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https://www.readbyqxmd.com/read/28546874/acute-paraparesis-and-sensory-loss-following-intravenous-corticosteroid-administration-in-a-case-of-longitudinally-extensive-transverse-myelitis-caused-by-spinal-dural-arteriovenous-fistula-case-report-and-review-of-literature
#1
Michael A DiSano, Russell Cerejo, MaryAnn Mays
INTRODUCTION: The underlying causes of longitudinally extensive transverse myelitis (LETM) are broad and include inflammatory processes, compression and spinal dural arteriovenous fistula (SDAVF). Presenting symptoms of SDAVF are nonspecific and often go misdiagnosed. Acute clinical deterioration from SDAVF has been described following exertion or valsalva. However, deterioration has been recently recognized following steroid administration and may contribute to increased morbidity. CASE PRESENTATION: We describe a 63-year-old woman with a 2-year history of intermittent lower extremity numbness and back pain, lumbar stenosis, who presented with subacute worsening of symptoms following a course of oral steroids for an upper respiratory infection...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28542102/influence-of-paravertebral-muscle-quality-on-treatment-efficacy-of-epidural-steroid-infiltration-or-surgical-decompression-in-lumbar-spinal-stenosis-analysis-of-the-lumbar-spinal-outcome-study-lsos-data-a-swiss-prospective-multi-center-cohort-study
#2
Michael Betz, Jakob M Burgstaller, Ulrike Held, Gustav Andreisek, Johann Steurer, Francois Porchet, Mazda Farshad
STUDY DESIGN: Prospective multi-center cohort study. OBJECTIVE: To study the question whether paravertebral muscle quality may affect the clinical outcome of epidural steroid infiltration (ESI) or surgical decompression in patients with symptomatic lumbar spinal stenosis (LSS). SUMMARY OF BACKGROUND DATA: To the present, the impact of paravertebral muscle quality on clinical outcome of epidural steroid infiltration (ESI) or surgical decompression in patients with lumbar spinal stenosis (LSS) has not been clarified...
May 25, 2017: Spine
https://www.readbyqxmd.com/read/28540126/neurological-complications-of-lumbar-and-cervical-dural-punctures-with-a-focus-on-epidural-injections
#3
Nancy E Epstein
BACKGROUND: Various types of lumbar dural punctures may contribute to neurological injury. The etiologies of dural injury include; inadvertent dural punctures due to epidurals placed for labor anesthesia, epidural steroid injections (ESI/transforaminal TESI; approximately 9 million ESI performed in the US per year), deliberate placement of intradural pain devices, and spontaneous cerebrospinal fluid (CSF) fistulas. Resulting neurological complications may include; spinal headaches/intracranial hypotension, subdural hematomas, and 6(th) nerve cranial palsies...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28540118/spinal-cord-injury-in-the-geriatric-population-risk-factors-treatment-options-and-long-term-management
#4
REVIEW
Tochukwu C Ikpeze, Addisu Mesfin
Spinal cord injuries (SCIs) are sustained by more than 12 500 patients per year in the United States and more globally. The SCIs disproportionately affect the elderly, especially men. Approximately 60% of these injuries are sustained traumatically through falls, but nontraumatic causes including infections, tumors, and medication-related epidural bleeding have also been documented. Preexisting conditions such as ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis can render the spine stiff and are risk factors as well as cervical spondylosis and ensuing cervical stenosis...
June 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28536850/effectiveness-of-daily-prednisolone-to-slow-progression-of-human-t-lymphotropic-virus-type-1-associated-myelopathy-tropical-spastic-paraparesis-a-multicenter-retrospective-cohort-study
#5
Ariella L G Coler-Reilly, Tomoo Sato, Toshio Matsuzaki, Masanori Nakagawa, Masaaki Niino, Masahiro Nagai, Tatsufumi Nakamura, Norihiro Takenouchi, Natsumi Araya, Naoko Yagishita, Eisuke Inoue, Yoshihisa Yamano
Millions of people are infected with human T-lymphotropic virus type 1 (HTLV-1) worldwide; notable endemic areas include Brazil, the Caribbean islands, Iran, and Japan. A small number of those infected develop the progressive neurodegenerative disease HTLV-1-associated myelopathy (HAM), also known as tropical spastic paraparesis (TSP), which is characterized by chronic spinal cord inflammation and accompanying myelopathic symptoms. The corticosteroid prednisolone (PSL) is a classic treatment for HAM/TSP, yet its effectiveness remains controversial owing to insufficient and conflicting studies...
