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 patient with uvular cancer presented with lower limb weakness and paresthesiae, headache, neck stiffness and multiple cranial palsies. No malignant cells were found on lumbar puncture. CT, and MRI were normal. Gadolinium-DTPA MRI disclosed multiple enhancing lesions consistent with leptomeningeal metastases. Gd-DTPA MRI is the best technique to demonstrate tumoral meningeal infiltration in cytology-negative patients suspected of having leptomeningeal metastases.
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PMID:Gadolinium-DTPA MRI in the diagnosis of a patient with leptomeningeal metastasis produced by uvular carcinoma. 188 52

Patients with sickle cell disease are predisposed to infection caused by Streptococcus pneumoniae. However, there has been only one published case of bacteremic pneumococcal meningitis in an adult with sickle cell anemia. We report here the cases of six adults with sickle cell disease, pneumococcal sepsis, and meningitis. Five patients were male and one was female. Their ages ranged from 18 to 34 years (mean, 25.7 years). Five patients had the SS and one had the SC hemoglobin phenotype. Only one patient had received pneumococcal vaccine (14 valent). This vaccine did not protect against the pneumococcal serotype causing his infection. All patients had high fever (mean, 39.8 degrees C [103.7 degrees F]) on admission; five had generalized weakness and four had neck stiffness. Leukocyte counts were greater than 30,000/mm3 in all patients. Streptococcus pneumoniae was isolated from the blood and the cerebrospinal fluid in all patients. The cerebrospinal fluid showed pleocytosis in six patients, an elevated protein level in five, and hypoglycorrhachia in two. Complications included renal failure in four patients, disseminated intravascular coagulation in one, and seizures in another. Two patients died. Pneumococcal sepsis and meningitis are uncommon in adults with sickle cell disease, but they carry a high morbidity and mortality. Wider use of the new 23-valent polysaccharide vaccine in these patients is recommended.
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PMID:Pneumococcal sepsis and meningitis in adults with sickle cell disease. 240 40

We present 3 new cases of cervical epidural abscess (CEA), a rare condition, along with a review of 12 other case reports. The average patient age was 45 years; just over half were male. The abscesses usually involved the mid to lower cervical region and extended an average of three to four segments. Neck stiffness was present in all patients; root pain and paresthesias were present less often. Weakness of one to four extremities developed in all but one patient. Sensory levels were frequently present, sometimes below the site of the lesion. All but two patients were febrile. All but two had elevated CSF protein, and all but two had a pleocytosis; myelography always revealed a complete or partial block. Staphylococcus aureus was the causative organism in 8 of 11 patients. CEA should be considered in a patient with neck stiffness, paresthesias, and/or radicular pain so that CT or myelography followed by surgical decompression and/or antimicrobial drugs can be initiated before prolonged weakness develops. One of our patients developed a syrinx causing a new neurologic deficit 3 years after treatment. Delayed syringomyelia, a rare complication of extramedullary lesions, lends support to vascular occlusion as the major mechanism of damage in epidural abscess.
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PMID:Cervical epidural abscess. 331

The authors report a case of mixed pial-dural arteriovenous malformation (mixed pial-dural AVM), which had feeders from both cortical branches of the internal carotid artery and middle meningeal artery of the external carotid artery. A clinical course of this case is presented and literatures are reviewed. Moreover the authors stress the rete mirabile anastomoses as an important factor in the genesis of the mixed pial-dural AVM. The patient, 30-year-old female, suddenly suffered from a severe headache on December 31, followed by gradual deterioration of consciousness. She was admitted to Otaru Second City Hospital one hour after the episode and neurological examination disclosed moderate confusion, right hemiparesis and neck stiffness. CT scan revealed a massive hematoma in the bilateral ventricles and left parietal lobe and skull plain film showed an enlargement of the groove of the middle meningeal artery. Angiography revealed a mixed pial-dural AVM in the left parietal lobe, which had feeders from both cortical branches of the left internal carotid artery and middle meningeal artery of the left external carotid artery. Two weeks later the admission, an operation was performed. A ligation of the external carotid artery at the neck was performed before a craniotomy, and the bleeding from the dura was minimal, and the AVM in the parietal lobe was removed completely. The patient recovered satisfactorily without any trouble and she was discharged with only a mild weakness at the right side. The clinical finding of the mixed pial-dural AVM is discussed and the rete mirabile anastomoses is emphasized as an important factor in the genesis of the mixed pial-dural AVM.
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PMID:[Mixed pial-dural arteriovenous malformation. Case report]. 646 43

Neurologic involvement of Lyme disease typically consists of meningitis, cranial neuropathy, and radiculoneuritis, alone or in combination, lasting for months. From 1976 to 1983, we studied 38 patients with Lyme meningitis. Headache and mild neck stiffness, which fluctuated in intensity, and lymphocytic pleocytosis were the common findings. Half of the patients also had facial palsies, which were unilateral in 12 and bilateral in seven. In addition, 12 patients had motor and/or sensory radiculoneuropathies; asymmetric weakness of extremities was the most common finding. Although incomplete presentations of neurologic involvement of Lyme disease may be confused with other entities, the typical constellation of neurologic symptoms represents a unique clinical picture.
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PMID:Neurological findings of Lyme disease. 651 50

