1/10. meningeal carcinomatosis manifested as bilateral progressive sensorineural hearing loss.OBJECTIVE: meningeal carcinomatosis is defined as the diffuse infiltration of the leptomeninges and subarachnoid space by malignant cells metastasizing from systemic cancer. The authors describe a rare case of meningeal carcinomatosis initially appearing as bilateral progressive sensorineural hearing loss. PATIENT: A 57-year-old man with lung cancer was referred to the authors' clinic because of progressive hearing loss, tinnitus, dizziness, and blurred vision for 1 month. RESULTS: magnetic resonance imaging revealed abnormal leptomeningeal enhancement. meningeal carcinomatosis was diagnosed by the detection of malignant cells in the cerebrospinal fluid after lumbar puncture. The patient died 1 year after diagnosis. CONCLUSIONS: meningeal carcinomatosis must be considered in the differential diagnosis in cancer patients with bilateral progressive sensorineural hearing loss. gadolinium-enhanced magnetic resonance imaging is a useful complementary diagnostic tool before lumbar puncture.- - - - - - - - - - ranking = 1keywords = spinal (Clic here for more details about this article) |
2/10. Acute multiple cranial neuropathy: a variant of guillain-barre syndrome?Three patients with acute multiple cranial neuropathy following benign infectious disease are reported. Complete or partial ophthalmoplegia, as well as facial and bulbar dysfunction, were noted in all. Cranial nerve involvement was bilateral. Other neurological deficits included sensory loss in two patients and transiently reduced tendon reflexes in the left arm in one. One patient had positive serum anti-GQ1b immunoglobulin g antibody during the acute phase of the illness. The cerebrospinal fluid had a normal cell count in all three patients, with raised protein concentrations in two. Electrophysiological evaluation showed peripheral nerve dysfunction in two patients. All three patients improved either spontaneously or coincident with immunotherapy. Our patients had many clinical features resembling those of typical guillain-barre syndrome (GBS), and hence their disorder may represent a regional variant, that is, a cranial form, of GBS. This form of GBS accounted for 5% of the GBS patient population in our series.- - - - - - - - - - ranking = 1keywords = spinal (Clic here for more details about this article) |
3/10. carbamazepine toxicity following Oxybutynin and dantrolene administration: a case report.OBJECTIVE: To report a case of carbamazepine toxicity following the administration of Oxybutynin and dantrolene. STUDY DESIGN: A case report. SETTING: The Spinal rehabilitation Department, Loewenstein Hospital, Raanana, israel. methods: A patient with C6D tetraplegia who sustained intoxication because of drug interaction is presented. She had been treated by carbamazepine 1000 mg/day for neuropathic pain for 2 years without clinical or laboratory signs of toxicity. After administration of Oxybutynin concomitantly with an increase in the dose of dantrolene, she presented the clinical symptoms and laboratory finding of carbamazepine intoxication. Trying to adjust the treatment to the patient's requirements, carbamazepine together with Oxybutynin and dantrolene was readministrated in lower doses. RESULTS: The combination of these drugs, even small doses, caused toxicity. Adding dantrolene and Oxybutynin elevated the blood level of carbamazepine, possibly by inhibition of cytochrome P450. CONCLUSION: A possible pharmacokinetic interaction between dantrolene and Oxybutynin should be borne in mind when considering carbamazepine medication for a patient with a spinal cord lesion.- - - - - - - - - - ranking = 1keywords = spinal (Clic here for more details about this article) |
4/10. Drop attacks secondary to superior canal dehiscence syndrome.Two patients with unprovoked drop attacks were found to have dehiscence of the superior semicircular canal on CT of the temporal bone. Both had conductive hearing loss, preservation of stapedius reflex, and abnormal vestibular evoked myogenic potentials. Neither had sound- or pressure-induced nystagmus. Repair of the dehiscence in one case stopped the drop attacks, supporting a causal relationship between the dehiscence and the drop attacks.- - - - - - - - - - ranking = 95.368596418159keywords = canal (Clic here for more details about this article) |
5/10. rehabilitation exercise for treatment of vestibular disorder: a case study.vertigo and dizziness are common symptoms in the general population. While the clinical picture is well known and widely described, there are different interpretations of Benign Paroxysmal Positional vertigo. The purpose of this case report was to describe the treatment of a 56 year old woman with complains of positional vertigo for 35 consecutive years. She suffered from a sudden onset of rotatory, unilateral horizontal canal type benign paroxysmal positional vertigo (BPPV). The symptoms started a day after falling from a bus, where she injured her head. Otherwise her medical history was unremarkable. She was treated with an individualized home exercise program of eye movement exercises, Brandt/Daroff exercises, and general conditioning exercises (i.e., laying on the left side from sitting on the bed, while the head rotated 45 degrees to the right, waiting for about one minute; twice a day on gradual basis, not laying on the side all the way, but to use enough pillows to lay about at 60 degrees). Four weeks from the start of physical therapy, the patient was free of symptoms, even when her neck was in the extended position.- - - - - - - - - - ranking = 19.073719283632keywords = canal (Clic here for more details about this article) |
