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PubMed1975

[Paraplegia caused by closed injury of the dorso-lumbar joint without apparent primary vertebral lesion].

Paraplegia due to closed trauma of the lumbo-dorsal junction, without bony lesions are exceptional. The author reports a case due to rupture of the posterior ligements, without vertebral displacement on the first films, but which became complicated secondarily by dislocation, which it was necessary to reduce by open operation. It thus seems that there occurred during this accident a marked vertebral displacement reponsible for paraplegia which became spontaneously reduced thanks to muscle contraction, but which recurred secondarily following muscular relaxation. This case illustrates the necessity for repeated X Rays in cases of marked lumbar trauma even if the initial films appear normal.

Adult↗
PubMedDate not supplied

[Paraplegia complicating umbilical artery catheterization].

Two cases of definitive paraplegia following umbilical artery catheterization are reported. In both patients, the paraplegia can be attributed to a myelomalacia secondary to the thrombosis or embolization of the feeding arteries of the cord. The treatment by fibrinolytic agents was unsuccessful and the only therapeutic approach appears to be a preventive one. This prophylaxis would best be accomplished by limiting the indications and duration of umbilical artery catheterization.

Catheterization↗
PubMed2002

[Cerebral paraplegia due to blunt head injury].

Cerebral paraplegia due to traumatic brain injury is a very rare condition. We present a case study of a man who sustained a blunt head injury, sub-dural hematoma of the falx and dorsal paraplegia. Eventually, he recovered almost completely neurologically and functionally.

Craniocerebral Trauma↗
PubMed1992

[Acute paraplegia and intramedullary cavitation in a patient with pulmonary tuberculosis].

This 42-year-old male patient voluntarily discontinued treatment for lung TBC and twenty days later developed acute paraplegia. Magnetic resonance imaging (MRI) demonstrated a large intramedullary cavity extending from T2 to the conus medullaris. Having resumed anti-TBC treatment, the patient progressed favourably, despite any change in cavity size. Tuberculous meningitis may be complicated by the appearance of intramedullary cavities by two distinct mechanisms: 1) adhesive arachnoiditis at the skull base with obstruction of Luschka and Magendie foramina, followed by hydrocephalus and hydromyelia; and 2) spinal cord arachnoiditis with the development of arachnoidal and intramedullary cysts. In either case, symptoms are of late presentation. To the best of our knowledge, this is the first report in the literature of lung tuberculosis associated with syringomyelia but without basal arachnoiditis. Acute clinical presentation with paraplegia is exceptional.

Acute Disease↗
PubMed2003

[Functional prognosis of paraplegia due to cord ischemia: a retrospective study of 23 patients].

The functional prognosis of spinal cord infarct is not well known, complicating care of patients suffering from ischemic paraplegia. The aim of this study was to evaluate the clinical and functional outcome of patients with spinal cord infarct treated in rehabilitation centers in order to identify factors influencing functional outcome. We studied cases of non-trauma-related paraplegia treated between 1992 and 1999. Spinal compression and infectious and inflammatory myelopathy were excluded. Age, gender, cardiovascular risk factors, initial and final clinical findings according to the American Spinal Injury Association (ASIA/IMSOP) criteria, MRI findings, and initial urodynamic findings were analyzed. Two groups were identified regarding extension of the spinal cord infarct to the cone or not. Assessment of functional outcome was based on the Frankel classification, ambulatory ability, wheelchair use, and bladder control. Cases of spinal cord infarct were then classified according to extension to the cone or not, determined on the basis of initial clinical, MRI, and urodynamic findings. Twenty-three patients (19 males and 4 females) were selected for analysis. Mean age was 54 years, with no mortality during the follow-up period. At discharge, the group of nine patients whose infarct had not extended to the medullary cone had a significantly better motor recovery using the ASIA motor score (p<0.01). Patients whose infarct did not extend to the cone used wheelchairs less often, were more often in Frankel class D (p<0.05), and had normal bladder control more often (p<0.05) than patients whose infarct extended to the cone. Lack of extension to the medullary cone appeared to be a factor predictive of better functional outcome.

Adolescent↗
PubMed2004

Non-traumatic acute paraplegia caused by cervical disc herniation in a patient with sleep apnoea.