May 23, 2017: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
https://www.readbyqxmd.com/read/28535546/cost-utility-analysis-of-lumbar-interlaminar-epidural-injections-in-the-treatment-of-lumbar-disc-herniation-central-spinal-stenosis-and-axial-or-discogenic-low-back-pain
#6
Laxmaiah Manchikanti, Vidyasagar Pampati, Ramsin M Benyamin, Joshua A Hirsch
BACKGROUND: Cost utility or cost effective analysis continues to take center stage in the United States for defining and measuring the value of treatments in interventional pain management. Appropriate cost utility analysis has been performed for caudal epidural injections, percutaneous adhesiolysis, and spinal cord stimulation. However, the literature pertaining to lumbar interlaminar epidural injections is lacking, specifically in reference to cost utility analysis derived from randomized controlled trials (RCTs) with a pragmatic approach in a practical setting...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28532172/cranio-spinal-rosai-dorfman-disease-case-series-and-literature-review
#7
Shashank S Joshi, Shilpa Joshi, Girish Muzumdar, Keki E Turel, Rajan M Shah, Indoo Ammbulkar, Muhammad Masood Hussain, Kishor A Choudhari
Rosai-Dorfman disease (RDD) is a rare condition similar to lymphomas, presenting with cervical lymphadenopathy in young adults. Extra-nodal involvement is relatively common but involvement of the central nervous system (CNS) is rare. Cranial RDD presents with symptoms of raised intracranial pressure, focal or generalised seizures, while spinal RDD presents with pain, peripheral neurological deficits and radiculopathy. In contrast to other similar neoplastic or degenerative conditions affecting the CNS, RDD is a benign, non-infective, granulomatous disorder...
May 22, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28526323/-18-f-fdg-pet-ct-helps-in-unmasking-the-great-mimicker-a-case-of-neurosarcoidosis-with-isolated-involvement-of-the-spinal-cord
#8
A Gholamrezanezhad, L Mehta
A 36 year-old male with no significant past medical history presented with lower extremity numbness, gait instability, and urinary and bowel retention of 4 weeks onset. Spine MRI revealed diffuse oedema of cervicothoracic spinal cord with several solid enhancing intramedullary lesions, suggestive of metastases. The (18)F-FDG PET/CT performed to identify the primary malignancy demonstrated mild hypermetabolic foci within the cervicothoracic cord, as well as a mildly hypermetabolic bilateral hilar lymphadenopathy and a mildly hypermetabolic pulmonary nodule, suggestive of sarcoidosis versus metastasis...
May 16, 2017: Revista Española de Medicina Nuclear e Imagen Molecular
https://www.readbyqxmd.com/read/28503326/incomplete-paraplegia-caused-by-extramedullary-hematopoiesis-in-a-patient-with-thalassemia-intermedia
#9
Nurhasyimah Hisamud-Din, Nadia Mohd Mustafah, Aishah Ahmad Fauzi, Natiara Mohamad Hashim
INTRODUCTION: Extramedullary hematopoiesis (EMH) is the production of blood cell precursors outside the bone marrow that occur in various hematological diseases. In patients with thalassemia intermedia, ineffective erythropoiesis drives compensatory EMH in the liver, pancreas, pleura, spleen, ribs and spine. CASE PRESENTATION: We describe a patient with thalassemia intermedia who presented with acute neurological symptoms caused by paraspinal EMH, which responded well to combination therapy of steroid, hypertransfusion, laminectomy and excision of pseudotumor and hydroxyurea therapy to boost the formation of fetal haemoglobin...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28484568/concurrent-multiple-intracranial-and-intramedullary-conus-tuberculoma-a-rare-case-report
#10
Manish Jaiswal, Ashok Gandhi, Devendra Purohit, Radhey Shyam Mittal
Central nervous system (CNS) tuberculosis commonly manifests as tubercular meningitis. CNS tuberculomas are more common intracranially and less frequently involve the spinal cord. Combination of intramedullary with intracranial tuberculomas is extremely rare. We report a case of concurrent occurrence of intramedullary tuberculoma with multiple intracranial tuberculomas in a young 16-year-old boy, who presented with two weeks history of paresthesias and weakness of the lower limbs and diminution of vision in left eye, who had been treated for pulmonary tuberculosis...
