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PubMed1999

MR imaging of Dejerine-Sottas disease.

We report the MR findings in two patients with clinically and histologically proved Dejerine-Sottas disease. One patient had spinal involvement with multiple thickened and clumped nerve roots of the cauda equina; the second had multiple enlarged and enhancing cranial nerves. Although these findings are not specific for Dejerine-Sottas disease, they are suggestive of the diagnosis, which is further corroborated with history and confirmed with sural nerve biopsy and laboratory studies.

Adult↗
PubMed1985

Intraoperative spinal sonography in thoracic and lumbar fractures: evaluation of Harrington rod instrumentation.

Thirty-seven patients with thoracic and lumbar spine fractures were treated with Harrington rod instrumentation (HRI), and the progress and results of that surgery were monitored with intraoperative spinal sonography (IOSS). Adequate neural tissue decompression and spinal column alignment was achieved in less than one-half (14/31, 45%) of the patients in whom HRI was performed as the first step of the surgical procedure. As a result of these findings, further surgical maneuvers were performed which, in most cases, resulted in adequate spinal realignment and neural tissue decompression. In six patients, direct surgical reduction of displaced bone fragments was performed before HRI. Since total decompression of neural tissue may be important in patients with spinal cord or cauda equina injuries, it is recommended that IOSS be used in all cases of HRI for thoracic and lumbar spine fractures. The need to perform additional surgical maneuvers to accomplish neural tissue decompression may be obviated if intraoperative sonography shows adequate decompression with HRI alone.

Cauda Equina↗
PubMed1991

Diagnostic potential of contrast MRI in lumbar schwannomas.

Contrast enhancement in magnetic resonance imaging (MRI) is fast becoming a valuable means of diagnosing spinal pathology. The paramagnetic contrast agent, gadopentetate dimeglumine, used since 1986, delineates extradural, extramedullary intradural, as well as intramedullary lesions without myelography. However a combination of contrast MRI and water-soluble contrast myelography may prove especially useful in diagnosing mobile lesions in the lumbar region, particularly involving the cauda equina. Nerve root attachment (small spherical areas of void signal) and visualization of both the rounded cephalic and caudal ends were two other features delineated well on MRI. We report four cases of lumbar schwannomas where MRI was used alone or in conjunction with water-soluble contrast myelography to make the diagnosis.

Adult↗
PubMed1992

Magnetic coil stimulation of the spinal cord in the dog. Effect of removal of bony structure on eddy current.

Magnetic coil stimulation applied to the spine excites the lumbosacral roots rather than the spinal cord itself. To evaluate the mechanism responsible for this phenomenon, the effects of volume conduction on the activation of neural elements were studied. In ten intact dogs compound muscle action potentials could be recorded in the soleus muscle only when the magnetic coil was placed over the cauda equina. After laminectomy and pediculotomy, compound muscle action potentials also could be elicited when the magnetic coil was placed over the spinal cord. These findings suggest that the bony structure surrounding the spinal cord interferes with the spread of magnetically induced eddy currents to the spinal cord.

Action Potentials↗
PubMed1988

Spinal cord involvement as the presenting symptom of acute monocytic leukemia.

Spinal cord involvement in leukemia is rare and has been described only once in association with acute monocytic leukemia. A patient whose presenting symptom of acute monocytic leukemia was the syndrome of cauda equina compression due to an epidural and retroperitoneal leukemic mass is reported. Peripheral blood smears were normal throughout the evolution of the disease. The radiological, surgical, and pathological findings are presented, and the therapeutic, along with the prognostic implications of spinal cord involvement by leukemia are discussed.

Adult↗
PubMed1981

Posttraumatic pseudomeningomyelocele (enlarging fracture?) in a vertebral body. Case report.

An unusual case is reported in which a posttraumatic peudomeningomyelocele developed over many years inside the body of a fractured lumbar vertebra, eroding the pedicle and causing progressive neurological deficit. The wall of the sac was mostly formed by the scalloped bar bone, and partly by a membrane resembling the dura. The terminal part of the conus medullaris and some nerve roots of the cauda equina formed the contents and parts of the wall of the outpouching of the subarachnoid space into the vertebral body. A comparison is drawn between this lesion and formation of an "enlarging fracture" of the skull. The surgical technique used for obliteration of this pseudomeningomyelocele is described.