A case of a young women with paroxysmal nocturnal hemoglobin (PNH) who developed thrombosis of the cerebral veins after beginning a regimen of oral contraceptives is presented. She was 24 years old and presented with a 3-week history of frontal headache, neck stiffness, paraesthesiae of both arms, and weakness of the left leg. She had begun use of Microgynon 2 months before presentation, but had discontinued use when symptoms began. Hematological studies showed a shortened partial thromboplastin time, high fibrinogen and factor VIII levels, and prlonged euglobulin clot lysis time. Though this patient had a history of coagulation difficulties, it was not until after taking the estrogen-containing contraceptive preparation that PNH developed. The mechanism of thrombosis may be related to the liberation of thromboplastic material from hemolysed erythrocytes and to interaction between complement-sensitive platelets and complement components in plasma. It is suggested that the estrogen augmented the previously existing thrombotic condition in this patient, and that administration of estrogen-containing preparations should not occur in women with thrombotic disorders.
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PMID:Cerebral vein thrombosis and the contraceptive pill in paroxysmal nocturnal haemoglobinuria. 744 35

Eight horses had forelimb lameness which was considered unrelated to primary forelimb pain, but was associated with radiographic abnormalities of one or more cervical vertebrae. There was no evidence of ataxia or weakness. The degree and character of the forelimb lameness varied between horses. In 4 horses, selective local analgesic techniques were used to rule out lameness associated with pain in the forelimb. In the other 4 horses, radiographic examination of the cervical region was performed on the basis of forelimb lameness seen in conjunction with neck stiffness and/or neck pain. Three horses had marked modelling of the synovial articular facet joints in the caudal cervical region; a 4th horse had modelling and a fracture involving the synovial articulation between the 4th and 5th cervical vertebrae. One horse had abnormalities of the intercentral articulation between the 7th cervical and 1st thoracic vertebrae and a discrete mineralised opacity dorsal to it. Two horses had large lucent zones in a vertebral body. One horse had a fracture of the body of the 7th cervical vertebra. Five horses were humanely destroyed, 2 returned to their previous level of activity after a prolonged period of rest and 1 was still being rested at the time of writing.
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PMID:Forelimb lameness associated with radiographic abnormalities of the cervical vertebrae. 822 74

A 51-year-old man suffered from impotence for 10 months. Five months before he developed difficulty in urination and walking because of his both leg weakness. He was admitted to the hospital because of urinary incontinence, paraplegia and occipital headache. Neurologic examination revealed neck stiffness and Lhermitte's sign. The cranial nerves were intact with the exception of choked disc. He had weakness of lower extremities and right arm, and sensory loss on the right side including face. The plantar responses were extensor bilaterally. MR images revealed diffuse swelling in the cervical and thoracic spinal cord on a T 1-weighted image without enhancement by Gd-DTPA and diffuse high intensity of the spinal cord on a T 2-weighted image. MR image of the brain revealed the low intensity in the left temporal and occipital lobe with slightly enhancement by Gd-DTPA, the high intensity in the left temporal and occipital lobe white matter on a T 2-weighted image. Diagnosis of malignant lymphoma (B cell type) was made by brain biopsy. Combined chemotherapy was performed and his symptoms resolved and the lesions on MRI disappeared. The number of cases of primary spinal intramedullary malignant lymphoma was very rare and the majority of the cases had weakness or sensory impairment in the lower extremities in the initial symptoms. This is the first case which had impotence as the initial symptom. In addition, it must be taken into consideration of this disease when the patient has myelopathy with unknown etiology.
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PMID:[A case of primary central nervous system lymphoma with the onset of impotence]. 1039 Oct 76

Cervical spondylotic myelopathy is the most common cause of spinal cord dysfunction in older persons. The aging process results in degenerative changes in the cervical spine that, in advanced stages, can cause compression of the spinal cord. Symptoms often develop insidiously and are characterized by neck stiffness, arm pain, numbness in the hands, and weakness of the hands and legs. The differential diagnosis includes any condition that can result in myelopathy, such as multiple sclerosis, amyotrophic lateral sclerosis and masses (such as metastatic tumors) that press on the spinal cord. The diagnosis is confirmed by magnetic resonance imaging that shows narrowing of the spinal canal caused by osteophytes, herniated discs and ligamentum flavum hypertrophy. Choice of treatment remains controversial, surgical procedures designed to decompress the spinal cord and, in some cases, stabilize the spine are successful in many patients.
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PMID:Cervical spondylotic myelopathy: a common cause of spinal cord dysfunction in older persons. 1099 31

Adult T-cell lymphoma (ATL-L) developing initially in the meninges is rare. An autopsy case of ATL-L with an acute onset of meningitis and generalized lymphadenopathy in association with a cervical cord schwannoma is reported here. A 78-year-old woman with sensori-motor weakness of both arms over a 1-year period, developed febrile episodes and drowsiness with neck stiffness. Lumbar puncture revealed an increased protein content (161 mg/dL) and increased cell count (463/3) consisting of 99% of lymphocytes which contained atypical lymphocytes with multilobulated nuclei ('flower cells'), which are characteristic of ATL-L. Viral titers were positive only for HTLV-I antibodies (serum X 640: CSF X 16). Biopsy of an enlarged retroperitoneal lymph node revealed malignant lymphoma of the T-cell type. Brain MRI was negative, whereas an intradural extramedullary mass was found at the C4 level. With a diagnosis of ATL-L stage IV, chemotherapy was commenced, which was effective in reducing the generalized lymphadenopathy as well as the cervical mass and restoring the CSF findings to normality. The cervical cord mass was verified to be a solitary schwannoma, and ATL-L involvement was found not only in the leptomeninges, but also within the cervical cord schwannoma.
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PMID:Adult T-cell lymphoma involving the leptomeninges associated with a spinal cord schwannoma. 1166 21


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