• Title/Summary/Keyword: Spastic paraparesis

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A Case of Cerebral Adrenomyeloneuropathy with Extensive Cerebral Lesions (광범위한 대뇌병터를 보인 대뇌형 부신척수신경병증 1예)

  • Kim, Hyun-Jung;Min, Ju-Hong;Lee, Kwang-Woo
    • Annals of Clinical Neurophysiology
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    • v.9 no.2
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    • pp.97-101
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    • 2007
  • We report a 31-year-old man with cerebral adrenomyeloneuronopathy variant, who presented as progressive gait disturbance. He had spastic paraparesis, hyperreflexia without Babinski's sign and sensory symptom. No adrenal insufficiency was noted. Brain MRI showed extensive high signal intensities in bilateral temporal lobes and posterior periventricular white matter in T2 weighed imaging without cerebrospinal fluid abnormality. His nerve conduction study showed sensorimotor demyelinating polyneuropathy and the level of saturated very-long-chain fatty acids was high in his plasma, although neuropsychological test was normal.

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Cervico-Thoracic Intradural Extramedullary Lipoma

  • Jun, Young-Hoon;Kim, Se-Hoon;Kim, Sang-Dae;Lim, Dong-Jun
    • Journal of Korean Neurosurgical Society
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    • v.38 no.4
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    • pp.316-319
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    • 2005
  • A 42-year-old female was admitted with an 11-month history of progressive spastic paraparesis and ataxic gait. Magnetic resonance imaging showed intraspinal space occupying lesion compressing the spinal cord posteriorly, located from C5 to T2 with iso to high signal intensity at T2-weighted images and high signal intensity at T1-weighted images. The patient underwent surgery for decompression of the affected spinal cord because of the progressive neurological deficit. At surgery, the lesion was intradural extramedullary lipoma composed with mature adipose tissue. Partial tumor removal to decompress the neural structures and laminoplasty to avoid postoperative instability and deformity were performed. Postoperatively, she demonstrated improvement in paraparesis and was able to walk without assistance. Though attempts to decrease the size of or even to totally remove a lipoma are not required to achieve satisfactory results and carry considerable risks of surgical morbidity, a careful and limited decompression of the affected spinal cord through a partial removal of the tumor and laminoplasty could result in a significant neurological improvement.

A Case of Thoracic Vertebral Chondroblastoma, Treated with 3-D Image Guided Resection and Reconstruction

  • Lee, Yoon-Ho;Shin, Dong-Ah;Kim, Keung-Nyun;Yoon, Do-Heum
    • Journal of Korean Neurosurgical Society
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    • v.37 no.2
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    • pp.154-156
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    • 2005
  • We present a case of chondroblastoma in the thoracic vertebra. A 40-year-old patient with upper back pain and lower extremity weakness was admitted to our clinic. On neurological examination, the patient exhibited lower extremity spastic paraparesis. Magnetic resonance imaging revealed a mass infiltrating the 7th thoracic vertebra and its adjacent structures with concomitant compression of the epidural space. After right upper lung tuberculoma was resected through the transthoracic approach, T7 total corpectomy was done with anterior stabilization using a MESH cage and T7 rib bone graft. Two weeks after the first operation, remained part of vertebra was removed and posterior stabilization was performed using a pedicle screw fixation and cross linkage bar with the assistance of the navigation system. The final pathologic diagnosis of the vertebral lesion was benign chondroblastoma.

Atypical Presentation of Spinal Tuberculosis Misadiagnosed as Metastatic Spine Tumor

  • Kim, Dong-Woo;Choi, Hyu-Jin;Kim, Hyung-Dong;Song, Young-Jin
    • Journal of Korean Neurosurgical Society
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    • v.39 no.6
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    • pp.451-454
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    • 2006
  • We present a case of a 68-year-old female with an atypical form of spinal tuberculosis, which involved posterior elements with multiple foci in two noncontiguous vertebral levels. The lesions caused spastic paraparesis and urinary hesitation. There was no evidence of pulmonary or other extrapulmonary tuberculous disease. Based on clinical and radiographic findings, this atypical spinal tuberculosis was preoperatively misdiagnosed as metastatic spine tumor. The histopathologic finding confirmed tuberculosis and the patient was treated successfully with surgery and antituberculous therapy. In case of a spinal lesion of unknown origin, it is important to be aware that atypical spinal tuberculosis can mimic metastatic spine tumor and tuberculosis should always be considered.

