1/86. Fisher syndrome with tetraparesis and antibody to GQ1b: evidence for motor nerve terminal block.A Fisher syndrome (FS) patient with antibody to tetrasyaloganglioside GQ1b (GQ1b) developed late limb weakness. Serial motor conduction velocities (MCVs) showed a marked reduction of distal compound muscle action potential (CMAP) amplitudes, worse at 2-3 weeks, followed by a dramatic increase in week 5. Motor conduction velocities were always in the normal range, distal motor latencies changed only slightly, and conduction block in intermediate nerve segments was absent. These electrophysiological data might suggest an axonal neuropathy or a distal demyelinating conduction block. However, the dramatic increase of distal CMAP amplitudes over a short time without significant changes of distal motor latencies, CMAP duration, and morphology indicate that weakness in this FS patient might be due to a block of acetylcholine release from motor terminals, possibly mediated by anti-GQ1b antibodies.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
2/86. Posterior interosseous nerve palsy following placement of the compass elbow hinge for acute instability: a case report.We describe a case of posterior interosseous nerve palsy that developed after application of a hinged elbow external fixation device. Our hypothesis that forearm pronation during ulnar half pin insertion may have been causative is supported by anatomic findings noted during subsequent cadaveric dissection. Based on our observations we recommend that the ulnar half pins required with this device be inserted with the forearm in supination.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
3/86. Stereotactic radiosurgery for cavernous sinus cavernous hemangioma--case report.A 40-year-old female presented with cavernous sinus cavernous hemangioma manifesting as left abducens and trigeminal nerve pareses. magnetic resonance imaging revealed a left cavernous sinus tumor. The tumor was partially removed. Histological examination of the specimen confirmed cavernous hemangioma. radiosurgery was performed using the gamma knife. The tumor markedly decreased in size after radiosurgery and morbidity was avoided. cavernous sinus cavernous hemangiomas may be difficult to treat surgically due to intraoperative bleeding and cranial nerve injury. Stereotactic radiosurgery can be used either as an adjunct treatment to craniotomy, or as the primary treatment for small cavernous sinus cavernous hemangioma.- - - - - - - - - - ranking = 0.4keywords = nerve (Clic here for more details about this article) |
4/86. abducens nerve palsy complicating pregnancy: a case report.We report a case presented at 38 weeks gestation with abducens nerve palsy. No specific pathology was found. After reviewing all the previously reported cases, hypertension is found to be a common factor in all cases presenting in late pregnancy. The clinical course is benign and all resolved after delivery.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
5/86. Nontraumatic acute spinal subdural hematoma: report of five cases and review of the literature.Acute subdural spinal hematoma occurs rarely; however, when it does occur, it may have disastrous consequences. The authors assessed the outcome of surgery for this lesion in relation to causative factors and diagnostic imaging (computerized tomography [CT], CT myelography), as well as eventual preservation of the subarachnoid space. The authors reviewed 106 cases of nontraumatic acute subdural spinal hematoma (101 published cases and five of their own) in terms of cause, diagnosis, treatment, and long-term outcome. Fifty-one patients (49%) were men and 55 (51%) were women. In 70% of patients the spinal segment involved was in the lumbar or thoracolumbar spine. In 57 cases (54%) there was a defect in the hemostatic mechanism. spinal puncture was performed in 50 patients (47%). Late surgical treatment was performed in 59 cases (56%): outcome was good in 25 cases (42%) (in 20 of these patients preoperative neurological evaluation had shown mild deficits or paraparesis, and three patients had presented with subarachnoid hemorrhage [SAH]). The outcome was poor in 34 cases (58%; 23 patients with paraplegia and 11 with SAH). The formation of nontraumatic acute spinal subdural hematomas may result from coagulation abnormalities and iatrogenic causes such as spinal puncture. Their effect on the spinal cord and/or nerve roots may be limited to a mere compressive mechanism when the subarachnoid space is preserved and the hematoma is confined between the dura and the arachnoid. It seems likely that the theory regarding the opening of the dural compartment, verified at the cerebral level, is applicable to the spinal level too. Early surgical treatment is always indicated when the patient's neurological status progressively deteriorates. The best results can be obtained in patients who do not experience SAH. In a few selected patients in whom neurological impairment is minimal, conservative treatment is possible.- - - - - - - - - - ranking = 0.2keywords = nerve (Clic here for more details about this article) |
