11/33. Galloping ophthalmoplegia and numb chin in burkitt lymphoma.A 57-year-old man developed complete bilateral ophthalmoplegia over a period of 10 days, together with bilateral facial pain and numbness of the chin. He had no other clinical manifestations. Findings on brain magnetic resonance imaging and spinal fluid formula from the first lumbar puncture were normal, but cerebrospinal fluid flow cytometry disclosed a kappa restriction monoclonal B-cell population, indicating malignant lymphoma. Computed tomography of the chest, abdomen, and pelvis then revealed multiple enlarged lymph nodes. biopsy of an inguinal node showed findings consistent with burkitt lymphoma. Within six weeks, intravenous and intrathecal chemotherapy resolved all neurologic findings except a partial right-side sixth nerve palsy and mild chin numbness. Eighteen months after disease onset, the patient remained in remission. Meningeal spread of burkitt lymphoma is not commonly a presenting feature in immunocompetent adults. chin numbness, a characteristic feature caused by infiltration of the mental nerve, should facilitate earlier recognition, which may be life saving.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
12/33. Neck-tongue syndrome.OBJECTIVE: To discuss a case of neck-tongue syndrome (NTS) affecting a dancer/figure skater, review literature summarizing the pathogenesis and treatment, and offer new categorization of neck-tongue syndrome. CLINICAL FEATURES: A 24-year-old female dancer/skater sought treatment for recurrent episodes of right-sided upper neck pain with associated ipsilateral numbness of her tongue following brisk active rotation. Radiographs revealed a narrowing of the left para-odontoid space. physical examination revealed a mildly painful restriction in rotation at C1-2 with no apparent muscular hypertonicity. INTERVENTION AND OUTCOME: The patient had sought chiropractic treatment for this condition several times since she was 8 years old. Diversified chiropractic adjustments were applied to restrictions throughout the cervical spine as determined by the clinician. No other interventions were employed. The patient experienced significant improvement in frequency and intensity of the neck and tongue symptoms following spinal manipulative therapy applied to her cervical spine. CONCLUSIONS: There are 2 categories of NTS: complicated NTS due to the presence of an underlying disease process (inflammatory or degenerative) and uncomplicated NTS (idiopathic or trauma-related). This case report is of uncomplicated NTS that responded favorably to spinal manipulative therapy directed at the cervical spine. In the absence of upper cervical instability, spinal manipulative therapy appears to be beneficial and should be considered in all cases of uncomplicated NTS.- - - - - - - - - - ranking = 18.037696324756keywords = upper (Clic here for more details about this article) |
13/33. Sacral hemangioblastoma in a patient with von hippel-lindau disease. Case report and review of the literature.Hemangioblastomas are histologically benign neoplasms that occur sporadically or as part of von hippel-lindau disease. Hemangioblastomas may occur anywhere along the neuraxis, but sacral hemangioblastomas are extremely rare. To identify features that will help guide the operative and clinical management of these lesions, the authors describe the management of a large von hippel-lindau disease-associated sacral hemangioblastoma and review the literature. The authors present the case of a 38-year-old woman with von hippel-lindau disease and a 10-year history of progressive back pain, as well as left lower-extremity pain and numbness. Neurological examination revealed decreased sensation in the left S-1 and S-2 dermatomes. magnetic resonance imaging demonstrated a large enhancing lesion in the sacral region, with associated erosion of the sacrum. The patient underwent arteriography and embolization of the tumor and then resection. The histopathological diagnosis was consistent with hemangioblastoma and showed intrafascicular tumor infiltration of the S-2 nerve root. At 1-year follow-up examination, pain had resolved and numbness improved. Sacral nerve root hemangioblastomas may be safely removed in most patients, resulting in stabilization or improvement in symptomatology. Generally, hemangioblastomas of the sacral nerve roots should be removed when they cause symptoms. Because they originate from the nerve root, the nerve root from which the hemangioblastoma originates must be sacrificed to achieve complete resection.- - - - - - - - - - ranking = 123.32556947426keywords = back pain, back (Clic here for more details about this article) |
14/33. Spinal congenital dermal sinus associated with upper thoracic meningocele. Case Report.The congenital dermal sinus is an abnormal epithelium-lined sinus tract between the skin surface and deeper tissues. It occurs during neurulation when the neural groove closes to form the neural tube on Day 26 of gestation and results from a failure of neuroectoderm to separate from the cutaneous ectoderm. The most frequent location is the lumbosacral area; an upper thoracic location is quite rare. This 37-year-old man presented with headache and numbness in both arms. No specific neurological findings were observed. physical examination revealed a dimple at T-2. radiography and magnetic resonance imaging of the thoracic spine revealed spina bifida at T1-3, a meningocele, and a dermal sinus tract complex. The treatment approach and outcome in this unusual case are presented.- - - - - - - - - - ranking = 97.833301706143keywords = headache, upper (Clic here for more details about this article) |
