Neurological complications attributed to coronavirus disease-19 (COVID-19) infection have been reported including acute disseminated encephalomyelitis, Guillain-Barré syndrome, and so on. Herein, we report a 49-year-old woman presented with acute encephalopathy and paraplegia simultaneously after COVID-19 infection. Brain magnetic resonance imaging (MRI) showed symmetric hyperintense basal ganglia lesions on T2-weighted imaging. Cerebrospinal fluid pleocytosis, motor axonal neuropathy and enhancement of conus medullaris nerve roots on spine MRI were observed. We treated her with high-dose corticosteroid and intravenous immunoglobulin.
Background Pain and autonomic dysfunction are prominent symptoms in some patients with carpal tunnel syndrome (CTS). Infrared thermography (IRT) has been used to evaluate CTS by measuring the cutaneous temperature and sympathetic vasomotor function.
Methods This study enrolled the 66 hands of 33 subjects, some of which had clinical CTS and the others were healthy. The enrolled patients completed the Boston Carpal Tunnel Questionnaire (BCTQ) and Historical-Objective scale, and underwent nerve conduction studies (NCSs) and IRT. Skin temperature was measured at the fingertips and the thenar and hypothenar regions in each hand. We analyzed (1) the correlations between self-reported severity, physician-assessed severity, and test results, and (2) the sensitivity and specificity of IRT in diagnosing CTS.
Results No significant correlation was observed between the results of the BCTQ, NCS, and IRT. IRT had a low sensitivity and high specificity in diagnosing CTS.
Conclusions IRT cannot replace NCS in diagnosing CTS, nor did it provide an advantage in combination with NCS. However, lower temperatures at the median nerve in some hands with moderate-to-severe CTS suggested the involvement of sympathetic nerve fiber function. Follow-up studies with a larger-scale and complementary design are required to elucidate the relationships.
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Infrared medical thermography, medical applications, and its basic principles: A review Ali Faisal Abdulkareem, Auns Qusai Hashim, N. Aldahan, A.J. Ramadhan BIO Web of Conferences.2024; 97: 00140. CrossRef
Background Acute transverse myelitis(ATM) is a group of disorders characterized by focal inflammation of the spinal cord and resultant neural injury. It can be diagnosed by Transverse Myelitis Consortium WorkingGroup(TMCWG) criteria. But there are some cases which were not satisfied with idiopathic ATM criteria, both clinically and radiologically, especially in acute stage. So we analyzed 27 cases retrospectively, which were diagnosed as idiopathic ATM.
Methods All the records of the patients at Gil Medical Center with a diagnosis of idiopathic ATM from 2001 to 2005 were reviewed. And clinical manifestations including neurological examination, radiologic features and cerebrospinal fluid (CSF) findings were analyzed.
Results Among the patients(20 men and 7 women; mean age, 45.3 years), 11 cases could not be diagnosed as idiopathic ATM according to the TMCWG criteria ; 6 cases did not have well marginated upper sensory level and 5 cases were not satisfied with spinal cord inflammation.
Conclusions Although most cases of suspected idiopathic ATM were suitable for TMCWG criteria, some cases were not satisfied with this diagnostic criteria, especially in acute stage. Subsequent study might be needed to evaluate the reliability and clinical application of the criteria.
Magnetoencephalography (MEG), the measurement of magnetic field produced by neuronal current associated with normal and pathologic brain activities, is a totally noninvasive method for localizing functional regions of the brain. During the past several years, may clinical research centers are working to expand various fundamental functional brain regions, which can be easily localized, as well as to characterize magnetic abnormalities which accompany a wide variety of cerebral disease. At present, MEG is used in a number of clinical centers throughout the world for the presurgical functional localization of eloquent cortex, and for the non-invasive localization of epileptiform activity. And also, non-invasiveness means that it can be used for screening and repetitive of follow-up measurement without concern for adverse effects. As procedures for activating various functional brain regions are standardized, and as the effects of specific cerebral disease on the MEG are carefully documented in controlled studies, the number of routine neurological applications for MEG will increase significantly. In this paper, the basic principles of MEG are reviewed briefly with its clinical application to neurologic disease.
Although the etiology and pathogenesis of amyotrophic lateral sclerosis(ALS) in unknown, increasing evidence support a role autoimmune machanisms in motor neuron degeneration. The coexistence of immune disease in ALS supports that an altered immune system may contribute to disease pathogenesis. A 55-year-old woman was admitted to our department due to dysarthria and gait disturbance. On physical and neurologic examination, she showed thyroid enlargement, tongue atrophy, muscle weakness, fasciculation, and increased deep tendon reflex. The electrophysiological studies are compatible with motor neuron disease. Cytological findings of thyroid were compatible with hashimoto's thyroiditis. Thus, we report a case of ALS combined with Hashimoto's thyroiditis. And the simultaneous presentation with ALS and Hashimoto's thyroiditis led us to consider whether this was simply a chance association or not.
Background and Objectives: A nerve conduction study (NCS) has been known as a useful method to evaluate thetherapeutic effect of operation in carpal tunnel syndrome (CTS). To evaluate the temporal relationship between symptomaticand electrophysiological improvement, we compared the preoperative symptoms and electrophysiological resultswith postoperative those.Methods: We analyzed the NCS changes before and after minimal release of carpal tunnel in 26 patients (34 hands)with CTS. The time of postoperative symptomatic changes, postoperative electrophysiological changes and temporalrelationship between symptomatic and electrophysiological changes were evaluated.Results: The mean age was 49
The occurrence of polyneuropathy in association with monoclonal gammopathy of undetermined significance(MGUS) is quite common. However, reports of MGUS associated cranial neuropathies are rare. A 63 year-old womenwas presented with diplopia and swallowing difficulty. Neurological examination showed limitation of abduction ofright eye, right peripheral facial palsy, decreased hearing and gag reflex, left side deviation of uvula, and decreasedDTR. Sensorimotor polyneuropathy were observed with elctrophysiological studies. Protein and immunoelectrophoresisrevealed IgG
Polyneuropathy that is associated with monoclonal gammopathy of undetermined significance (MGUS) similar to chronic inflammatory demyelinating polyneuropathy (CIDP) has been reported before, whereas a connection to acute inflammatory demyelinating polyneuropathy (AIDP) has not been. A 52 year-old man was presented with ascending paralysis beginning 1 day ago. Neurological examinations showed facial diplegia and decreased motor power and deep tendon reflexes in all extremities. On electrophysiologic study, sensorimotor polyneuropathy was observed. Proteinand immunoelectrophoresis revealed IgA
Meralgia paresthetica (MP) is a benign entrapment neuropathy which is characterized by sensory impairment and paresthesia in the cutaneous distribution of the lateral femoral cutaneous nerve. A 79-year-old woman presented with intermittent right inguinal burning sensation. The sensory nerve conduction study (NCS) showed decreased right sidesensory nerve action potential (SNAP) on lateral femoral cutaneous nerve compared to the contralateral one. Abdomino-pelvic CT showed bilateral huge renal cysts (The size of largest one on right side: about 6.2
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