• Title/Summary/Keyword: quadriparesis

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A Case of Tuberculous Meningitis Combined with Acute Cervical Epidural Abscess and Cervical Spondylitis (급성 경추 경막외 농양 및 경추척추염과 동반된 결핵성 수막염 1예)

  • Lee, Dong Kuck
    • Annals of Clinical Neurophysiology
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    • v.4 no.2
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    • pp.140-145
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    • 2002
  • Neurologic sequelae of tuberculous meningitis include hemiparesis, paraparesis, quadriparesis, aphasia, developmental delay, dementia, blindness, visual field defect, deafness, cranial nerve palsies, epilepsy, and hypothalamic and pituitary dysfunction. But cervical epidural abscess and cervical spondylitis are rare. A 64-year-old woman who was diagnosed as tuberculous meningitis presented a severe neck pain and stiffness after 3 weeks of anti-tuberculous medication. Electromyography and cervical X-ray showed a cervical spondylosis with polyradiculopathy. But cervical MRI showed an acute cervical epidural abscess and mild cervical spondylitis. After continuous anti-tuberculous medication with supportive care, she showed a slow clinical improvement. But about 1 month of anti-tuberculous therapy, she presented a more aggravation of neck pain, neck stiffness, radicular pain, and neck motion limitation. Follow-up cervical MRI showed an more advanced cervical spondylitis. Afterthen she has recovered slowly by cervical laminectomy with posterior stabilization and continuous anti-tuberculous medication.

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Bickerstaff's Brainstem Encephalitis with Guillain-Barr$\acute{e}$ Syndrome Presenting Severe Paralytic Ileus (길랑-바레증후군이 동반된 Bickerstaff 뇌줄기뇌염에서 나타난 심한 마비성 장 폐색)

  • Park, Min-Su
    • Annals of Clinical Neurophysiology
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    • v.11 no.1
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    • pp.33-36
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    • 2009
  • Bickerstaff's brainstem encephalitis (BBE) is an autoimmune central nervous system disorder. It can occur in more limited forms and may overlap with Guillain-Barr$\acute{e}$ syndrome (GBS). A 49-year-old female presented with rapidly progressive paralytic ileus, urinary retention, deep drowsiness, ophthalmoplegia, dysarthria, ataxia, quadriparesis and hyporeflexia after viral meningitis. She was diagnosed as BBE with GBS and treated with immunoglobulin. She was completely recovered after 1 month. It is a rare case of BBE overlapping with GBS presenting with severe paralytic ileus.

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A case report of Sikgwol treated with Gamiyukgunja-tang (가미육군자탕(加味六君子湯) 투여 후 치료된 식궐(食厥) 환자 치험 1례)

  • Kim, Jun-Hong;Kim, Tae-Yong;Shin, Hyeon-Su;Park, Jun-Beom
    • The Journal of Internal Korean Medicine
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    • v.26 no.3
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    • pp.715-719
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    • 2005
  • The chief symptoms of Sikgwol are confusion, aphasia and quadriparesis. Sikgwol is caused by overeating in instances of deficiency syndrome of the stomach. The symptoms of Sikgwol are similar to those caused by cerebral vascular injury. After medication with Gamiyukgunja-tang and acupunture therapy, the patient symptoms improved rapidly within the first week. Results support the clinical efficacy of Gamiyukgunja-tang for Sikgwol.

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Craniovertebral Junction Tuberculosis with Atlantoaxial Dislocation : A Case Report and Review of the Literature

  • Lee, Dae-Kyu;Cho, Keun-Tae;Im, So-Hyang;Hong, Seung-Koan
    • Journal of Korean Neurosurgical Society
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    • v.42 no.5
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    • pp.406-409
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    • 2007
  • Craniovertebral junction (CVJ) tuberculosis is a rare disease, potentially causing severe instability and neurological deficits. The authors present a case of CVJ tuberculosis with atlantoaxial dislocation and retropharyngeal abscess in a 28-year-old man with neck pain and quadriparesis. Radiological evaluations showed a widespread extradural lesion around the clivus, C1, and C2. Two stage operations with transoral decompression and posterior occipitocervical fusion were performed. The pathological findings confirmed the diagnosis of tuberculosis. Treatment options in CVJ tuberculosis are controversial without well-defined guidelines. But radical operation (anterior decompression and posterior fusion and fixation) is necessary in patient with neurological deficit due to cord compression, extensive bone destruction, and instability or dislocation. The diagnosis and treatment options are discussed.

Catastrophic Intramedullary Abscess Caused by a Missed Congenital Dermal Sinus

  • Dho, Yun-Sik;Kim, Seung-Ki;Wang, Kyu-Chang;Phi, Ji Hoon
    • Journal of Korean Neurosurgical Society
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    • v.57 no.3
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    • pp.225-228
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    • 2015
  • Congenital dermal sinus (CDS) is a type of occult spinal dysraphism characterized by a midline skin dimple. A 12-month-old girl presented with fever and ascending quadriparesis. She had a midline skin dimple in the upper sacral area that had been discovered in her neonatal period. Imaging studies revealed a holocord intramedullary abscess and CDS. Overlooking CDS or misdiagnosing it as benign sacrococcygeal dimple may lead to catastrophic infection and cause serious neurological deficits. Therefore, further imaging work-up or consultation with a pediatric neurosurgeon is recommended following discovery of any atypical-looking dimples in the midline.

