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numbness of limbs

Kunal Gandhi, Dharmendra Prasad, Vinay Malhotra, Dhananjai Agrawal
Gitelman's syndrome is an autosomal recessive renal tubular disorder characterized by hypomagnesemia, hypokalemia, hypocalciuria, and metabolic alkalosis. Hypocalcemic tetany as a presentation of Gitelman's syndrome has rarely been reported in literature. We report a rare case of Gitelman's syndrome presenting with hypocalcemic tetany along with hypokalemic periodic paralysis. A 17-year-old female was admitted to our hospital with a history of perioral numbness and carpal spasms of five days duration with progressive quadriparesis developing over a period of few hours...
September 2016: Saudi Journal of Kidney Diseases and Transplantation
Manuela L Ferreira, Andrew McLachlan
Sciatica is a debilitating condition affecting approximately 25 % of the population. Typically, the patient will complain of lower limb pain that is more severe than pain in the lower back, usually accompanied by numbness and motor weakness. Most international guidelines recommend pharmacological management for the pain relief of sciatica, including paracetamol, non-steroidal anti-inflammatory drugs, opioid analgesics, anticonvulsants, and corticosteroids, among others. However, the evidence for most of these pharmacological options is scarce, and the majority of clinical trials exclude older patients...
October 13, 2016: Drugs & Aging
Brian C Smedick, David van Wyck
Acute compartment syndrome (ACS) involving the leg can occur in association with various traumatic and nontraumatic conditions, and it can have serious longterm consequences when unrecognized or untreated. Nontraumatic causes of ACS, such as those associated with cases of prolonged immobilization and/or extremity compression, can be easily overlooked, and several cases of ACS occurring with prolonged surgical positioning can be found in the literature. We present the case of a 19-year-old Army paratrooper who developed acute anterior and lateral compartment syndrome of the lower extremity after being immobilized in an aircraft for hours with several hundred pounds of equipment compressing his lower extremities...
2016: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Lekhjung Thapa, Nooma Sharma, Ramesh Sharma Poudel, Tirtha Raj Bhandari, Riwaz Bhagat, Ashis Shrestha, Shakti Shrestha, Dipendra Khatiwada, Louis R Caplan
BACKGROUND: Baseline stroke knowledge in a targeted population is indispensable to promote the effective stroke education. We report the baseline knowledge, attitude, and practice (KAP) of high school students with respect to stroke from Nepal. MATERIALS AND METHODS: A self-structured questionnaire survey regarding KAP about stroke was conducted in high school students of 33 schools of Bharatpur, Nepal. Descriptive statistics including Chi-square test was used, and the significant variables were subjected to binary logistic regression...
October 2016: Journal of Neurosciences in Rural Practice
Fei Han, Ding-Rong Zhong, Hong-Lin Hao, Wei-Ze Kong, Yi-Cheng Zhu, Hong-Zhi Guan, Li-Ying Cui
BACKGROUND: Hypertrophic pachymeningitis (HP) is a chronic disease characterized by inflammatory hypertrophy and fibrosis of dura mater. It can be divided into cranial and spinal forms depending on the location of the lesion. HP involving 2 separate sites simultaneously is quite uncommon. CASE SUMMARY: This study presents a case of a 49-year-old woman with pathologically confirmed cranial and lumbosacral hypertrophic pachymeningitis associated with systemic lupus erythematosus (SLE), which is a rare etiology of HP...
September 2016: Medicine (Baltimore)
George Sikalengo, Adria Ramirez, Diana Faini, Kim Mwamelo, Manuel Battegay, Levan Jugheli, Christoph Hatz, Klaus Reither, Emilio Letang
BACKGROUND: Extrapulmonary tuberculosis (EPTB) is associated with high rates of morbidity and mortality. Diagnosis of EPTB is challenging in resource-limited settings due to difficulties in obtaining samples, as well as the paucibacillarity of the specimens. Skeletal tuberculosis accounts for 10-35 % of EPTB cases, with vertebral osteomyelitis (Pott's disease) representing 50 % of the cases. We present two cases of suspected Pott's disease, diagnosed through GeneXpert MTB/RIF assay in urine at a rural Tanzanian hospital...
September 26, 2016: BMC Infectious Diseases
Yuri Nakamura, Kei-Ichiro Takase, Takuya Matsushita, Satoshi Yoshimura, Ryo Yamasaki, Hiroyuki Murai, Kazufumi Kikuchi, Jun-Ichi Kira
A 34-year-old man presented with an acute onset of upbeat nystagmus, slurred speech, and limb and truncal ataxias. The patient had a history of limb ataxia and gait disturbance previously treated as brainstem encephalitis with corticosteroids 3 years previously. Brain magnetic resonance imaging showed pontine developmental venous anomaly (DVA) and hemorrhagic infarction within the drainage territory of the DVA. Three months later, the patient exhibited recurrent limb ataxia, double vision, and numbness of the left side of the body...
