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https://www.readbyqxmd.com/read/29050399/diagnostic-criteria-for-chronic-lymphocytic-inflammation-with-pontine-perivascular-enhancement-responsive-to-steroids-clippers
#1
W Oliver Tobin, Yong Guo, Karl N Krecke, Joseph E Parisi, Claudia F Lucchinetti, Sean J Pittock, Jay Mandrekar, Divyanshu Dubey, Jan Debruyne, B Mark Keegan
Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a central nervous system inflammatory syndrome predominantly affecting the brainstem, cerebellum, and spinal cord. Following its initial description, the salient features of CLIPPERS have been confirmed and expanded upon, but the lack of formalized diagnostic criteria has led to reports of patients with dissimilar features purported to have CLIPPERS. We evaluated clinical, radiological and pathological features of patients referred for suspected CLIPPERS and propose diagnostic criteria to discriminate CLIPPERS from non-CLIPPERS aetiologies...
September 1, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/29034173/mycobacteria-bovis-osteomyelitis-following-intravesical-bcg-for-bladder-cancer
#2
Karan Seegobin, Satish Maharaj, Cherisse Baldeo, Carmen Isache, Bharatsinh Gharia, Lara Zuberi
Mycobacteria Bovis osteomyelitis is a rare adverse effect after Bacillus Calmette-Guerin (BCG) intravesical therapy. A 62-year-old male presented with acute spinal cord compression three months after completing his second course of therapy for bladder cancer. The first course with intravesical BCG was complicated with an episode of hematuria. He reported intermittent subjective fever for 3 weeks thereafter which resolved with Tylenol. Interferon-α2 B was added to the second cycle of intravesical BCG with the indication here being residual tumor, and was tolerated well...
2017: IDCases
https://www.readbyqxmd.com/read/29030418/short-delay-to-initiate-plasma-exchange-is-the-strongest-predictor-of-outcome-in-severe-attacks-of-nmo-spectrum-disorders
#3
Mickael Bonnan, Rudy Valentino, Stéphane Debeugny, Harold Merle, Jean-Louis Fergé, Hossein Mehdaoui, Philippe Cabre
INTRODUCTION: Severe attacks of neuromyelitis optica spectrum disorder (NMO-SD) are improved by plasma exchange (PLEX) given as an adjunctive therapy. Initial studies failed to demonstrate a delay of PLEX treatment influenced clinical outcome; however PLEX was always used late. We examine the clinical consequences of delay in PLEX initiation on severe optic neuritis and spinal cord attacks in NMO-SD. METHODS: All of our patients who suffered attacks of NMO-SD, treated in our centre by PLEX, were retrospectively considered for inclusion...
October 13, 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/29028962/clinical-features-of-acute-flaccid-myelitis-temporally-associated-with-an-enterovirus-d68-outbreak-results-of-a-nationwide-survey-of-acute-flaccid-paralysis-in-japan-august-december-2015
#4
Pin Fee Chong, Ryutaro Kira, Harushi Mori, Akihisa Okumura, Hiroyuki Torisu, Sawa Yasumoto, Hiroyuki Shimizu, Tsuguto Fujimoto, Nozomu Hanaoka, Susumu Kusunoki, Toshiyuki Takahashi, Kazunori Oishi, Keiko Tanaka-Taya
Backgroud: Acute flaccid myelitis (AFM) is an acute flaccid paralysis (AFP) syndrome with spinal motor neuron involvement of unknown etiology. We investigated the characteristics and prognostic factors of AFM clusters coincident with an enterovirus D68 (EV-D68) outbreak in Japan during autumn 2015. Methods: An AFM case series study was conducted following a nationwide survey from August to December 2015. Radiographic and neurophysiologic data were subjected to centralized review, and virology studies were conducted for available specimens...
October 6, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29028790/imaging-factors-that-distinguish-between-patients-with-asymptomatic-and-symptomatic-cervical-spondylotic-myelopathy-with-mild-to-moderate-cervical-spinal-cord-compression
#5
Jun Ming Cao, Jing Tao Zhang, Da Long Yang, Yi Peng Yang, He Huan Xia, Liu Yang
BACKGROUND Not all patients with spinal cord compression due to cervical spondylotic myelopathy (CSM) have clinical symptoms and signs. The aim of this study was to investigate and compare the imaging findings in asymptomatic and symptomatic patients with CSM with mild to moderate cervical spinal cord compression. MATERIAL AND METHODS A retrospective clinical study included 68 patients. Group A (n=30) had no symptoms and signs; group B (n=38) had symptoms and signs of cervical myelopathy. The age, sex, body mass index (BMI), history of steroid treatment, duration of symptoms, number of spondylotic cervical segments, Torg ratio, range of motion (ROM), incidence of cervical segmental instability, overall curvature of the cervical spine, direction of spinal cord compression, and spinal cord magnetic resonance imaging (MRI) signal intensity were compared...