Adult↗
PubMed1998

Secondary superficial siderosis of the central nervous system in a patient presenting with sensorineural hearing loss.

We present a 50-year-old man who was investigated for sensorineural hearing loss. On MRI of the brain superficial siderosis of the central nervous system was seen, while MRI of the spine revealed an ependymoma of the cauda equina. This case illustrates the importance of performing T2-weighted imaging of the brain and posterior fossa when sensorineural hearing loss is present. Spine imaging is mandatory when superficial siderosis of the brain is diagnosed without identification of a bleeding source in the brain.

Brain↗
PubMed1994

Intradural lumbar disc herniation--a case report.

One case of intradural lumbar disc herniation at the L3-L4 disc level with cauda equina syndrome is reported. Myelo-CT demonstrated an intradural tumor-like lesion with complete block. An intradural fragment of sequestrated disc material was found intraoperatively. Accurate preoperative diagnosis of the intradural nature of the disease and prompt surgical treatment resulted in a smooth recovery.

Aged↗
PubMed2004

Immunoadsorption therapy for a child with Guillain-Barre syndrome subsequent to Mycoplasma infection: a case study.

We report an 11-year-old boy with apparently the motor axonal form of Guillain-Barre syndrome (GBS) who presented with severe paralysis and respiratory insufficiency by the 3rd day from onsets of symptoms. His serum anti-Mycoplasma pneumoniae and anti-Galactocerebroside (Gal-C) IgM antibody were significantly elevated. Magnetic resonance imaging, following contrast injection, showed enhancement of the cauda equina. The patient responded quickly and dramatically to immunoadsorption therapy using a tryptophan-immobilized column, with recovery of respiratory failure and muscle strength, dominantly in the left extremities. Immunoadsorption therapy should be considered for patients with anti Gal-C antibody-associated GBS.

Antibodies, Bacterial↗
PubMed1995

[Spinal intradural arachnoid cyst associated with enlarged filum terminale].

This is a report of a spinal intradural arachnoid cyst associated with an enlarged filum terminale. A 9-year-old female was admitted to our hospital complaining of lumbosacral pain. Neurological examination revealed no abnormal findings. CT scan showed a round shaped mass lesion in the right dorsolateral side of the spinal canal between the level of L1 to S1/2. The mass lesion disclosed isodensity and was not enhanced. A small low density mass lesion was visualized in the dural sac at the same level. MRI showed the mass lesion with low signal intensity on the T1-weighted image, and high signal intensity on the T2. The small mass lesion in the dural sac was demonstrated with low signal intensity on the T1 and T2-weighted image. In addition to this finding, Chiari malformation type I was disclosed. It was suspected that this mass lesion was extradural arachnoid cyst associated with an enlarged filum terminale. Osteoplastic laminotomy between L3 to S1/2 was performed, and an arachnoid cyst was found in the intradural space. It compressed the cauda equina and enlarged tough filum terminale. The cyst was removed subtotally, and the filum terminale was cut off. Postoperative course was uneventful and the lumbosacral pain disappeared. It was thought that this pain might be derived from the intradural arachnoid cyst, or the enlarged filum terminale.(ABSTRACT TRUNCATED AT 250 WORDS)

Arachnoid Cysts↗
PubMed2000

Anti-PMP22 antibodies in patients with inflammatory neuropathy.

An experimental model of inflammatory radiculoneuropathy is induced by immunising rats with peripheral myelin protein 22 (PMP22). We have investigated whether PMP22 may be important in inducing human inflammatory neuropathy. We examined sera of patients with Guillain-Barré syndrome (GBS), chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), other neuropathies (ONP) and normal controls for IgM and IgG antibodies against PMP22 by ELISA (against synthetic PMP22 extracellular peptide fragments) and Western blot (against cauda equina). Antibodies were detected by both methods in 52% of patients with GBS, 35% with CIDP, 3% with ONP and no normal controls. We conclude that an immune response against PMP22 may play a role in the pathogenesis of the inflammatory neuropathies.

Adolescent↗
PubMedDate not supplied

[Saccoradiculography: contribution and indications in lumbar pathology in Abidjan (Ivory Coast)].

