1/18. Acute anticholinergic syndrome due to Jimson seed ingestion. Clinical and laboratory observation in six cases.Ten patients presented with acute anticholinergic syndrome secondary to Jimson seed (datura stramonium) ingestion. Six of the 10 patients required hospitalization because of hyperpyrexia and severe neurologic derangement. Electroencephalograms recorded immediately after admission showed [1] slow wave activity, and [2] bizarre rhythmical bursts of high-voltage sharp wave activity; both of which rapidly resolved during the next 24 hours, as did the associated clinical findings of hyperreflexia, bilateral dorsiflexor Babinski responses, and decerebrate posturing. Previously unreported elevation of serum glutamic-oxalacetic transaminase and lactic dehydrogenase and prothrombin time prolongation are documented. The pathogenic mechanism accounting for abberation of these laboratory values remains undefined. All patients showed rapid clinical improvement; follow-up neurologic evaluation and electroencephalograms have been within normal limits. Because of the widespread availability and potential abuse of the Jimson seed, the clinical syndrome associated with its toxicity merits recognition.- - - - - - - - - - ranking = 1keywords = cord (Clic here for more details about this article) |
2/18. osteopetrosis associated with familial paraplegia: report of a family.A clinical analysis of three members of a family with documented osteopetrosis and familial paraplegia is presented. All patients had a long history of increased bone density and slowly progressing paraparesis of both legs. A thorough review of the literature has revealed no other cases which presented with paraplegia without spinal cord compression. Although the etiologic factor or factors remain unknown, our review supports the contention that this is a distinct clinical entity.- - - - - - - - - - ranking = 27.279322243489keywords = spinal, spinal cord, cord (Clic here for more details about this article) |
3/18. Neurologic disturbances in Paget disease of bone: response to calcitonin.The neurologic manifestations of Paget disease and the therapeutic effect of calcitonin were studied in 49 patients. Twenty-four patients (49%) had neurologic disorders involving cranial nerves other than the auditory system, brainstem, spinal cord, or spinal roots and nerves. Eighteen of the 24 patients (75%) showed significant subjective or objective improvement after calcitonin treatment. The effect of calcitonin treatment on spinal cord compression was dramatic in three of six patients. The observations made of these patients support previous data suggesting that the neurologic signs and symptoms of Paget disease have their pathogenesis in both mechanical impingement and vascular distortion. The importance of early detection of neurologic signs and symptoms is emphasized, since prompt treatment with calcitonin may prevent severe complications.- - - - - - - - - - ranking = 69.272166429503keywords = spinal, spinal cord, cord (Clic here for more details about this article) |
4/18. One-stage decompression and stabilization in the treatment of spinal tumors.Nowadays, extradural vertebral neoplasms which compress the spinal cord are being diagnosed earlier and therefore laminectomy for decompression relieves many patients of their neurological deficits before permanent cord damage has set in. In addition, radiotherapy and oncological treatment have prolonged life expectancy as well as the quality of life in these patients. As the indications for surgery have grown, the problem of spinal instability resulting from direct involvement of the supporting structures of the spine or due to the surgical procedure per se, must be considered. Many of these patients would rapidly return to leading their normal activities if not confined to bed rest or uncomfortable orthopedic devices. The Authors present 9 patients with extradural vertebral lesions: 4 plasmacytomas, 3 metastatic carcinomas, 1 malignant lymphoma and 1 aggressive osteoblastoma treated by simultaneous decompression and stabilization of the spine. All patients showed remarkable improvement of neurological symptoms except in one case where massive pulmonary embolism caused death a few hours after surgery. This surgical treatment offers the advantages of performing wider and better decompressive maneuvers and, at the same time, assuring fast mobilization of the patient after surgery who is often in poor general conditions, thus reducing post-operative complications due to delayed physical therapy and bed confinement.- - - - - - - - - - ranking = 101.84693195612keywords = spinal, spinal cord, cord (Clic here for more details about this article) |