October 13, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29025172/-anti-myelin-oligodendrocyte-glycoprotein-antibodies-in-paediatric-patients-with-optic-neuritis
#6
Helmut Tegetmeyer, Andreas Merkenschlager
Background Myelin oligodendrocyte glycoprotein (MOG) is located on the surface of oligodendrocytes and myelin in the central nervous system. MOG-IgG is associated with acute disseminated encephalomyelitis (ADEM), relapsing and bilateral optic neuritis (NNO), and transverse myelitis (TM) in both paediatric and adult patients. The combination of NNO and TM or other inflammatory brain lesions is a typical feature of neuromyelitis optica spectrum disorders (NMO-SD) which are associated with specific pathogenic autoantibodies against the water channel aquaporin-4 (AQP4-IgG)...
October 2017: Klinische Monatsblätter Für Augenheilkunde
https://www.readbyqxmd.com/read/29021984/mri-findings-of-early-stage-hyperacute-hemorrhage-causing-extramedullary-compression-of-the-cervical-spinal-cord-in-a-dog-with-suspected-steroid-responsive-meningitis-arteritis
#7
Adriano Wang-Leandro, Enrice-Ina Huenerfauth, Katharina Heissl, Andrea Tipold
A 9-month-old female Weimaraner was presented to the emergency service due to episodes of fever and neck pain. Physical examination revealed a stiff neck posture and elevated body temperature. Shortly after clinical examination was performed, the dog developed peracute onset of non-ambulatory tetraparesis compatible with a C1-C5 spinal cord (SC) lesion. Immediately thereafter (<1 h), MRI of the cervical SC was performed with a 3-T scanner. A left ventrolateral intradural-extramedullary SC compression caused by a round-shaped structure at the level of C3--C4 was evidenced...
2017: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/29019639/spine-conditions-cervical-spine-conditions
#8
Marc A Childress
There are a variety of causes of neck pain, including trauma and degenerative changes. The history of onset helps to direct evaluation, including the need for imaging or ancillary testing. Patterns of pain, weakness, and other specific physical examination findings also aid in diagnosis. Management of most soft tissue injuries involves early mobilization, whereas fractures are managed based on patterns of instability. Acute spinal cord injury requires emergent care, to include possible decompressive surgery...
October 2017: FP Essentials
https://www.readbyqxmd.com/read/29017806/implementation-of-a-bundled-protocol-significantly-reduces-risk-of-spinal-cord-ischemia-after-branched-or-fenestrated-endovascular-aortic-repair
#9
Salvatore T Scali, Moses Kim, Paul Kubilis, Robert J Feezor, Kristina A Giles, Brittney Miller, Javairiah Fatima, Thomas S Huber, Scott A Berceli, Martin Back, Adam W Beck
OBJECTIVE: Spinal cord ischemia (SCI) is a devastating complication after branched or fenestrated endovascular aortic repair (B/FEVAR) for thoracoabdominal aortic disease. The purpose of this analysis was to describe the impact of a bundled clinical care protocol designed to reduce the risk of SCI in this population of patients. METHODS: A bundled SCI prevention protocol including cerebrospinal fluid drainage, blood pressure parameters, transfusion goals, and pharmacologic adjuncts (steroids, naloxone) was initiated in May 2015...
October 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29016914/spinal-cord-injury-during-attempted-cervical-interlaminar-epidural-injection-of-steroids
#10
Milton H Landers
Background: Interlaminar cervical epidural injections are commonly performed in the practice of interventional pain medicine. Injury to the spinal cord following injection into the substance of the cord is a known complication of this procedure, but it has rarely been reported and illustrated in the literature. Objective: To describe and analyze a case where an inadvertent injection of contrast medium into the cervical spinal cord occurred. Highlighted is the dissonance between how the procedure was performed and published guidelines for its performance...