September 19, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Awder A Khazendar, Hemin M Hama Ameen, Nzar I Jabbar, Seerwan O Hasan, Talar S Ahmed, Alaa A Ali
BACKGROUND: Intradural extramedullary spinal teratoma (IEST) is a rare condition in adult patients with male predominance. It is commonly associated with spinal dysraphism, lumbar puncture and prior spinal surgeries. The study presents a 37-year-old male diagnosed with upper lumbar intradural extramedullary mature cystic teratoma without dysraphism or prior surgical interventions. CASE DESCRIPTION: Patient's symptoms included a lumbar backache which progressed to the toes, as well as the anterior region of both the thighs...
September 15, 2016: World Neurosurgery
Alvin J X Lee, Rachel Benamore, Monika Hofer, Meenali Chitnis
A 60-year-old male was diagnosed with T3, N3, M1b epidermal growth factor receptor (EGFR) mutant lung adenocarcinoma. Five months later he developed significant headaches, weakness and numbness of the left leg, and unsteadiness of gait. Magnetic resonance imaging (MRI) brain demonstrated subtle gyral enhancement indicative of early leptomeningeal infiltration. He was commenced on second-line erlotinib which improved his lower limb symptoms. Three months later he developed increased urinary frequency and redeveloped leg symptoms...
September 2016: Oxford Medical Case Reports
Aria Nouri, Lindsay Tetreault, Kristian Dalzell, Juan J Zamorano, Michael G Fehlings
BACKGROUND: Degenerative cervical myelopathy encompasses a group of conditions resulting in progressive spinal cord injury through static and dynamic compression. Although a constellation of changes can present on magnetic resonance imaging (MRI), the clinical significance of these findings remains a subject of controversy and discussion. OBJECTIVE: To investigate the relationship between clinical presentation and quantitative MRI features in patients with degenerative cervical myelopathy...
September 5, 2016: Neurosurgery
Na Niu, Xinxin Cao, Ruixue Cui
Cervical and lumbosacral nerve roots and plexus involvement in Erdheim-Chester disease (ECD) is rare. A 50-year-old man with progressive edema in bilateral lower extremities, numbness, weakness, and muscle atrophy of upper limb for 2 years had been misdiagnosed of neuritis or cervical spondylosis until he presented bone pain. In addition to bilateral symmetric involvement in long bones, bilateral hypermetabolism in cervical and lumbosacral nerve roots was found by FDG PET/CT scan. ECD was diagnosed by bone biopsy...
November 2016: Clinical Nuclear Medicine
Kazuhiro Itaya, Manabu Inoue, Natsuko Iizuka, Yuki Shimizu, Nobuhiro Yuki, Hiroo Ichikawa
A 17-year-old male with no medical history noticed weakness of his limbs with imbalance and subsequent finger tremors. Physical examination revealed features of polyneuropathy, including diffuse weakness, distal symmetrical numbness with impaired deep sensation and areflexia in all limbs. Postural tremor was present in fingers. Ataxia was apparent in both lower limbs, causing a wide-based gait with a positive Romberg sign. Cerebrospinal fluid contained elevated total protein without pleocytosis. A nerve conduction study disclosed demyelinating features with prolonged terminal latencies, slow velocities with delayed F-wave latencies, and prominent temporal dispersion...
September 29, 2016: Rinshō Shinkeigaku, Clinical Neurology
Marina R Makarov, Samuel H Dunn, Dustin E Singer, Karl E Rathjen, Brandon A Ramo, Chukwudi K Chukwunyerenwa, John G Birch
BACKGROUND: Epiphysiodesis is well-established surgical treatment for the management of leg length discrepancy (LLD) in children; however, a variety of complications may occur. This study evaluates the nature, rate, and potential risk factors of complications associated with epiphysiodesis in a large patient population treated in 1 institution. METHODS: We evaluated the medical and radiographic records of 863 children who had lower extremity epiphysiodesis to manage LLD between 1980 and 2011...
