141/206. Transverse cervical myelopathy: an unusual complication of retropharyngeal abscess. retropharyngeal abscess complicated by suppuration in the central nervous system, intra- or extraaxial, is rare. Acute transverse myelopathy complicating a retropharyngeal abscess may be more frequent than epidural spinal abscess and usually affects the thoracic cord. Therefore, the occurrence of acute high cervical transverse myelopathy is rarely encountered and warrants reporting. The need for neuroradiologic diagnostic evaluation is emphasized in order to rule out a surgically treatable lesion. ( info) |
142/206. Transverse myelitis from intraarterial penicillin. A child was given intramuscular benzathine penicillin and experienced manifestations of sudden, irreversible transection of the spinal cord in the lower thoracic region. The biopsy supported an intravascular injection with occlusion of the spinal vasculature as the etiological mechanism. A review of similar cases reveals a recurring pattern--intramuscular injection with standard techniques and sites into a small muscle mass without evident blood return followed by rapid progression of paralysis. The problem seems to turn upon an inability to recognize the inadvertent intraarterial injection. ( info) |
| A case of transverse myelitis in a 25-year-old patient was described. The transverse myelitis was caused by toxic cause, probably as a result of benzene poisoning. This diagnosis was based on: The differential diagnosis. The patient's occupation. The abnormal high urinary phenol levels. The coincidence of decreasing urinary phenol values with an amelioration of the clinical condition of patient. After consulting the literature, we think that this case of transverse myelitis based on a benzene poisoning is the first ever described. ( info) |
144/206. Functional walking in paralyzed patients by means of electrical stimulation. Three partially paralyzed patients were unable to walk even after maximal rehabilitation attempts at a major rehabilitation center. One 36-year-old man had transverse myelitis, a 57-year-old man had had a stroke, and the third patient, a 35-year-old man, had incurred a traumatic brain injury. The three patients were unable to flex the hips, had adductor spasm and weak hip and knee extension, and lacked ankle dorsiflexion. Intramuscular stainless steel wire electrodes activated by timers were placed in the quadriceps, hip flexors, extensors, and abductors, as needed. Muscle force and foot contact evaluations were done using the Cybex and the Cleveland veterans Administration gait Laboratory. After implantation of intramuscular electrodes, all three patients had improved function but still desired some supervision in walking. A ten-fold increase in knee torque was noted in one patient, thereby providing him with nearly normal strength. No implant complications were noted. The study demonstrated the feasibility of functional neuromuscular stimulation (FNS) gait augmentation in a previously nonwalking patient outside the laboratory. Further improvements will require the development of an implantable, multichannel, programmable microprocessor-controlled stimulator. ( info) |
| A case of acute transverse myelitis associated with respiratory infection by mycoplasma pneumoniae is described. Circulating antibodies to myelin were detected suggesting that mycoplasma related neurological damage is mediated by producing an immunological myelopathy. ( info) |
146/206. Congenital spinal extradural cyst (lateral meningocele) simulating acute transverse myelitis. Report of a case. Congenital spinal extradural cysts are rare and may be the cause of acute paraplegia. In their clinical features they closely resemble acute transverse myelitis. Immediate decompression of the spinal cord and removal of the cyst may lead to restoration of normal function. myelography differentiates these two conditions by showing a cyst in communication with the spinal canal. This investigation must be mandatory. ( info) |
| 43-year-old man developed transverse myelitis following an infection with mycoplasma pneumoniae. Among the uncommon neurological complications following infection with this organism, transverse myelitis has been reported rarely but may be more frequent than previously thought. Posterior spinal column involvement might result in a permanent neurological deficit despite the usually good prognosis. ( info) |
| We examined a woman who had acute transverse myelopathy (ATM) associated with respiratory illness due to mycoplasma pneumoniae. To our knowledge, only one previously described case documented this relationship with serologic studies of spinal fluid. Since 16% to 35% of ATM patients experience antecedent respiratory illness, evidence of M pneumoniae infection should be sought in all cases. ( info) |
149/206. Acute transverse myelopathy complicating tetanus. A 12-year-old boy presented with typical features of short incubation tetanus. Spastic paraparesis with a mid-thoracic sensory level was present from the time of the initial examination. x-rays of the spine and lumbar myelogram were normal. The paraparesis improved rapidly and within a month the patient was free of neurological deficit. The case is possibly a rare example of tetanus involving the central nervous system other than the anterior horn cells. ( info) |
| In tropical regions transverse myelitis may be caused by involvement with schistosoma or the eggs of this organism. Although 200 million people seem to be infected with this disease, involvement of the spinal cord is rare. A case of a 15-year-old boy is described and some literature reviewed. ( info) |