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.
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
A 73-year-old man with progressive quadriparesis was diagnosed as Guillain-Barré syndrome. On the 6th hospital day, thepatient complained of sudden chest discomfort. The blood test and echocardiography suggested myocardial injury, and acutemyocardial infarction was considered. However, coronary angiography displayed no vascular lesion, and the electrocardiographyand echocardiogram showed marked improvement 14 days later. We concluded the patient had a reversible cardiomyopathywhich is a rare complication of Guillain-Barré syndrome.
Background Tarsal tunnel syndrome (TTS) is an entrapment neuropathy that occurs in the ankle. Previous studies reportedthat this disease was due to physiologic factors and structural lesions in the ankle or foot. The authors investigated the causativefactors of TTS and their frequency via operative findings. The diagnostic value of MRI was also evaluated based onthe concordance between the operative findings and the MRI findings. Methods: This study was performed in retrospectiveby using medical record of the patients who underwent operations with TTS from August 2003 to May 2010. Physical examination,nerve conduction study, and MRI were conducted on patients who visited department of neurology or orthopedicsurgery due to pain and sensory abnormality of their ankle and foot. Results: 34 patients underwent the operation. Ganglionaccounted for the largest portion of the operative findings. In addition, varicose veins, intrinsic foot muscle hypertrophy, tenosynovitis,and fascia thickening were mainly observed. Of the 34 patients, 33 patients underwent pre-operative MRI, of whom18 patients showed MRI findings consistent with the operative findings. Conclusions: Space-occupying lesions accounted forthe majority of the causative factors in TTS patients who underwent the surgical treatment. In this study, the MRI appeareduseful for identifying causes of TTS.
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