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.

Citations

• 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
Carpal tunnel syndrome (CTS) and tarsal tunnel syndrome (TTS) are thought to share a similar pathophysiology,compression of the median and plantar nerve by the carpal tunnel and flexor retinaculum. A few reports introduced the relationshipbetween idiopathic CTS and TTS without definite evidence of coexistence. The current study was designed to analyze theelectrophysiologic characteristics of combined idiopathic CTS and TTS by comparing with each idiopathic CTS or TTS.Methods: We retrospectively collected patients with combined idiopathic CTS and TTS (CTS-TTS group) from June 2001 toFebruary 2009. Patients with each idiopathic CTS or TTS were collected as controls. Electrophysiologic data of median and plantarnerves were compared between CTS-TTS group and controls. Results: CTS-TTS group was composed of 31 patients. Control groupof each CTS or TTS were 50 CTS and 49 TTS patients. In comparison of median nerve conduction study between CTS-TTS groupand CTS control group, decreased compound muscle action potential amplitude (p<0.001), decreased median sensory nerve actionpotential amplitude (p<0.001) and sensory nerve conduction velocity at finger stimulation (p=0.013) were prominent in CTS-TTSgroup. Decreased medial plantar sensory nerve action potential amplitude (p=0.034) was indicated when CTS-TTS groups and TTScontrol group were compared. Conclusions: If the electrophysiology study of patients with CTS or TTS was suggestive of severe degreeof nerve injury, concerns about the possibility of combined CTS and TTS would be helpful.

Background
Carpal tunnel syndrome (CTS) and tarsal tunnel syndrome (TTS) are thought to share a similar pathophysiology,compression of the median and plantar nerve by the carpal tunnel and flexor retinaculum. A few reports introduced the relationshipbetween idiopathic CTS and TTS without definite evidence of coexistence. The current study was designed to analyze theelectrophysiologic characteristics of combined idiopathic CTS and TTS by comparing with each idiopathic CTS or TTS.Methods: We retrospectively collected patients with combined idiopathic CTS and TTS (CTS-TTS group) from June 2001 toFebruary 2009. Patients with each idiopathic CTS or TTS were collected as controls. Electrophysiologic data of median and plantarnerves were compared between CTS-TTS group and controls. Results: CTS-TTS group was composed of 31 patients. Control groupof each CTS or TTS were 50 CTS and 49 TTS patients. In comparison of median nerve conduction study between CTS-TTS groupand CTS control group, decreased compound muscle action potential amplitude (p<0.001), decreased median sensory nerve actionpotential amplitude (p<0.001) and sensory nerve conduction velocity at finger stimulation (p=0.013) were prominent in CTS-TTSgroup. Decreased medial plantar sensory nerve action potential amplitude (p=0.034) was indicated when CTS-TTS groups and TTScontrol group were compared. Conclusions: If the electrophysiology study of patients with CTS or TTS was suggestive of severe degreeof nerve injury, concerns about the possibility of combined CTS and TTS would be helpful.