Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C1762617 (weakness)
 37,932 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of posttraumatic syringomyelia which appeared 26 years after the injury was presented. A patient was 61 year old female, who sustained thoraco-lumbar spine injuries rendering her to paraplegic in 1954. Eleven months later she had an operation of T6-T9 and L1-L2 laminectomies and regained motor and sensory functions of the both lower extremities. She was ambulatory with crutches till 1979. In 1980, burning pain was noticed in the left scapular region, and thereafter, extended to the ulnar side of the left forearm. The pain became progressively worse and intractable. Analgesics were ineffective. Two years later muscle atrophies and weakness in the left finger intrinsic muscles appeared. Absent deep tendon reflexes in the left upper extremity, dissociated sensory loss (in the left C2-S1 and right T5-T12 dermatomes) and paraparesis were also documented. Metrizamide CT scan performed 24 hours after the intrathecal injection disclosed an intramedullary syrinx between C2 and L1 vertebral levels. No communication with the fourth ventricle was seen. A syringoperitoneal shunt with low pressure valve was placed. The pain subsided immediately after this procedure. However, no improvement in motor and sensory functions were observed. Pathophysiological mechanisms involved in post-traumatic syrinx formation and its development were discussed. We prefer hypothesis proposed by Ball and Dayan to Gardner's hydrodynamic theory regarding to development of the syrinx secondary to spinal cord injury.
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PMID:[A case report of post-traumatic syringomyelia]. 651 29

A 71-year-old man experienced gradually progressive leg weakness, urinary retention, and mild loss of sensation in dermatomes T8 through T12 bilaterally. After 5 to 6 weeks of illness, he developed flaccid paraplegia and sensory loss below T8. He died 16 weeks after onset of neurological symptoms. Neuropathologically, there was widespread, subtotal necrosis of the spinal cord, largely of nonhemorrhagic character, from T8 downward. Dorsal and anterior median spinal veins were occluded by a partially organized thrombus. Comparison of this case with 19 previously recorded examples of venous infarction of the spinal cord (8 hemorrhagic, 7 nonhemorrhagic, and 4 embolic) suggests major differences in clinical presentation, rate of progression, and length of survival among the three groups.
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PMID:Nonhemorrhagic venous infarction of the spinal cord. 674 84

A 37-year-old man had multicentric meningeal plasma cell granuloma of the spinal cord. The presenting symptoms were back pain and progressive numbness and weakness of both legs for 6 months. Through physical examination, hypoesthesia below the inguinal region and decreased muscle power of both legs with bilateral ankle clonus was seen. Computed tomographic myelogram and magnetic resonance imaging showed 2 extramedullary intradural masses at the T5 and T12-L1 levels. The latter produced all the neurologic deficits. The patient underwent 2 consecutive operations: laminectomy with removal of the tumor at the T12-L1 level, and thoracotomy with partial corpectomy and removal of the tumor at T5 level. Findings from both operations showed that the tumors arose from the dura and grew inward compressing the spinal cord. Microscopically, these 2 tumors showed identical pictures of plasma cell granuloma and were characterized by numerous granulomas formed by mature plasma cells with Russell bodies and histiocytes set in a fibrotic background. The patient was discharged with complete recovery of sensory and motor functions of both legs.
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PMID:Multicentric plasma cell granuloma of spinal cord meninges. 767 76

Somatosensory evoked potential (SEP) monitoring of thoracolumbar procedures typically includes posterior tibial and peroneal nerve recordings. The addition of femoral nerve SEP monitoring, however, should better predict the evolution of postoperative neurologic deficits affecting the midlumbar roots. To assess the value of intraoperative femoral SEPs, 26 cases of traumatic injury to the thoracolumbar spine between T12 and L4 were prospectively assessed. Twenty-four had clear femoral nerve responses bilaterally recorded from an epidural electrode. Five had significant intraoperative SEP changes: one had isolated femoral nerve changes, two had only peroneal or tibial nerve changes, and two had concomitant changes in both femoral and peroneal or tibial nerves. Loss of the femoral nerve response in one patient was correlated with marked postoperative knee extensor weakness, in spite of immediate action taken by the surgeon. The authors conclude that femoral nerve SEPs provide an effective tool to monitor the midlumbar roots intraoperatively.
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PMID:The efficacy of femoral nerve intraoperative somatosensory evoked potentials during surgical treatment of thoracolumbar fractures. 823 63

Case-1: A 72-year-old woman with no past neurological history was scheduled for a rectum resection under general combined with epidural anesthesia. An epidural catheter was introduced at T11-12 interspace without any difficulties. During the operation, she had hypotensive episode needing dopamine, but waked up from anesthesia without any event. When she became alert, she complained muscle weakness and loss of sensation in both lower extremities. On the day after surgery, she became quadriplegic and completely insensitive under Th4 level, but her MRI of the spine showed no abnormal findings. A month after the operation, her MRI showed diffuse spinal degeneration below C4 level and she had flaccid paralysis below Th1 with complete sensory loss below Th7 level. Case-2: A 62-year-old man with no past neurological history was scheduled for gastrectomy under general combined with epidural anesthesia. An epidural catheter was placed via T12-L1 without any difficulty. Operative course was uneventful and awakening from anesthesia was normal. He showed muscle weakness and hypesthesia of lower extremities two hours after the operation, and we stopped continuous injection of epidural anesthesia. His paralysis became worse but MRI of his spine showed no abnormality on the day after the operation. He became complete flaccid paralytic and had complete sensory loss below T7 level. The MRI examination two weeks after the operation showed degeneration below middle thoracic spinal cord. His neurologic symptoms have not improved for two years. The etiology of neurologic deficits of these two case is not obvious although the relation between epidural anesthesia and neurologic symptoms was most likely.
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PMID:[Permanent paraplegia following epidural and general anesthesia: two case reports]. 872 1