July 11, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28991690/neuromyelitis-optica-spectrum-disorders-with-antibodies-to-myelin-oligodendrocyte-glycoprotein-or-aquaporin-4-clinical-and-paraclinical-characteristics-in-algerian-patients
#11
Melissa Bouzar, Smail Daoudi, Samira Hattab, Amel A Bouzar, Kumaran Deiva, Brigitte Wildemann, Markus Reindl, Sven Jarius
BACKGROUND: Neuromyelitis optica (NMO) is a severe autoimmune inflammatory disorder of the central nervous system. NMO and its abortive forms are referred to as NMO spectrum disorders (NMOSD). NMOSD are mostly associated with antibodies to aquaporin-4 (AQP4-IgG). However, recent studies have demonstrated antibodies to myelin oligodendrocyte glycoprotein (MOG-IgG) in a subset of patients. Data on NMOSD in North Africa are sparse. OBJECTIVE: To describe the frequency of MOG-IgG and AQP4-IgG among patients with optic neuritis (ON) and/or myelitis in Algeria as well as the clinical and paraclinical features associated with these antibodies...
October 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28984753/cervical-epidural-analgesia-complicated-by-epidural-abscess-a-case-report-and-literature-review
#12
REVIEW
Jun-Hui Zhang, Zhi-Li Wang, Li Wan
RATIONALE: Spinal epidural abscess is an uncommon complication in clinical practice. If the abscess is large enough, the patient will rapidly develop neurologic signs of spinal injury, and urgent neurosurgical intervention may be required. PATIENT CONCERNS: Rapid and correct diagnosis and treatment is important for spinal epidural abscess complication. DIAGNOSES: This report describes a cervical epidural abscess (CEA) caused by epidural analgesia, wherein the patient was punctured twice...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28984538/lessons-learned-from-administration-of-high-dose-methylprednisolone-sodium-succinate-for-acute-pediatric-spinal-cord-injuries
#13
Michelle C Caruso, Margot C Daugherty, Suzanne M Moody, Richard A Falcone, Karin S Bierbrauer, Gary L Geis
OBJECTIVE Methylprednisolone sodium succinate (MPSS) has been studied as a pharmacological adjunct that may be given to patients with acute spinal cord injury (ASCI) to improve neurological recovery. MPSS treatment became the standard of care in adults despite a lack of evidence supporting clinical benefit. More recently, new guidelines from neurological surgeon groups recommended no longer using MPSS for ASCI, due to questionable clinical benefit and known complications. However, little information exists in the pediatric population regarding MPSS use in the setting of ASCI...
October 6, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28973360/motor-evoked-potentials-correlate-with-magnetic-resonance-imaging-and-early-recovery-after-acute-spinal-cord-injury
#14
Sanjay S Dhall, Jenny Haefeli, Jason F Talbott, Adam R Ferguson, William J Readdy, Jacqueline C Bresnahan, Michael S Beattie, Jonathan Z Pan, Geoffrey T Manley, William D Whetstone
BACKGROUND: While the utilization of neurophysiologic intraoperative monitoring with motor evoked potentials (MEPs) has become widespread in surgery for traumatic spine fractures and spinal cord injury (SCI), clinical validation of its diagnostic and therapeutic benefit has been limited. OBJECTIVE: To describe the use of intraoperative MEP at a large level I trauma center and assess the prognostic capability of this technology. METHODS: The SCI REDCap database at our institution, a level I trauma center, was queried for acute cervical SCI patients who underwent surgery with intraoperative monitoring between 2005 and 2011, yielding 32 patients...
July 7, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28970675/role-of-low-plasma-volume-treatment-on-clinical-efficacy-of-plasmapheresis-in-neuromyelitis-optica
#15
Akshay Batra, Sundar Periyavan
BACKGROUND: Neuromyelitis optica (NMO) is an autoimmune demyelinating disease preferentially targeting the optic nerves and spinal cord. Plasmapheresis (PP) is an effective adjunct therapy in severe NMO attacks. The recommended minimum plasma volume to be treated per session of PP is equivalent to total plasma volume (TPV) of the patient. AIM: To study the effect of lower plasma volume treated in patients with NMO on clinical efficacy of plasmapheresis in comparison to minimum recommended volume...