A Case of Critical Illness Polyneuropathy and Myopathy (중환자 다발신경병증 및 근육병 1예)

  • Moon, So-Young;Lee, Sang-Soo;Lee, Sung-Hyun;Shin, Dong-Ick
    • Annals of Clinical Neurophysiology
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    • v.9 no.1
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    • pp.19-22
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    • 2007
  • Critical illness polyneuropathy (CIP) and critical illness myopathy (CIM) occur commonly in the patients who have been on mechanical ventilation for more than 1 week. Even in some patients diagnosed with CIP, an underlying myopathy may be the primary cause of the muscle weakness. The cormorbid status of CIP and CIM is called as critical illness polyneuropathy and critical illness myopathy (CIPNM). We describe a 56-year-old man with acute quadriparesis and areflexia after systemic inflammatory response syndrome. The diagnosis of CIPNM is important to avoid unnecessary investigations and unreasonably pessimistic prognosis. Electrophysiologic studies are essential for the diagnosis and for planning further clinical management.

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Descending Necrotizing Mediastinitis Combined with Cervical Spine Injury (경추 손상과 동반된 하행성 괴사성 종격동염)

  • 금동윤;양보성
    • Korean Journal of Bronchoesophagology
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    • v.7 no.1
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    • pp.76-79
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    • 2001
  • A 60-year-old male was admitted due to cervical spine injury (C7-T1 fracture dislocation) and quadriparesis after slip down. During conservative management in department of neurologic surgery, he complainted of fever, dyspnea, neck swelling. Follow up cervicothoracic CT revealed abscess pocket in paraglottic, retropharyngeal, anterior cervical spaces and mediastinum. Also noted bilateral pleural effusions. Under impression of descending necrotizing mediastinitis (DNM). cervical drainage and bilateral chest tube insertion was performed immediately. On next day. mediastinal drainage through mediastinotomy was performed with careful handling of cervical spine. Escherichia coli was identified in bacteriologic culture. Wire fixation of dislocated C7-T1 spine through Posterior approach was performed on 30th days after mediastinotomy. Right chest tube was removed on 40th days. At now, the patient is on rehabilitation and physical training program. DNM is relatively rare, but lethal disease with high mortality. Immedate and sufficient mediastinal drainage is essential in treatment.

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Bilateral Simultaneous Hypertensive Intracerebral Hemorrhages in Both Thalami

  • Choi, Jeong-Wook;Lee, Jung-Kil;Kim, Jae-Hyoo;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • v.38 no.6
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    • pp.468-470
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    • 2005
  • The recurrent intracerebral hemorrhage[ICH] in hypertensive patients is not an unusual event, but the simultaneous occurrence of multiple ICH is rare. A 70-year-old woman presented with bilateral simultaneous hypertensive intracerebral hemorrhages in both thalami. The complaints of the patient were unconsciousness [semicomatose mental state] and quadriparesis Grade II. The patient was managed conservatively. At discharge, the patient was awake [drowsy mental state], but Grade III according to the Glasgow Outcome Score. This paper reviews the clinical relevance, possible etiology, and treatment of bilateral thalamic ICH.

X-linked Charcot-Marie-Tooth disease case with a novel missense mutation in GJB1 gene

  • Lee, Jong-Mok;Shin, Jin-Hong
    • Journal of Genetic Medicine
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    • v.15 no.2
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    • pp.107-109
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    • 2018
  • X-linked Charcot-Marie-Tooth disease type 1 (CMTX1) is caused by the mutation in GJB1 gene, characterized by the transient central nervous system involvement and long standing peripheral polyneuropathy which does not fulfill the criteria of demyelination or axonopathy. We describe a 37-year-old man with progressive bilateral leg weakness since his early teen. He suffered transient right hemiparesis, followed by quadriparesis at 14 years of age. When we examined him at 37 years of age, he presented a distal muscle weakness on lower extremities with a sensory symptom. The nerve conduction study demonstrated a motor conduction velocity between 26 and 49 m/s. The whole exome sequencing revealed a novel variant c.136 G>A in GJB1. This report will raise awareness in this rare disease, which is frequently misdiagnosed early in its course.

Acute Motor Axonal Neuropathy Combined with Acute Disseminated Encephalomyelitis (급성 파종성 뇌척수염에 동반된 급성 운동 축삭형 신경병증)

  • Yu, Seong-Yong;Lim, Eui-Seong;Shin, Byoung-Soo;Seo, Man-Wook;Kim, Young-Hyun
    • Annals of Clinical Neurophysiology
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    • v.6 no.1
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    • pp.52-56
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    • 2004
  • Acute motor axonal neuropathy (AMAN) is a subtype of Guillain-Barre syndrome and characterized by selective involvement of motor fibers. Acute disseminated encephalomyelitis (ADEM) is a demyelinating disease of central nervous system. The coincidence of central and peripheral nervous system involvement has been reported rarely. We described a 37-year-old male patient presented with fever and altered consciousness. The examination of cerebrospinal fluid and brain magnetic resonance imaging was compatible with acute disseminated encephalomyelitis. Several days after admissionb his mentality was improved but quadriparesis, multiple cranial neuropathies, and areflexia were detected. Electrophysiologic studies suggested axonal form of motor dominant polyneuropathy. We report a case of acute motor axonal neuropathy combined with ADEM. We consider that this case is an example of simultaneous immunologic process to the common pathogenic epitope of central nervous system and peripheral nervous system.

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