Four cases of thoracic spondylotic myelopathy are reported, one man and three women, respectively 61, 66, 67 and 76 years old. Clinical presentation was numbness and weakness in the lower limbs in two cases, weakness alone in one and numbness alone in the last one. Diagnosis was settled by both myelography and CT-myelogram in three cases, by both MRI and CT-scan in the other one. The involved thoracic levels were both T9-T10 and T10-T11 for two cases and T11-T12 for the other one. The stenosis was due to hypertrophic ossification of the ligamentum flavum in three cases and to osteophytic changes in one. A laminectomy was performed for each patient and three patients had a significant recovery and the fourth a mild one. Thoracic myelopathy is an uncommon disease which requires a meticulous study of myelogram and now MRI to be recognized and to be cured by laminectomy. As for cervical myelopathy, it results from mechanical and ischemic factors which can lead to a definitive myelomalacia.
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PMID:[Thoracic spondylotic myelopathies. Apropos of 4 new cases]. 908 41

Injury to the spinal cord often results in abnormal lateral curvature of the spine, or scoliosis, that is associated with neuromuscular weakness. The lateral curvature of the spine is thought to be a consequence of insufficient or asymmetrical loading of the vertebrae. To study neuromuscular scoliosis, an animal model of spinal cord injury was used in which the spinal cord was partially (3/4) transected, with the left lateral columns left intact. Partial transection of the spinal cord in the rat caused scoliosis that was maximal four to five vertebrae distal to the lesion site. As in previous experiments involving unilateral spinal cord lesions, the scoliotic curves were convex on the weakened side. Subtotal transection at T5 or T11 resulted in lateral displacement of vertebrae T9-T12 or L2-L5, respectively, of up to 11 mm. Interestingly, this vertebral displacement is greatly reduced by clenbuterol, a beta2-adrenoceptor agonist that has been found to retard loss of muscle contractility and bone mineralization due to denervation. Together these results suggest that stimulation of beta2-receptors opposes vertebral unloading due to neuromuscular weakness and thereby acts as a countermeasure to scoliosis.
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PMID:Clenbuterol, a beta2-adrenoceptor agonist, reduces scoliosis due to partial transection of rat spinal cord. 914 94

Neurilemoma of the spinal cord occurred in a mother and daughter. Case 1 was a 75-year-old woman with gait disturbance. Examination revealed weakness of the lower extremities, and magnetic resonance (MR) imaging showed an intradural extramedullary tumor at T12. After laminectomy, the histologic diagnosis was mixed Antoni type A and B neurilemoma. Case 2 was a 48-year-old woman (daughter of case 1). She presented with cervical pain and numbness of both hands. Examination revealed weakened intrinsic muscles of the right hand and paresthesia of the right upper arm. MR imaging showed a giant hourglass-shaped extradural tumor at C2 and C3. The histologic diagnosis was Antoni type A neurilemoma. Only six families with neurilemoma have been reported, including our patients. Gene analysis of such patients may clarify the etiology of neurilemoma.
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PMID:Familial neurilemoma of the spinal cord in a mother and daughter. 972 9

We report a rare case of mumps myelitis in which parotid swelling appeared 3 days after the symptoms of myelitis. A 10-year-old boy presented with acute paraplegia of grade I-II on MRC (Medical Research Council) scale and retention of urine with normal sensations. Central motor conduction to tibialis anterior (CMCT-TA) on the right side was 32 ms and 24 ms on the left side. Spinal MRI revealed hyperintense signal changes extending from C3 to T12. After 5 days of methylprednisolone therapy, there was marked improvement in weakness, micturition normalized and CMCT-TA also returned to normal. MRI repeated after 1 month was also normal. This response seems to be due to antiedema and to the antiinflammatory effect of methylprednisolone, because of a temporal relationship between MPS and clinical improvement. However, the possibility of natural recovery cannot be ruled out.
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PMID:Myelitis: a rare presentation of mumps. 973 49

We report the occurrence of an epidural haematoma after the removal of a lumbar epidural catheter, which had been inserted 2 days previously for surgery to revise a thrombosed femoral-popliteal graft. Pre-operatively the patient received intravenous heparin by infusion, but this was stopped 7 h prior to epidural insertion. Coagulation studies were normal. The epidural catheter insertion was unremarkable. Postoperatively, the patient received a continuous epidural infusion of fentanyl (3 micrograms.ml-1) and bupivacaine (0.0625%), in addition to systemic anticoagulant therapy with heparin. On the second postoperative day, the patient was noted to have developed bilateral leg weakness (following transfer to another department for Doppler studies). The epidural catheter was inadvertently removed while the patient was anticoagulated and paraparesis developed overnight. After a significant delay, an epidural haematoma was diagnosed and treated by decompressive laminectomy. At operation an epidural haematoma extending posteriorly from T12 to L3 was removed.
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PMID:Epidural haematoma following anticoagulant treatment in a patient with an indwelling epidural catheter. 1020 79


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