April 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28483686/persistent-hiccups-after-an-epidural-steroid-injection-successfully-treated-with-baclofen-a-case-report
#11
Berdale Colorado, Gregory Decker
Persistent hiccups are an established adverse reaction to epidural steroid injections. Although oral baclofen has been used to treat hiccups in various clinical settings, none of the previously reported studies that used baclofen were related to hiccups occurring after spinal injections/procedures. We report a case of a man who developed persistent hiccups after a transforaminal epidural steroid injection that was treated successfully with oral baclofen. LEVEL OF EVIDENCE: To be determined...
May 5, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28468527/spinal-racemose-cysticercosis-case-report-and-review
#12
Hussam A Yacoub, Ira Goldstein, Mohammad El-Ghanem, Leroy Sharer, Nizar Souayah
Cysticercosis is a common helminthic infection worldwide, endemic in Central and South America, sub-Saharan Africa, and Southeast Asia. Neurocysticercosis typically involves brain parenchyma, subarachnoid space, and the ventricular system. Although the spinal cord is frequently involved in patients with parenchymal neurocysticercosis, isolated spinal involvement is rare, occurring in only 1-3% of patients. We report a case of racemose spinal neurocysticercosis with brain parenchyma involvement in a 49-year-old Mexican man, who presented with unsteady gait and bilateral arm numbness and weakness...
May 4, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28437329/metastatic-spinal-cord-compression-and-steroid-treatment-a-systematic-review
#13
Abhishek Kumar, Michael H Weber, Ziya Gokaslan, Jean-Paul Wolinsky, Meic Schmidt, Laurence Rhines, Michael G Fehlings, Ilya Laufer, Daniel M Sciubba, Michelle J Clarke, Narayan Sundaresan, Jorrit-Jan Verlaan, Arjun Sahgal, Dean Chou, Charles G Fisher
STUDY DESIGN: Systematic review. OBJECTIVES: We conducted a systematic review of the literature to answer the following questions regarding the use of steroid therapy in metastatic spinal cord compression (MSCC): 1. In cases of MSCC, what is the effect of steroid administration before definitive radiotherapy or surgery on ambulatory status, bowel and bladder function and survival? 2. What steroid dosing regimens are associated with the best outcomes concerning neurological symptoms and complication prevention in cases of MSCC? SUMMARY OF BACKGROUND DATA: Currently, there is significant variation in the initial bolus dose, daily maintenance dose and duration of treatment when steroids are used as a bridge to definitive therapy for MSCC...
May 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28420330/anti-mog-antibody-positive-adem-following-infectious-mononucleosis-due-to-a-primary-ebv-infection-a-case-report
#14
Yoshitsugu Nakamura, Hideto Nakajima, Hiroki Tani, Takafumi Hosokawa, Shimon Ishida, Fumiharu Kimura, Kimihiko Kaneko, Toshiyuki Takahashi, Ichiro Nakashima
BACKGROUND: Anti-Myelin oligodendrocyte glycoprotein (MOG) antibodies are detected in various demyelinating diseases, such as pediatric acute disseminated encephalomyelitis (ADEM), recurrent optic neuritis, and aquaporin-4 antibody-seronegative neuromyelitis optica spectrum disorder. We present a patient who developed anti-MOG antibody-positive ADEM following infectious mononucleosis (IM) due to Epstein-Barr virus (EBV) infection. CASE PRESENTATION: A 36-year-old healthy man developed paresthesia of bilateral lower extremities and urinary retention 8 days after the onset of IM due to primary EBV infection...
April 19, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28409420/single-fraction-spine-stereotactic-ablative-body-radiotherapy-with-volumetric-modulated-arc-therapy
#15
Matthew M Gestaut, Nitika Thawani, Sangroh Kim, Veera R Gutti, Sameer Jhavar, Niloyjyoti Deb, Andrew Morrow, Russell A Ward, Jason H Huang, Mehul Patel
This study investigated a single institution's experience with volumetric modulated arc therapy (VMAT) directed stereotactic ablative body radiotherapy (SABR) for vertebral metastases. From 2010 to 2014, 95 lesions of spinal metastases in 73 patients were treated with SABR using VMAT. Clinical local control, pain level, and use of steroid medication were employed to evaluate treatment responses. The majority (79%) of patients were treated with a radiation dose of 20 Gy in a single fraction. However, when normal tissue constraints could not be achieved, the dose was reduced to 18 Gy (11%) or 16 Gy (8%) in 1 fraction...
