
Spinal Cord Infarction ◽  
History Of ◽  
Extensor Plantar Response ◽  
Magnetic Resonance Imaging Mri ◽  
Repeat Examination

Anterior Spinal Cord Infarction (ASCI) syndrome typically results from ischemia that affects the anterior spinal artery territory characterized by history of sudden onset flaccid paraplegia or quadriplegia depending on the level of the lesion. We describe a 57-years-old woman with sudden onset flaccid weakness of the lower limbs and numbness of the feet of two days duration, preceded by a day history of fever and several episodes of vomiting. Examination initially revealed bilateral hypotonia, hyporeflexia and dense paraplegia, with preservation of dorsal column sensations (fine touch/2-point discrimination, position and vibration sensation). Twenty-four hours thereafter a repeat examination showed hyper-reflexia and extensor plantar response with spastic paraplegia. Thoracic spine Magnetic Resonance Imaging (MRI) revealed thinning of the spinal cord extending from T1 to T9 levels with associated widening of the thecal sac suggestive of anterior spinal cord infarction with no other signal changes seen within the substance.

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