Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A new case of sub-occipital Pott's disease is reported: a 26 year old, coloured male patient from Senegal was admitted for: cervical pain of 6 month duration, neck stiffness, dysphagia, left XII paralysis and left hemiparesis. The radiological study found an anterior atlanto-axial subluxation, basilar impression, and increased thickness of the retropharyngeal soft tissue, lysis of the left occipital condyle and the left lateral mass. CT scan study revealed a retropharyngeal mass and an epidural contrast-enhanced lesion at the C2 C3 C4 levels. Chest-X ray showed one tuberculous lesion at the right apex. The research of Acid Fast Bacilli in gastric secretion samples and the results of the retropharyngeal mass puncture were positive. An antituberculous trichemotherapy was started. After early reduction by skull tongs traction, an occipito-cervical arthrodesis by Roy Camille plates was performed, followed by the wearing of a minerva plaster jacket and then a plastic collar. Each one for a 5 month period. One year later, there remained only a left XII paralysis, but the bony reconstruction was not yet obvious on tomography. A survey of the literature of 70 cases of sub-occipital Pott's disease has pointed out these findings: cervical pain (98%), neck stiffness (82%), Atlantoaxial subluxation (68%), thickened prevertebral soft tissue shadow (77%), lateral mass lysis (48%) other tuberculous focus (29%). The main therapeutic trends are: early and long-lasting antituberculous poly-chemotherapy, early reduction of subluxations, prolonged contention for slight osteolytic lesions and for major: lytic lesions, a posterior surgical procedure either by bone graft combined with wires or preferably fusion by means of occipito-cervical plates. The removal of abscess is discussed.
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PMID:[Suboccipital Pott's disease]. 344 87

Pott's disease is the most common form of bone and joint tuberculosis, notably in the thoracolumbar spine. The sub-occipital localization remains exceptional, raising a major risk of spinal instability and severe bulbo-medullary complications. We report 2 new cases of tuberculous spondylodiscitis at the cervico-occipital junction revealed by signs of spinal compression associated with torticolis and dysphagia. The diagnosis was provided by CT scan and MR imaging and was confirmed histologically on a transoral biopsy of the retropharyngeal abscess. The patients were successfully treated with antituberculosis drugs combined with external stabilization of the spine. The diagnostic aspects, notably the neuroradiological findings in this particular localization of Pott's disease are recalled.
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PMID:[Sub-occipital Pott's disease. Diagnostic imaging in 2 cases]. 1097 Sep 67

Craniocervical Pott's disease remains exceptional, and may cause spinal instability and severe cervicomedullary complications. We report eight cases of tuberculous spondylodiscitis at the craniocervical junction revealed by signs of spinal cord compression, torticollis and dysphagia. The value of CT and MR imaging is discussed.
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PMID:[Sub occipital Pott's disease: report of 8 cases]. 1502 36

We present our experience in the diagnosis, surgical management and long-term follow-up of congenital and acquired osseous-ligamentous abnormalities or pathologies of the craniovertebral junction. The purpose of this study was: (i) to determine the incidence and degree of cervicomedullary compression in pediatric and young adult patients with congenital and acquired abnormalities, and (ii) to correlate cervicomedullary compression with other imaging and clinical factors to determine to what extend cervicomedullary compression is successfully treated with a posterior decompressive procedure, transoral decompression, and medical management. Between January 1995 and December 2004, 26 cases were managed in our department. These patients had: rheumatoid arthritis (RA) (3); traumatic injury (2); congenital basilar impression (5, in 2 cases a posteriorly oriented or retroflexed odontoid); infection (10); craniovertebral junction Pott's disease (9); os odonteideum (3); condylus tertius (1); and tumor (2). Six of the patients (23.1%) had syringomyelia. Only three (11.3%) were in the pediatric age group. Symptoms and signs included headache (72%), ataxia (38%), lower cranial nerve dysfunction (54%), quadriparesis (44%), hyperreflexia (76%), Hoffman positivity (72%), achilles clonus (72%) nystagmus (33%) and dysphagia (22%). The mean follow-up time was 44 months (range 3-85). Twelve (46.2%) had undergone posterior fossa decompression; seven (26.6%) had ventral decompression. Seven of the patients (26.6%) had medical management. The major morbidity included pharyngeal wound sepsis leading to dehiscence (3.8%), valopharyngeal insufficiency (3.8%), cerebrospinal fluid leakage (3.8%), postoperative macroglossia (3.8%) and inadequate anterior decompression (3.8%). Transient neurological deterioration occurred in two patients (7.6%). Our management paradigm will result in some neurologic improvements and limit the progression of symptoms. Patients with these pathologies are likely to show a good neurologic outcome when treatment, whether with or without surgery, is administered early in the course of the disease.
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PMID:Management of cervicomedullary compression in patients with congenital and acquired osseous-ligamentous pathologies. 1733 28

A 31-year-old female pharmacist of Nigerian origin, now resident in London, described 4 months of worsening left-sided subscapular pain despite the use of increasingly potent analgesia. She also described progressive dysphagia, first to solids and later to liquid foods. She remained systemically well, with no associated symptoms and normal physiological observations. In light of raised plasma inflammatory markers and chest radiography demonstrating a widened paraspinal stripe, the patient underwent CT and subsequent MRI of the thorax and upper spine. This revealed bony destruction of multiple higher thoracic vertebrae, with an associated epidural abscess mediating spinal cord impingement at T5. A large prevertebral collection spanning C7-T9 directly compressing and displacing the oesophagus was demonstrated. These findings collectively suggested spinal tuberculosis (Pott's disease); PCR confirmed the presence of Mycobacterium tuberculosis. The patient was successfully treated with oral anti-tuberculous chemotherapy and physiotherapy.
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PMID:Shoulder pain and dysphagia with an unexpected cause. 2271 2

Retropharyngeal abscess is a rare, deep seated infection of the neck that usually affects young children. Chronic retropharyngeal abscess is rare and results from tuberculosis of the spine. Such swelling in the neck gradually increases in size and is detected during the routine radiological screening for symptoms like pain, dysphagia, fever, dyspnoea, progressive inspiratory stridor (from laryngeal obstruction), neck hyperextension etc, but rarely leads to sudden death due to airway obstruction. Thus the forensic pathologist rarely comes across such type of cases. Present case concerns obstruction of upper airway by a large retropharyngeal cold abscess leading to death in a 13-year-old female child from a lower socio-economic family. The possible explanation for the progression and fatal outcome of such abscesses associated with the Pott's disease is being discussed in the light of available literature.
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PMID:Fatal case of retropharyngeal abscess associated with Pott's disease. 2391 Aug 33