• The Korean Journal of Pain
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• v.9 no.2
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• pp.439-442
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• 1996

Continuous epidural analgesia has been used widely for chronic pain control, especially in cancer patients. As one of the complications, paraplegia developed during continuous epidural analgesia may be caused by epidural abscess, epidural hematoma, neural damage, chronic adhesive arachnoiditis, anterior spinal artery syndrome, delayed migration of extradural catheter into subdural space or subarachnoid space and preexisting disease. A 55-years-old male with lung cancer was implanted with continuous thoracic epidural catheter for pain control. Twenty days after catheterization, moderate back pain, weakness of lower extremity and urinary difficulty were developed. We suspected epidural abscess at first and made differential diagnosis with MRI which showed metastatic cancer at T2-4 spine, And compressed spinal cord was the main cause of the lower extremity paralysis.

• Journal of Korean Neurosurgical Society
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• v.42 no.6
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• pp.492-494
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• 2007

We present a case with seizure, confusion, hypesthesia and paraplegia after intrathecal injection of fluorescein. A 41-year-old man was admitted to our institution for the management of the CSF leakage. Intrathecal injection of fluorescein was performed and he complained of severe pain and numbness in the lower extremities at the end of the injection. Four hours later, he exhibited confusion, paraparesis and two episodes of generalized seizures. Two days later, he showed paraplegia and all sensory modalities below the T12 level were absent. Spine magnetic resonance imaging revealed myelopathic change in the lower thoracic spinal cord. There was no improvement of weakness and sensory deficits in lower extremity even 14 days after fluorescein injection. We speculated that thoracic myelopathy was associated with the intrathecal injection of fluorescein. In spite of its rarity, the complication after intrathecal injection of fluorescein could be serious. Thus, obtaining an informed consent with discussion with patient before the procedure is mandatory.

• Journal of Korean Neurosurgical Society
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• v.55 no.1
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• pp.57-60
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• 2014

Rhabdoid tumor of the kidney (RTK) is a rare malignancy in infancy. Central nervous system involvement in RTK is already known. However, solitary spinal metastasis in RTK has been hardly reported. The authors report a case of metastatic RTK to spine causing paraplegia in an 8-month-old girl. Since the patient was young, the diagnosis of spine metastasis was delayed until paraplegia was seen after radical nephrectomy. Thorough neurological examination should be performed for early diagnosis of spinal metastasis in young patients with RTK. If there are any abnormal signs in neurologic examination, magnetic resonance images of brain and spine are recommended.

• Annals of Clinical Neurophysiology
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• v.8 no.2
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• pp.193-195
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• 2006

Acute paraplegia attributable to disc herniation is known to occur most frequently at the thoracic level. A 50-year-old male presented with progressive limb weakness and hypoactive deep tendon reflexes. On the basis of clinical features and neurological findings, the diagnosis of Guillain-Barre syndrome was suspected. Spinal MRI showed cervical disc herniation. He underwent emergency surgery consisting of removal of herniated disc and anterior fusion. We emphasize that there is a possibility of acute progression of paralysis secondary to nontraumatic enlargement of cervical disc herniation.

• Journal of Veterinary Clinics
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• v.20 no.1
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• pp.52-58
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• 2003

Fifteen dogs with clinical signs of paraparesis, paraplegia and urinary dysfunction were referred to Veterinary Medical leaching Hospital, College of Veterinary Medicine, Konkuk University. According to physical and neurologic examination, survey radiograph and myelography, these patients were diagnosed as thoracolumbar intervertebral disc disease. All of them were treated with medical (prednisolone or carprofen, antibiotics), acupuncture (Ji Zhong, Bai Hui, Zhong Shu, Pang Guang Shu, Zu San Li, Huan Tiao) and physical therapy (hydrotherapy, thermotherapy, massage, manipulation, swimming). Of twelve patients were recovered of neurologic deficits within 21 days after the onset of treatment. However, three dogs were not resolved, which were found to have other spinal cord disease concomitantly. All of patients showed normal urination after treatment. Until 21 months after treatment, there were no recurrence in twelve patients. This study indicated that the conservative therapy could be effectively managed in paraparesis or paraplegia and urinary dysfunction which caused by intervertebral disc disease.

• Journal of the Korean Orthopaedic Association
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• v.56 no.2
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• pp.178-182
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• 2021

Spinal hematomas are a rare but serious complication that is typically observed in the epidural space. Spinal subdural hematomas are a dangerous clinical situation because of their potential to cause significant compression of the neural elements and can be mistaken easily for spinal epidural hematomas. This paper reports a case of a severe whole lumbar subdural hematoma after a simple epidural injection that was treated with surgical decompression with excellent clinical results.