A 57-year-old man with obstructive sleep apnoea presented with acute progression of myelopathy into paraplegia resulting from cervical disc herniation at C4-C5 and C5-C6 levels. There was no associated history of trauma. Rapid progress to paraplegia from non-traumatic cervical disc herniation rarely occurs. Diagnostic and treatment modalities are discussed. The possible relationship between cervical myelopathy and sleep apnoea is also discussed.

Acute Disease↗
PubMed2005

[Acute paraplegia caused by hypertensive spinal epidural haematoma].

The hypertension is an uncommon cause in acute spinal epidural haematomas. The severe motor disability and need to emergency treatment to avoid the permanent neurological impairments underline its importance. Seventy-five year old male, admitted with acute paraplegia, numbness in the lower extremities and urinary incontinence for 4 hours. The neurological examination showed complete paraplegia, numbness from the below of thoracal 9 dermatomes, and loss of all sensory motor reflexes including anal reflexes. The blood pressure was 210/120 mm Hg on his admission. Thoracolomber magnetic resonance examinations detected an acute epidural haematoma, which was compressing to the cord. The patient underwent emergent laminectomy involving T 9 to L 2 and clots were removed with microsurgical technique. The patient was mobilized on the 3. and discharged from the hospital on the 7. postoperative day without neurological impairment. Although majority of the spontaneous spinal epidural haematomas is a recognized idiopathic condition, hypertension is much more commonly seen etiological factor than estimated. Early diagnosis, surgical decompression of the spinal cord and high dose corticosteroids might result in complete recovery.

Aged↗
PubMed2005

Acute paraplegia in a young adult long-evans rat resulting from T-cell lymphoma.

We describe an unusual case of acute paraplegia in a young adult (7.5-month-old) Long-Evans rat that resulted from a spontaneous T-cell lymphoma. At presentation, a neurologic exam revealed normal pelvic limb flexor reflexes, the absence of an anal reflex, and deep pain recognition. Radiographs did not identify any obvious spinal abnormality or osseous trauma, although the liver and spleen were prominent. Hematologic analysis disclosed leukocytosis with atypical lymphocytes. At necropsy, red, friable to gelatinous masses were found associated with the ventral aspect of the vertebral column at the levels of the thoracic and lumbar vertebrae. Impression smears of the mass revealed a monocytic cell population with cells averaging 7 to 10 microm in diameter and having scant cytoplasm and pleomorphic nuclei, characteristics consistent with a lymphoid neoplasm. Histologically, the neoplasm was unencapsulated, poorly demarcated and highly infiltrative, invading and effacing the bone marrow and epidural space of the vertebral column. Neoplastic cells also were identified in the femoral bone marrow, spleen, liver, iliac and sacral lymph nodes, and lung. Immunophenotyping showed the neoplasm to be of T-cell origin. Although the lymphoma did not invade the meninges of the spinal cord, its impingement on the central and peripheral nervous systems resulted in foci of Wallerian degeneration that contributed to the paraplegia. This case report highlights the importance of having lymphoma and leukemia among the differential diagnoses in cases of acute paralysis in rodents.

Animals↗
PubMed2006

[Abdominal massage as intervention for patients with paraplegia caused by spinal cord injury--a pilot study].

UNLABELLED: Patients with paraplegia caused by spinal cord injuries have to deal with the loss of the central nervous regulation of the bowel functions. The management of defaecation can take a lot of their daily time. To support the colon motility, different methods of abdominal massage are used in nursing practice. But a review of current international literature reveals, that there is still a lack of evidence for the effect of abdominal massage on defaecation. In order to prove this effect, a pilot study was conducted using a quasi-experimental design with time series and including seven patients with paraplegia caused by spinal cord injury. Data were collected over three weeks: one week before intervention, during the intervention week and one week after intervention. In the intervention week, the patients received a specific abdominal massage each morning before breakfast. Following outcome-criteria have been considered: frequency and duration of defaecation, amount and consistency of faeces as well as subjective perception of the massage and its effects. RESULTS: Some distinctive changes in the frequency and duration of defaecation could be registered over time. Most patients regarded the massage as a comfortable intervention that may have positive effects of the defaecation. Due to the pilot character of the study further research is necessary in order to validate these effects.

Abdomen↗
PubMed1991

Familial spastic paraplegia: an electrophysiological study of central sensory conduction pathways.