5/18. neurologic manifestations of cogan syndrome.cogan syndrome is a multisystem inflammatory vascular disease, characterized by nonsyphilitic interstitial keratitis and vestibuloauditory symptoms. Recent reports have directed attention to involvement of other organ systems. Respiratory, cardiovascular, gastrointestinal, and musculoskeletal problems are common, as are laboratory abnormalities and general symptoms such as fever, chills, and weight loss. Prominent neurologic problems in two patients prompted a review of 79 cases of cogan syndrome. More than half had nervous system involvement, including electroencephalographic or spinal fluid abnormality, headache, psychosis, coma, convulsion, neuropathy, and stroke. cogan syndrome should be considered when neurologic deficits are accompanied by eye, ear, and systemic symptoms.- - - - - - - - - - ranking = 14.713521942526keywords = spinal (Clic here for more details about this article) |
6/18. Oligoclonal gamma-globulin of cerebrospinal fluid in neurobrucellosis.The clinical manifestations and laboratory findings of two cases of neurobrucellosis are described. The cerebrospinal fluid (CSF) protein electrophoresis showed increased gamma-globulins and decreased relative values of pre-albumin and albumin, associated to high values of total CSF protein. The evidence of oligoclonal morphology of CSF gamma-globulins suggests that part of them had an intrathecal origin, in addition to an increased crossing of the damaged blood-CSF barrier. Similar oligoclonal appearance of CSF gamma-globulins was observed in two additional cases of neurobrucellosis previously reported.- - - - - - - - - - ranking = 73.567609712631keywords = spinal (Clic here for more details about this article) |
7/18. Whipple's disease of the central nervous system.Whipple's disease presenting as a neurological disease without gastrointestinal symptoms is an unusual occurrence. A 40 year old man suffered hypersomnia, memory loss and progressive ophthalmoplegia for 6 months prior to death. The nature of this disease was not established during life. Extensive granulomatous inflammation affecting the hypothalamus, hippocampus and periaqueductal gray matter of the brain was found to represent Whipple's disease by electron microscopy. Characteristic lesions were also present in spleen, mesenteric lymph nodes, small intestine and myocardium. Bacillary bodies and membranous inclusions similar to those seen in visceral lesions of Whipple's disease were present in macrophages. The findings supported the theory of direct involvement of the central nervous system by bacilli rather than a metabolic origin for the lesions.- - - - - - - - - - ranking = 3.1130802733212keywords = inflammation (Clic here for more details about this article) |
8/18. herpes zoster-associated encephalitis: clinicopathologic report of 12 cases and review of the literature.Herpes-zoster associated encephalitis (HZAE) is an uncommon complication of herpes zoster. Over 8 years, we evaluated 12 patients with this clinical diagnosis. The majority of our patients were elderly, immunosuppressed, and found to have disseminated skin lesions prior to the onset of CNS symptoms. All patients had abnormal EEGs, and CSF pleocytosis was found in most. In the seven patients who were tested, specific antibody to the varicella-zoster membrane antigen (FAMA) was detected in spinal fluid during the course of the illness. Although three patients died during the period of active infection, the virus could not be definitively implicated as the cause of death. These HZAE patients could not be distinguished from our other herpes zoster patients on the basis of age, initially involved dermatome, or mortality rate. However, among herpes zoster patients who survived, duration of hospitalization was significantly longer in those with a diagnosis of HZAE. All surviving HZAE patients had a slow but eventual return to their prior cognitive status.- - - - - - - - - - ranking = 14.713521942526keywords = spinal (Clic here for more details about this article) |
9/18. hypernatremia with choroid plexus hematomas and elevated CSF protein level.A 3-month-old infant had hypernatremia, neurologic dysfunction, and an unusually high level of cerebrospinal fluid protein. The autopsy findings included cerebral edema, intravascular coagulation, and bilateral choroid plexus hematomas. Extensive destruction of the choroid plexus, in combination with diffuse intravascular coagulation may explain the much greater elevation of CSF protein than previously described with hypernatremia.- - - - - - - - - - ranking = 14.713521942526keywords = spinal (Clic here for more details about this article) |
10/18. Cryptococcal chorioretinitis.A 40-year-old man developed obstructive hydrocephalus of uncertain cause followed by bilateral intraocular inflammation, which was initially diagnosed as toxoplasmic retinochoroiditis. When visual acuity in the left eye decreased to no light perception and vision in the right eye was failing, a diagnostic enucleation of the blind left eye was performed. A diagnosis of cryptococcal endophthalmitis was established and the remaining right eye showed improvement after systemic anticryptococcal therapy.- - - - - - - - - - ranking = 3.1130802733212keywords = inflammation (Clic here for more details about this article) |
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