• Annals of Clinical Neurophysiology
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• v.1 no.1
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• pp.19-25
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• 1999

Background & Objectives : In cerebral palsy, spastic paraplegia is one of the most crippling motor manifestations. Reducing the spasticity may improve gait and decrease the incidence of lower-extremity deformities. The spasticity may result from abnormally increased afferent signals via dorsal roots onto interneurons and anterior horn and spreading of reflex activation to other muscle groups. To assess the influence of dorsal rhizotomy to spasticity, the authors analyzed five cerebral palsy patients with spastic paraplegia. Methods : The operation entailed and L1-2 laminectomy, ultrasonographic localization of conus medullaris and identification of lumbosacral dorsal roots. The innervation patterns of each dorsal root were examined by electromyography (EMG) responses to electrical stimulation. Tetanic stimulation was applied to individual rootlets of each root after reflex threshold was determined. the reflex responses were graded and rootlets producing high grade response were selected and cut. Short-term postoperative evaluations were performed. Results : Intraoperative EMG monitoring was satisfactorily performed in all five cases. One month after the operations, all patients showed greatly reduced spasticity which was measured by the instrumental gait analysis. Bilateral knee and ankle jerks were normalized and tip-toe gait with scissoring disappeared in all patients. Conclusion : Intraoperative EMG monitoring seems useful for the selective dorsal rhizotomy to reduce spasticity.

• Archives of Reconstructive Microsurgery
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• v.15 no.2
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• pp.65-69
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• 2006

Purpose: We performed vastus lateralis (VL) muslce or myocutaneous flap for close of the trochanteric skin defect usually happened in paraplegia and report our 6 cases. Materials and Methods: Between March 2004 and August 2005 we performed 4 cases of VL muscule flap with skin graft and 2 cases of VL myocutaneous flap for close of the trochanteric skin defect in 6 paraplegia patients. There were 5 men and 1 woman and mean age was 52.2 years and mean diameters of skin defect was $8.3{\times}8.3\;cm$. The mean follow up period was 18 months. The survival of flap, complications, healing time and patient's satisfaction were evaluated. Results: All flaps were survived except 1 case of margin necrosis. In 2 cases, blood-serous discharges were continued after operation which might be due to dead space and treated with $2{\sim}3$ times debridement and delayed close. Mean time to heal the skin defect was 7.6 weeks. No infection and recurrence in follow up periods. Cosmetic results judged by patients are that 3 cases are good and 3 cases are fair. Conclusion: VL muscle and myocutaneous flap is good treatment method among the numerous methods in treatment-failed cases of trochanteric skin defects of paraplegia patients. This surgical procedure is simple, constant blood supply, good pliability, cosmetic results and also appliable to other skin defect of pelvis girdle like sacrum and ischium.

• Journal of Korean Neurosurgical Society
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• v.40 no.4
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• pp.273-276
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• 2006

Although cavernous angioma itself is not rare, the epidural spinal localization is uncommon and makes preoperative differential diagnosis difficult. An extraordinary case of a thoracic epidural cavernous angioma in very young age, causing sudden paraplegia is presented. Only 79 cases have been reported in the literatures and among them, this kid was the youngest. A 23-month-old boy was referred to us with a 2-day history of sudden both lower limb weakness. Two days before admission, he got up at morning and was unable to stand and even to move the legs. MRI revealed an epidural mass surrounding spinal cord associated with cord compression at the level of the C5 through T3. Through posterior approach with exposure of C6 to T3 level, the hematomatous mass was removed subtotally due to intraoperative bleeding and its ventral location. After the first operation, the weakness of bilateral lower extremities was improved so as to move gainst the gravity. But the next day, the limb weakness was aggravated as same as preoperative status due to mass effect of new hematoma. The second operation was performed to remove the hematoma and to control the bleeding focus. Several weeks later, the limb weakness was improved and he was able to walk. The literatures about spinal cavernous angioma are reviewed.

• Journal of Korean Medicine Rehabilitation
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• v.19 no.4
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• pp.219-228
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• 2009

Objectives : This study was performed to report the effect of oriental medical treatment in the paraplegia and pain after epidural nerve block. Methods : A 39-year-old woman who underwent epidural nerve block at a local clinic was admitted with motor weakness of lower limbs, severe lower radiating pain and decreased sensation when voiding and defecating. We treated her by acupuncture, a herbal medicine, a bee venom injection, moxibustion and cupping treatment and physical theraphy from 11th July 2008 to 14th October 2008. Results : After treatment, most symptoms decreased, VAS(Visual Analog Scale) score changed from 9 to 2. and examinated muscle power changed from 2-3 to 4-5. Conclusions : Our study suggested that oriental medical treatments are significantly effective in the paralplegia and pain after epidural nerve block. And further studies will be aid to identify underlying mechanism of treatment.