An electrophysiological assessment has been performed studying somatosensory, visual and auditory pathways in clinically affected and unaffected members from 4 pedigrees with the autosomal form of 'pure' familial spastic paraplegia (n = 32). In some members from 2 families, testing of all 3 sensory pathways showed abnormal results, even in those clinically unaffected. In another family, some had abnormal somatosensory and visual pathways, with no involvement of the auditory pathway. In a further family, the somatosensory and brainstem auditory pathways were abnormal, with sparing of the visual pathway. These findings indicate that the neuronal degeneration in familial spastic paraplegia extends beyond the spinal cord and involves the visual and auditory pathways. The differences between families, and the asymptomatic abnormalities in clinically unaffected members, suggest diversity in the expression of the genetic defect.

Evoked Potentials, Auditory, Brain Stem↗
PubMed1990

[An autopsy case of complicated form of spastic paraplegia with amyotrophy, mental deficiency, sensory impairment, and parkinsonism].

An autopsied case of complicated form of spastic paraplegia with many unusual clinical and pathological features is reported. Present case: a 31-year-old male. His parents are first cousins. Pregnancy and delivery had been unremarkable. Though he was mentally retarded, his physical development was normal. He was considered normal until age 10. He suffered from progressive disturbance in gait at the age of 11. He could not walk without assistance at the age of 22. Neurological examination revealed the following findings. He was obese and mentally deteriorated. Spastic paraplegia with increased tendon reflexes and pathological reflexes was prominent. Though slight sensory disturbance was present in the lower extremities, neither involuntary movement nor cerebellar ataxia was observed. In the age of late 20's, dementia, general muscular atrophy, and Parkinsonism developed. At the age of 30, he could not move by himself. He was apathic and indifferent, and showed forced laughing. Muscle tonus was flaccid because of general muscular atrophy and peripheral neuropathy. He died of acute gastric enlargement. Neuropathological findings were characterized by mal-development of the central nervous system (CNS) and the multisystem degeneration. There existed cerebral white matter hypoplasia with hypogenesis of the corpus callosum and ectopia of neurons of the cerebral and cerebellar cortex. Hypoplasia of melanin pigment was also observed in the remaining neurons of the substantia nigra and the locus ceruleus. Many neurons in the CNS included lipofuscin granules of variable shapes. Some of them showed clusters of several block-like inclusions which were green with luxol fast blue and cresyl violet stain.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Paraplegia, syringomyelia tarda and neuropathic arthrosis of the shoulder: a triad.

A casually related triad of syringomyelia tarda, postparaplegia with secondary neuropathic arthrosis of the shoulder has been presented. The development of neuropathic arthrosis of the shoulder has been presented. The development of neuropathic arthrosis of the shoulder in 2 of our paraplegic patients prompted us to look for a correlation and/or a common etiology. Paraplegia secondary to spinal cord injury could be causative or at least an associated factor in a delayed proximal syringomyelia. It is the syringomyelia which can lead to the neuropathic arthrosis in the upper extremity, mainly, in the shoulder. There is an interesting pathological association of paraplegia and syringomyelia with neuropathic arthrosis. Earlier awareness of any neurological changes in the upper extremity of the paraplegic patient could point to recognition of syringomyelic process and portend a tendency toward neuropathic arthrosis of the shoulder. This would require a high index of suspicion, and subsequently a preventative, protective orthopedic approach to minimize the usual functional deformity that occurs when this neuropathy involves the shoulder.

Adult↗
PubMed1990

[An autopsied case of alcoholic cerebellar degeneration with spastic paraplegia and neuropathy].

A 45 year-old-female was admitted to Kanagawa Rehabilitation Center because of marked spastic paraplegia. There was no family history of neurological diseases. She had been drinking a great excess of alcohol since twenty years of age. Though she noticed the unsteadiness of gait several years prior to the admission, she had not been examined. On admission neurological examination revealed pyramidal weakness of both legs, and slight sensory impairment in distal part of the lower extremities. But she had neither difficulty in speech nor abnormal findings in the upper extremities. Her mentality was well preserved. Though computed tomography revealed cerebellar cortical atrophy, no signs of cerebellar impairment could not be found except spastic paraplegia. Blood chemistry failed to reveal liver dysfunction. There was no pernicious anemia. These symptoms were almost stationary until her death. At the age of 53, she died of gastric cancer. Postmortem examination disclosed marked degeneration of cerebellum and spinal cord. Cerebellar cortical degeneration, which was characterized by involvement of all layers of the cortex, showed unique distribution. The lingula, central lobule, culmen, superior portion of declive, anterior lobules and anteromedial half of simple lobule were severely degenerated, while other lobules were spared excluding moderate degeneration in inferomedian portion of the hemisphere. These cortical degeneration was prominent much more in vermis than in hemisphere. There was a mild myelin pallor in the lamellar white matter and slight fibrous gliosis. In the dentate nucleus, there were moderate neuronal loss with gliosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Alcoholism↗
PubMed1990

[A case of suspected allergic granulomatosis and angiitis with a rapid clinical course of paraplegia].