July 2017: Asian Journal of Transfusion Science
https://www.readbyqxmd.com/read/28962959/effect-of-interlaminar-epidural-steroid-injection-in-patients-with-central-cervical-spinal-stenosis
#16
Dong Gyu Lee, Min Cheol Chang
OBJECTIVE: The authors investigated the effect of interlaminar ESI for the management of central cervical spinal stenosis-induced posterior neck pain. METHODS: Forty-five patients with posterior neck pain caused by central cervical spinal stenosis were recruited retrospectively. For the ESI procedure, a 21-g Touhy needle was inserted into the epidural space between C7 and T1, and 20 mg (40 mg/mL) of dexamethasone with 4 mL of normal saline was injected. The effect of the procedure was evaluated using a numerical rating scale (NRS) at 1, 2, and 3 months after the procedure...
September 26, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28958166/igg4-related-disease-presenting-as-intradural-extramedullary-lesion-a-case-report-and-review-of-the-literature
#17
Kelly J Bridges, Caitlin H DeDeaux, Khoi D Than
OBJECT: IgG4-related disease (IgG4-RD) is a fibro-inflammatory disorder affecting various anatomical sites, and only recently was identified to affect the dura of the spine. The authors present the second reported case of an intradural extramedullary lesion consistent with IgG4-related spinal disease. METHODS: A literature review was performed that identified 15 other cases of spinal disease, and common features of all known reported spinal IgG4-RD are discussed...
September 28, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28955005/accurate-diagnosis-of-chronic-low-back-pain-in-a-high-level-college-athlete-a-case-report
#18
Kenji Yokoyama, Kazuta Yamashita, Masatoshi Morimoto, Fumitake Tezuka, Fumio Hayashi, Yoichiro Takata, Toshinori Sakai, Kosaku Higashino, Takashi Chikawa, Hiroshi Yonezu, Akihiro Nagamachi, Koichi Sairyo
A 21-year-old woman who was high-level college softball player presented with a 6-month history of low back pain that had been treated unsuccessfully by medication at local clinics. There was tenderness in the left paravertebral muscle at the lower lumbar level. X-ray and computed tomography revealed congenital scoliosis and an L6 hemivertebra. Short tau inversion recovery magnetic resonance imaging showed a fluid collection at the left L6-S1 facet joint. We performed a diagnostic facet injection, consisting of 1% lidocaine and steroids, that was infiltrated into the left facet joint at L6-S1...
2017: Journal of Medical Investigation: JMI
https://www.readbyqxmd.com/read/28953648/intramuscular-hematoma-with-motor-weakness-after-trigger-point-injection-a-case-report
#19
Sang Gyun Kim, Kwang Seok Shim, Dong Won Lee, Eun Ju Kim, Sang-Gon Lee, Ji-Hyang Lee, Ji Hyun An
RATIONALE: Although trigger point injection is known as an easy and low-risk procedure, it is contraindicated to patients with hemorrhagic disorders or who regularly take anticoagulants/antiplatelets. However, taking clopidogrel is not a defined contraindication to this low-risk procedure. PATIENT CONCERNS: The chief complaint of a 76-year old woman regularly taking clopidogrel was low back and left buttock pain which prolonged for several years. DIAGNOSES: The patient was diagnosed with L4-5 and L5-S1 spinal stenosis at the orthopedics department and was referred for lumbar spinal epidural steroid injection...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28951257/protective-effects-of-the-neurosteroid-allopregnanolone-in-a-mouse-model-of-spontaneous-motoneuron-degeneration
#20
Maria Meyer, Laura I Garay, María Sol Kruse, Agustina Lara, Gisella Gargiulo-Monachelli, Michael Schumacher, Rachida Guennoun, Hector Coirini, Alejandro F De Nicola, Maria Claudia Gonzalez Deniselle
Amyotrophic lateral sclerosis (ALS) is a devastating disorder characterized by progressive death of motoneurons. The Wobbler (WR) mouse is a preclinical model sharing neuropathological similarities with human ALS. We have shown that progesterone (PROG) prevents the progression of motoneuron degeneration. We now studied if allopregnanolone (ALLO), a reduced metabolite of PROG endowed with gabaergic activity, also prevents WR neuropathology. Sixty-day old WRs remained untreated or received two steroid treatment regimens in order to evaluate the response of several parameters during early or prolonged steroid administration...
September 22, 2017: Journal of Steroid Biochemistry and Molecular Biology
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