A Case of Korean Medicine Treatments Including Chuna Therapy in Lower Extremity Weakness and Gait Disturbance Due to Lumbar Disk Herniation and Spinal Stenosis (요추 추간판 탈출증 및 척추관 협착으로 인한 하지 근력 저하 및 보행 장애 환자에 대한 추나요법을 포함한 한방복합치료 치험 1예)

  • Jung, Su-Eun;Park, Song-Mi;Cho, Sung-Woo
    • Journal of Korean Medicine Rehabilitation
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    • v.31 no.2
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    • pp.99-108
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    • 2021
  • The study reports the clinical case of a patient with lower extremity weakness and gait disturbance treated with Korean medicine treatments including Chuna therapy. The patient suffered lower extremity weakness and gait disturbance with diagnosis of lumbar disk herniation and spinal stenosis. As a treatment, the doctor applied Chuna therapy, herbal medicine, acupuncture, pharmacopuncture, cupping and moxa. The effect of treatment was evaluated by numeral rating scale (NRS), self-walkable distance, functional independence measure (FIM), Oswestry disability index (ODI) and manual muscle test (MMT). NRS decreased from 6 to 4 at the leg. Self-walkable distance increased from 0 m to 10 m, FIM increased 85 to 96 points while ODI decreased 64% to 54%. MMT of hip flex and knee extension improved from grade 3+, grade 3 to grade 4, respectively. Korean medicine treatment can be effective for patients who suffer lower extremity weakness and gait disturbance due to lumbar disk herniation and spinal stenosis. Further clinical studies are required to verify these findings.

Magnetic Resonance Imaging Features of Suspected Acute Spinal Cord Infarction in Two Cats (두 마리 고양이에서 발생한 급성 척수 경색의 자기 공명 영상학적 진단 증례)

  • Jung, Sun-Young;Kim, Bo-Eun;Ji, Seo-Yeoun;Yoon, Jung-Hee;Choi, Min-Cheol
    • Journal of Veterinary Clinics
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    • v.30 no.4
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    • pp.320-323
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    • 2013
  • Spinal cord infarction is becoming recognized as an important cause of acute myelopathy in cats. Although the definitive diagnosis is confirmed through postmortem histopathologic examination, MR imaging features provide valuable informations for the diagnosis of spinal cord infarction. The aim of this report is to describe MR findings of acute spinal cord infarction in two cats and to evaluate usefulness of low field MRI (0.3Tesla) as a potential diagnostic tool of acute spinal cord infarction. A cat (unknown age, neutered male mixed breed cat) was referred one day after the acute onset of non-ambulatory spastic tetraparesis and the other cat (a 9-year-old, neutered female domestic short hair cat) was presented due to the acute onset of non-ambulatory paraparesis and one day later paraplegia. The lesions of the MR images were shown on the spinal cord parenchyma over C2 to C6 in case 1 and L2 to L5 in case 2. The MR images in these two cases were characterized by focal intramedullary lesions, mainly involving grey matter which were hyperintense T2 weighted and FLAIR images and hyperintense on DWI and hypointense on ADC map. The MR findings in both cases were highly suggestive of acute spinal cord infarctions, based upon previous reported small animal cases and human cases. In conclusion, based on MR features, together with the history and clinical examination findings, MRI modality can be used as an antemortem tool for the diagnosis of acute spinal cord infarction in cats.

Characteristic MR Imaging Features and Serial Changes in Adult-Onset Alexander Disease: A Case Report (성인형 알렉산더병의 자기공명영상 소견 및 추적 관찰상의 변화: 증례 보고)

  • Ha Yun Oh;Ra Gyoung Yoon;Ji Ye Lee;Ohyun Kwon;Woong-Woo Lee
    • Journal of the Korean Society of Radiology
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    • v.84 no.3
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    • pp.736-744
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    • 2023
  • Adult-onset Alexander Disease (AOAD) is a rare genetically determined leukoencephalopathy that presents with ataxia, spastic paraparesis, or brain stem signs including speech abnormalities, swallowing difficulties, and frequent vomiting. The diagnosis of AOAD is frequently proposed based on the findings on MRI. We demonstrate two cases (37-year-old female and 61-year-old female) with characteristic imaging findings and changes in follow-up MRI in patients with AOAD, which were confirmed via glial fibrillary acidic protein (GFAP) mutation analysis. On MRI, the typical tadpole-like brainstem atrophy and periventricular white matter abnormalities were noted. The presumptive diagnoses were made based on the typical MRI appearances and, subsequently, confirmed via GFAP mutation analysis. Follow-up MRI demonstrated the progression of atrophy in the medulla and upper cervical spinal cord. Our report could help raise awareness of characteristic MRI findings of AOAD, thus helping clinicians use GFAP analysis for AOAD diagnosis confirmation.