A 68-year-old man with suspected allergic granulomatosis and angiitis is reported. He had received 10 mg of prednisolone daily since July 1988 for asthma. He abruptly developed muscle weakness of the lower extremities, followed two days later by paraplegia. Six days after the onset of the muscle weakness, he was hospitalized. He showed disturbance of recent memory, disorientation, neck rigidity, paraplegia, mild muscle fasciculation and hypesthesia. He also showed paralytic ileus. Laboratory findings showed leukocytosis (24580/mm3), eosinophilia (56% of the peripheral white blood cells and 19% of the cells in the cerebrospinal fluid), on erythrocyte sedimentation rate of 31 mm/h, and the IgE level of 1200 IU/ml. The ECG showed loss of the r-wave in V1 and V2. A granulomatous lesion anterior to the spinal cord was found on myelography and MRI. Prednisolone was given at a dose of 60 mg daily resulting in improvement of the clinical symptoms and eosinophilia. There was disappearance of the granuloma on MRI performed after prednisolone therapy. Despite the severe manifestation of allergic granulomatosis and angiitis, prednisolone therapy had a marked effect in this patient. The granulomatous lesion anterior to the spinal cord shown by MRI suggested an eosinophilic granuloma, and may have been the etiology of some of the neurological symptoms.

Aged↗
PubMedDate not supplied

Paraplegia following spinal anesthesia in a patient with chronic renal failure.

Paraplegia after spinal anesthesia secondary to hematoma formation has been described. Many such reports have involved patients with a variety of coagulation disorders. This article describes a patient with clotting abnormalities, apparently due to chronic renal failure, who developed paraplegia after spinal anesthesia secondary to subarachnoid hematoma formation.

Anesthesia, Spinal↗
PubMed1989

[A hepatocellular carcinoma revealed by paraplegia caused by a vertebral metastasis].

Described is a 57-year-old male with a complaint of a gait disturbance. On admission to hospital, he was suffering from almost complete paraplegia. Roentgenograms of the spine showed extensive destruction in the body of the second thoracic vertebra. Magnetic resonance computed tomography revealed a vertebral tumor that was compressing the vertebral cord. Thus, a laminectomy of the 1st to 3rd thoracic vertebra was performed to relieve the compression. Histological examination of the tumor showed it to be a metastatic vertebral tumor from a hepatocellular carcinoma (HCC). Subsequently, by abdominal computed tomography and an examination of the AFP serum level the existence of the HCC was confirmed. This is a very rare case of an HCC that was revealed by paraplegia caused by bone metastasis.

Carcinoma, Hepatocellular↗
PubMed1989

[Paraplegia associated with HTLV-1 virus].

Human T-Cell Leukaemia Virus (HTLV) has been found to be endemic in the Caribbean Islands. So-called spastic paraplegia of unknown origin, described in Martinique (named tropical spastic paraplegia in other countries) was found to be associated with signs of HTLV-l infection in 1984-1985. This association has since been found in non-tropical countries, particularly in Japan where HTLV-l is endemic. Numerous questions about the physiopathology of the neurological involvement and the systemic symptoms and signs remain unanswered. The identification of the retrovirus and of the diseases is only beginning.

HTLV-I Infections↗
PubMedDate not supplied

Acute aortic thrombosis presenting as painless paraplegia.

Two patients with acute aortic thrombosis presented with painless paraplegia secondary to spinal cord infarction. In one case, the initial symptom was unilateral leg weakness, leading to the misdiagnosis of stroke. In the other case, a patient with a large, painful vulvar abscess, experienced spontaneous relief of pain. In the complete absence of pain, both patients slept undisturbed and awoke with complete paraplegia, incontinence, and cadaveric extremities. Aortic reconstruction was advised to obviate thigh or hindquarter amputation, not to restore limb function. One patient died on the second postoperative day; the second remains well but paraplegic two years later.

Acute Disease↗