April 13, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28405033/post-caesarean-analgesia-what-is-new
#16
REVIEW
Sukhyanti Kerai, Kirti Nath Saxena, Bharti Taneja
Adequate post-operative analgesia after caesarean section (CS) is vital as it impacts the distinct surgical recovery requirements of the parturient. Although newer analgesic modalities and drugs for post-caesarean analgesia have been introduced over the recent years, review of the literature suggests suggests that we are far from achieving the goals of optimum post-operative analgesia. We conducted a systematic review of recent advances in modalities for post-caesarean analgesia. After systematic search and quality assessment of studies, we included a total of 51 randomised controlled trials that evaluated the role of opioids, transversus abdominis plane (TAP) block, wound infiltration/infusion, ketamine, gabapentin and ilioinguinal-iliohypogastric nerve block (II-IH NB) for post-caesarean analgesia...
March 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28394747/risk-and-protective-factors-associated-with-surgical-infections-among-spine-patients
#17
REVIEW
Alyssa G Blood, Melanie F Sandoval, Evalina Burger, Katherine Halverson-Carpenter
BACKGROUND: The purpose of the study was to identify patient-specific and procedure-specific risk and protective factors associated with post-operative surgical site infections (SSIs) among surgical spine patients. METHODS: CINAHL, PubMed, Ovid, Medline, and EBSCO databases were searched for articles within the past 10 years (January 2003-March 2015). The keywords and combinations used in the search included: Spine surgery, post-operative infection, risk factors, orthopedic infections...
April 2017: Surgical Infections
https://www.readbyqxmd.com/read/28378140/management-of-non-hodgkin-lymphoma-icmr-consensus-document
#18
Nirav Thacker, Sameer Bakhshi, Girish Chinnaswamy, Tushar Vora, Maya Prasad, Deepak Bansal, Sandeep Agarwala, Gauri Kapoor, Venkatraman Radhakrishnan, Siddharth Laskar, Tanvir Kaur, G K Rath, Rupinder Singh Dhaliwal, Brijesh Arora
Hitherto poor outcomes, paucity of data and heterogeneity in International approach to Pediatric NHL (Non-Hodgkin Lymphoma) prompted the need for guidelines for Indian population with vast variability in access, affordability and infrastructure across the country. These guidelines are based on consensus among the experts and best available evidence applicable to Indian setting. Evaluation of NHL should consist of easily doable and rapid tissue diagnosis (biopsy or flow cytometry of peripheral blood/malignant effusions), St Jude/IPNHLSS (International Pediatric Non-Hodgkin Lymphoma Staging System) and risk grouping with CSF (Cerebro-spinal fluid), bone marrow, whole body imaging [CECT (Contrast enhanced computerized tomography) ± MRI (Magnetic resonance imaging)] and blood investigations for LDH (Lactate dehydrogenase), TLS (Tumor lysis syndrome) and organ functions...
April 5, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28377867/effect-of-perioperative-steroids-on-dysphagia-after-anterior-cervical-spine-surgery-a-systematic-review
#19
Abidemi S Adenikinju, Sameer H Halani, Rima S Rindler, Matthew F Gary, Keith W Michael, Faiz U Ahmad
BACKGROUND: Dysphagia following anterior cervical spine surgery is common. Steroids potentially reduce post-operative inflammation that leads to dysphagia; however, the efficacy, optimal dose and route of steroid administration have not been fully elucidated. OBJECTIVE: The purpose of this systematic review is to evaluate the effect of peri-operative steroids on the incidence and severity of dysphagia following anterior cervical spine surgery. METHODS: A PubMed search adherent to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed to include clinical studies reporting use of steroids in adult patients following anterior cervical spine surgery...
2017: International Journal of Spine Surgery
https://www.readbyqxmd.com/read/28375916/neuropathic-pain
#20
Lindsay A Zilliox
PURPOSE OF REVIEW: Neuropathic pain is a frequently encountered condition that is often resistant to treatment and is associated with poor patient satisfaction of their treatment. Several medications have been shown to be effective in treating neuropathic pain associated with diabetic neuropathy and postherpetic neuralgia, and these medications are often used to treat neuropathic pain associated with other conditions as well. This article summarizes the diagnosis and assessment of patients with neuropathic pain as well as available pharmacologic and interventional treatment options...
April 2017: Continuum: Lifelong Learning in Neurology
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