15/33. serotonin reuptake inhibitor induced sensory disturbances.serotonin reuptake inhibitor induced sensory disturbances are reported rarely in the literature. This case report describes numbness and dysmorphic symptoms in the upper facial area associated with fluoxetine. There is no previous report of such an adverse reaction with any serotonin reuptake inhibitor in the literature and this report is intended to draw attention towards these unusual adverse effects.- - - - - - - - - - ranking = 9.0188481623781keywords = upper (Clic here for more details about this article) |
16/33. Severe interscapular pain and increased creatine kinase activity: the answer was in the ankles.Severe thoracic back pain with increased creatine kinase activity is a clinical presentation that suggests a variety of life threatening conditions. If initial examination is unrevealing, multiple diagnostic tests are usually performed attempting to identify the origin of the problem, sometimes neglecting apparently unrelated subtle physical findings. A patient is described in whom this was the initial presentation of a sensory demyelinating neuropathy, resulting in a diagnostic challenge. This case expands the differential diagnosis of severe thoracic back pain and increased creatine kinase activity, and illustrates the importance of physical examination in reaching a final diagnosis.- - - - - - - - - - ranking = 246.65113894852keywords = back pain, back (Clic here for more details about this article) |
17/33. Delayed ischemic stroke associated with methamphetamine use.A 19-year-old woman had right occipital infarction 3 months after she had injected methamphetamine. No other possible causes of stroke could be found in this case. magnetic resonance angiography revealed beading of the right posterior cerebral artery, which suggested vasculitis. Her symptoms were right-sided headache, left superior quadrant hemianopia, and left hypesthesia, which gradually improved without any treatment. methamphetamine has been known to cause hemorrhagic and ischemic stroke relatively soon after administration. We report here that methamphetamine may also cause chronic cerebral vasculitis and delayed ischemic stroke.- - - - - - - - - - ranking = 52.739060894253keywords = headache (Clic here for more details about this article) |
18/33. Spinal epidural abscess-from onset to rehabilitation: case study.Spinal epidural abscess (SEA) is a rare condition; consequently, the clinical significance of early diagnosis often is overlooked. The challenge with SEA is not its treatment, but achieving early diagnosis before neurological symptoms occur. Once neurological deficits are present, immediate treatment must be implemented to prevent deterioration that can result in paralysis. The common SEA signs and symptoms are fever, back pain, and radicular symptoms that can progress to weakness and paralysis. magnetic resonance imaging is the imaging of choice for diagnosis. Treatments include antibiotics and surgical evacuation of the abscess if neurologic deficits are present. nurses play a major role in caring for SEA patients by identifying those at risk, preventing complications, and collaborating with a multidisciplinary team to prepare patients for rehabilitation.- - - - - - - - - - ranking = 123.32556947426keywords = back pain, back (Clic here for more details about this article) |
19/33. radial nerve injury after general anaesthesia in the lateral decubitus position.A 43-year-old female patient underwent pyelolithotomy in the left lateral decubitus position. Her upper right arm was placed on a padded armboard. Surgery lasted for 240 min. Postoperatively, she complained of numbness of the dorsal part of her right hand and wrist drop. Neurological examination revealed hypoaesthesia of the dermatome of the right forearm and hand innervated by the radial nerve. electromyography revealed advanced axonal degeneration of the radial nerve below the level of the elbow. Treatment with diclofenac, vitamin B and physiotherapy was started. Her symptoms improved gradually and at the 60th postoperative day, motor weakness had completely resolved. In order to prevent peri-operative nerve injury, careful positioning of every patient on the operating table with proper padding is essential, with attention paid to time-dependent risks. If an injury occurs, diagnosis and treatment should be started as rapidly as possible.- - - - - - - - - - ranking = 9.0188481623781keywords = upper (Clic here for more details about this article) |
20/33. Bilateral traumatic neuroma of the anterior cervical nerve root: case report.STUDY DESIGN: Case report. OBJECTIVES: A rare case of anterior cervical second root traumatic neuroma with no history of trauma is reported, and possible etiology is discussed. SUMMARY OF BACKGROUND DATA: Traumatic neuroma is the reactive, nonneoplastic proliferation in the injured nerve. Several atypical locations of traumatic neuroma have been reported. To date, only 4 cervical traumatic neuroma cases with no history of trauma have been reported, and, to our knowledge, there is no case of bilateral cervical traumatic neuroma published in the literature. methods: A patient with a history of neck and left upper extremity pain, who had hypoesthesia in left C2 dermatome on neurologic examination is presented. A left C2-C3 hemilaminectomy and tumor extirpation were performed. RESULTS: A histopathologic study revealed features of a typical traumatic neuroma. The patient had no deficits on her postoperative neurologic examination, and her neck and left arm pain improved. The unusual location of this lesion and possible etiology of such a traumatic neuroma are discussed. CONCLUSIONS: A rare case of anterior bilateral cervical second root traumatic neuroma with no history of trauma is reported. An unnoticed history of trauma may play an etiologic role in the development of these lesions.- - - - - - - - - - ranking = 9.0188481623781keywords = upper (Clic here for more details about this article) |
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