Radiculography is used a great deal in our region and is often the only method available for examination of the lumbar spine. However, there has been little evaluation of the effectiveness of radiculography for lumbar diseases. To determine its value and indications in lumbar diseases we studied 322 patients who underwent radiculography. We studied 223 patients retrospectively and 99 patients prospectively. Radiculography had a sensitivity of 100%, a specificity of 86%, a positive predictive value of 92.7% and a negative predictive value of 100%. We found that the diagnostic accuracy of radiculography was higher if the examination was requested by a neuropathologist, if the patient had been ill for more than 2 months or had cauda equina syndrome, acute root pain, paralysis or debilitation. Such precise indications make it possible to avoid excessive examination and to make the best use of radiculography, particularly in areas without CT and MRI facilities. However, the examination should always be performed by a neuroradiologist or a physician with several years' radiculography experience.

Adolescent↗
PubMed2003

Leptomeningeal metastases from recurrent squamous cell cancer of the skin.

We report two patients with leptomeningeal metastases from squamous cell cancer of the skin. In one patient cauda equina metastases appeared 6 years after initial presentation; the tumor from radical neck dissection demonstrated perineural invasion suggesting a possible route for subarachnoid dissemination. The other patient presented 2 years after initial diagnosis with confusion and cranial nerve seven and twelve palsies. Both patients died from complications of leptomeningeal metastases.

Aged↗
PubMed2002

Vertebral metastases from oral squamous cell carcinoma.

PURPOSE: The purpose of this study was to review the incidence and clinical presentation of vertebral metastases related to squamous cell carcinoma of the oral cavity. PATIENTS AND METHODS: We conducted a retrospective review of our clinical experience with 597 cases of squamous cell carcinoma of the oral cavity. RESULTS: Four patients with vertebral metastases were identified, accounting for 0.7% of the series. Thirteen vertebrae were involved in these 4 patients. All patients showed advanced cervical metastases as evidenced by several histologically positive nodes with extracapsular invasion when the ablative tumor specimen was examined. All patients displayed symptoms of their vertebral metastases, including severe pain, hypercalcemic somnolence, and flaccid paralysis of the lower extremities as part of the cauda equina syndrome. CONCLUSIONS: Vertebral metastases are rare forms of distant metastasis related to squamous cell carcinoma of the oral cavity. Bone pain is a symptom that should result in expedient radiographic examination in such patients, particularly when advanced cervical metastases are identified during the primary tumor surgery, which places the patient at risk for distant metastatic disease.

Carcinoma, Squamous Cell↗
PubMed1984

Normal proximal and delayed distal conduction in the pudendal nerves of patients with idiopathic (neurogenic) faecal incontinence.

The latency of the response in the external anal sphincter muscle following transcutaneous stimulation of the cauda equina at the L1 vertebral level was measured in nine women with neurogenic faecal incontinence (mean 7.3 SD 0.7 ms) and 11 normal subjects (mean 5.6 SD 0.6 ms) (p = 0.01). There was no difference in conduction velocity between the L1 and L4 vertebral levels thus supporting the suggestion that conduction delay in faecal incontinence occurs distally.

Adult↗
PubMed1978

Subarachnoid hemorrhage due to intraspinal tumors.

Five cases of subarachnoid hemorrhage arising from an intraspinal tumor are presented, Three of these were ependymomas in the region of the cauda equina. One was a neurofibroma at L1. The fifth was a hemangioblastoma in the upper lumbar region. The literature dealing with subarachnoid hemorrhage due to intraspinal lesions is reviewed. The majority of cases of spinal subarachnoid hemorrhage are due to arteriovenous malformations, but 50 cases in which the bleeding developed from a neoplasm have been reported.

Adolescent↗
PubMed1978

Painful legs and moving toes: evidence on the site of the lesion.

A condition of painful legs with moving toes was described in 1971. Further examples of this condition are now reported, showing lesions in the posterior root ganglion, cauda equina, nerve roots, or a peripheral nerve of the lower limb. It is concluded that this syndrome is caused by a lesion of the afferent fibres of the posterior nerve roots. It is likely that this lesion causes frequent spontaneous impulses in the posterior roots which activate local circuits of interneurones and motoneurones and result in co-ordinated movements involving local muscles.

Adult↗