August 19, 2016: Journal of Pediatric Orthopedics
Andrew Lederman, David Turk, Antonio Howard, Srinivas Reddy, Michelle Stern
We present the case of a 24 yr old male who was diagnosed with gluteal compartment syndrome and was subsequently found to have developed lumbosacral radiculoplexopathy and complex regional pain syndrome. The patient's gluteal compartment syndrome was diagnosed within 24 h of presentation to the emergency room, and he underwent emergent compartment release. While recovering postoperatively, persistent weakness was noted in the right lower limb. Results of electrodiagnostic testing were consistent with a lumbosacral radiculoplexopathy...
2016: Journal of Rehabilitation Research and Development
Li Fu, Li Chen, Na Wei, Da-Yong Huang, Jing Shen, Jing-Shi Wang, Yi-Ni Wang, Hua Cui, Ling-Zhi Yang, Zhao Wang
OBJECTIVE: To investigate the clinical characteristics, therapeutic outcomes and prognostic factors of primary central nervous system lymphoma (PCNSL). METHODS: Clinical records of 31 cases of PCNSL were collected, the clinical charactenstics were analyzed retrospectively. Survival curves were estimated using Kaplan-Meier survival methodology and statistical significance of continuous variables was assessed via the Cox proportional hazard model. RESULTS: The median age was 52 years, with a ratio of male to female 1:1...
August 2016: Zhongguo Shi Yan Xue Ye Xue za Zhi
Sheng-hua He, Du-jun Ma, Xiang Zhao, Hao Ding, Jun Fang
OBJECTIVE: To study clinical effects of unilateral pedicle screw-rod system fixation combined with the single the cage of interbody fusion in the treatment of lumbar degenerative instability via paraspinal intermuscular approach under MAST Quadrant retractor. METHODS: From February 2010 to December 2011, 39 patients with lumbar degenerative instability after invalid conservative treatment were treated with unilateral fixation combined with interbody fusion via the paraspinal intermuscular approach under MAST Quadrant retractor...
May 2016: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
R Rudolf
In 1718, French surgeon Jean-Louis Petit refined the methods to prevent haemorrhage from severely injured limbs by a combined screw and pad attached to a bandage (Kirkup, 2007). He named this device tourniquet (from French tourner = to turn), because the screw allowed fine adjustment of the application without moving the bandage component. Since then, tourniquet has undergone several modifications and its use is a matter of constant debate. Tourniquets serve primarily in combat but also in civilian emergency medicine to prevent fatal exsanguination and an estimated number of 15,000 daily tourniquet applications (McEwen and Casey, 2009) illustrates its present clinical relevance...
August 6, 2016: Acta Physiologica
Koichi Nakao, Michito Namekawa, Soichi Kondo, Sayaka Ono, Imaharu Nakano
A 73-year-old woman who had hypertension developed a slight fever and general malaise with laboratory-proven hepatic dysfunction as well as frequent syncopal attacks 3 months before admission to our hospital. One month later, she developed urinary retention and distal limb numbness. Upon admission, her neurological examination showed reduced limb tendon reflexes, glove and stocking-type numbness, and diminished senses of touch, temperature, pain, and distal leg vibration and position. Serum cytomegalovirus (CMV) IgM antibody and CMV IgG antibody were elevated on admission, and both decreased thereafter, confirming CMV infection...
August 31, 2016: Rinshō Shinkeigaku, Clinical Neurology
Qian Wang, Bo Liu, Youde Yan
BACKGROUND: Mucormycosis is a kind of rare opportunistic fungal disease and the incidence of which has gradually increased. Disseminated mucormycosis (DM) is a life-threatening infection that mostly occurs in immunocompromised patients. The lung and brain are usually involved in disseminated mucormycosis, and other sites are scare. We report the first case of disseminated mucormycosis whose infection sites included lung, skin, liver, vertebra, and spinal cord that ensued after a right lung pneumonectomy in an immunocompetent patient...
2016: BMC Infectious Diseases
Chao-Feng Fu, Yuan-Dong Zhuang, Chun-Mei Chen, Gang-Feng Cai, Hua-Bin Zhang, Wei Zhao, Said Idrissa Ahmada, Ramparsad Doorga Devi, Md Golam Kibria
To report a minimally invasive paraspinal approach in the treatment of a case of spontaneous spinal epidural hematoma (SSEH). We additionally aim to review the relevant literature to enhance our knowledge of this disease. SSEH is an uncommon but potentially catastrophic disease. Currently, most appropriate management is emergence decompression laminectomy and hematoma evacuation. An 81-year-old woman was admitted to the neurology department with a chief complaint of bilateral numbness and weakness of the lower limbs and difficulty walking for 4 days with progressive weakness developed over the following 3 days accompanied with pain in the lower limbs and lower back...
June 2016: Medicine (Baltimore)
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