6/86. Nonunion of a pediatric lateral condyle fracture without ulnar nerve palsy: sixty-year follow-up.Displaced lateral condyle fractures in the pediatric population are usually treated with open reduction and internal fixation. Significant complications associated with the nonoperative management include nonunion, malunion, deformity, and tardy ulnar nerve palsy. However, few cases of nonunion of the lateral condyle and tardy ulnar nerve palsy with long-term follow-up have been reported. We present a radiographically documented case of a pediatric lateral condyle fracture and subsequent nonunion with significant cubitus valgus deformity without ulnar nerve palsy sixty years following injury.- - - - - - - - - - ranking = 1.4keywords = nerve (Clic here for more details about this article) |
7/86. Anterior lumbosacral radiculopathy after intrathecal methotrexate treatment.Intrathecal chemotherapy with methotrexate or cytosine arabinoside is the standard approach to prophylaxis and treatment of central nervous system leukemia in children. Progressive paraplegia, one of the devastating neurologic complications related to this mode of treatment, has been attributed to spinal cord toxicity. Reported are three children who developed progressive paraparesis after intrathecal methotrexate administration followed by complete or partial recovery. gadolinium enhancement of anterior lumbosacral spinal nerve roots was demonstrated in all three patients, and an elevation of cerebrospinal fluid immunoglobulin g synthesis was evident in two patients with more severe symptoms. The clinical data suggest that anterior lumbosacral radiculopathy is also a type of neurologic complication associated with intrathecal methotrexate treatment.- - - - - - - - - - ranking = 0.2keywords = nerve (Clic here for more details about this article) |
8/86. Motor neglect following left thalamic hemorrhage: a case report.We present a report on a patient who developed unilateral motor neglect of the right hemibody after a left thalamic hemorrhage. He presented with pure motor neglect without aphasia, ideomotor apraxia, or unilateral spatial neglect due to a lesion in the centromedian parafascicular (CMPF) and ventrolateral (VL) nuclei of the left thalamus. Although unilateral motor neglect is usually associated with right hemispheric lesions, a left thalamic lesion may also result in isolated motor neglect.- - - - - - - - - - ranking = 0.0048707636150168keywords = median (Clic here for more details about this article) |
9/86. Extracranial vertebral artery dissection causing cervical root lesion.The authors report an unusual manifestation of extracranial vertebral artery dissection (VAD), presenting with a predominantly motor radicular manifestation. Cervical magnetic resonance imaging (MRI) revealed the intramural hematoma in the dissected vessel wall, compressing mainly the segmental motor root and, to a lesser degree, the sensory ganglion. In the digital subtraction angiography (DSA), a circumscribed narrowing of the incriminated vessel was demonstrated. color-coded Duplex imaging (CDDI) revealed complete recanalization after a few days of anticoagulation treatment. Complete neurologic recovery was seen after 3 months. Considering the MRI data, the likely pathogenetic mechanism was compression of the nerve root by the intramural hematoma. The synopsis with similar cases in the literature points to the characteristic features, i.e., the association of neck pain with radicular motor deficit and the absence of degenerative disk disease. The respective syndrome should raise the suspicion of vertebral artery dissection, especially in young individuals.- - - - - - - - - - ranking = 0.2keywords = nerve (Clic here for more details about this article) |
10/86. abducens nerve paresis as first symptom of trigeminal neurinoma. Report of two cases and review of the literature.Two cases of neurinoma of the Gasserian ganglion with abducens nerve paresis as the first symptom are described and 27 cases culled from the literature are reviewed. The anatomo-surgical and clinical-radiological features of this pathology were re-assessed in an attempt to identify the pathogenetic mechanism responsible for a trigeminal neurinoma manifesting with VI cranial nerve palsy.- - - - - - - - - - ranking = 1.2keywords = nerve (Clic here for more details about this article) |
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