6/10. Diagnosing and treating benign paroxysmal positional vertigo.Gerontological nurses play a critical role in the early recognition of benign paroxysmal positional vertigo (BPPV), a condition that accounts for approximately 50% of vertigo in older adults. BPPV results in vertigo when debris collects in one or more of the semicircular canals, most typically the posterior canal. It may be differentiated from other forms of vertigo because it results in dizziness when recumbent or with head position changes. BPPV may be successfully treated with repositioning therapy, such as the Epley maneuver. nurses working in medical offices, longterm care facilities, and assisted living may be called on to perform this maneuver. Gerontological nurses play a key role in assessing and treating BPPV, therefore minimizing unnecessary testing and medication and reducing the suffering and expense for patients with this condition.- - - - - - - - - - ranking = 38.147438567264keywords = canal (Clic here for more details about this article) |
7/10. temporal bone findings in central nervous system leukemia.central nervous system (CNS) leukemia is a pathologic condition whereby leukemic cells enter the cerebrospinal fluid (CSF) causing meningeal irritation syndrome. temporal bone findings in the case of a 32-year-old man who died of CNS leukemia are presented. He complained of fullness of the ear 4 months prior to death and of dizziness 1 month prior to death. Leukemic cells were seen to have infiltrated the scala tympani of the basal turn in the cochlea, the saccule, and posterior semicircular canal along the vestibulocochlear nerve.- - - - - - - - - - ranking = 20.073719283632keywords = canal, spinal (Clic here for more details about this article) |
8/10. dizziness after head trauma: clinical and morphologic findings.Twelve patients with balance problems resulting from head injury were treated by a translabyrinthine or middle fossa vestibular neurectomy. The clinical, otoneurologic, and surgical data combined with morphologic findings on the removed operative eighth nerve specimens were evaluated with the aim of deciding the site of primary lesion in each case. In six patients a peripheral lesion was interpreted. Four of them had features of delayed endolymphatic hydrops syndrome, the fifth patient might have suffered a fracture of the stapedial footplate with associated perilymphatic fistula. The sixth patient had a deforming fracture of the internal auditory canal that had produced severe hearing loss and constant unsteadiness because of the compression of the eight nerve, which had atrophied as a result. Half of the patients were diagnosed as having a central lesion. Only one of them benefited from the neurectomy. This patient had a large arterial loop within the internal auditory canal and the symptoms may have arisen because of friction of the vessel of the proximal portion of the vestibular nerve. The other five patients probably had a lesion at the level of eighth nerve brain-stem junction or central to it.- - - - - - - - - - ranking = 38.147438567264keywords = canal (Clic here for more details about this article) |
9/10. Postdural puncture symptoms in a child.An 11-year-old boy suffered an inadvertent dural puncture during placement of an epidural catheter for postoperative analgesia. He developed symptoms of mild headache only, but severe and protracted orthostatic nausea and dizziness, which eventually resolved completely following epidural blood patch. His symptoms were atypical and could have been misinterpreted in the context of dural puncture for diagnosis, or for administration of intrathecal chemotherapy. The reported incidence of headache following dural puncture in children is low. It may be that the manifestations are different from those of adults and that the true incidence of symptoms related to leakage of cerebrospinal fluid is higher in children than currently recognised.- - - - - - - - - - ranking = 1keywords = spinal (Clic here for more details about this article) |
10/10. The step phenomenon in the recovery of vision with spinal manipulation: a report on two 13-yr-olds treated together.OBJECTIVE: To discuss the immediate increment of improvement in vision that occurs when the spine is manipulated. CLINICAL FEATURES: Two juvenile patients (13-yr-old female cousins) were found to have constricted visual fields and diminished visual acuities. INTERVENTION AND OUTCOME: Spinal manipulation was associated with recovery of normal vision over seven treatment sessions. It was noted that significant improvement in vision occurred immediately after the spinal manipulation treatments. Full recovery of vision was attained by series of these steps. In addition, both patients reported significant constitutional benefits after the treatment in addition to the improved vision. CONCLUSION: The change in visual function immediately related to spinal manipulation has been described as the "step phenomenon." The step phenomenon raises questions about the nature of the condition that may be treated by spinal manipulation and the method of action of the treatment. A vascular hypothesis is mentioned that could explain these events. The consistent occurrence of the step phenomenon indicates that spinal manipulation may have an effect on brain function.- - - - - - - - - - ranking = 8keywords = spinal (Clic here for more details about this article) |
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