المؤلفون: Govind Shiddapur, Sai Mounika Adapa, Kalyan Kumar Reddy Vutukuru, Mohith Prakash Kondapalli, Sonali Agarwal

المصدر: Journal of Clinical and Diagnostic Research, Vol 18, Iss 06, Pp 07-10 (2024)

مصطلحات موضوعية: immunisation, infection, neurological, quadriparesis, steroids, Medicine

الوصف: Acute Disseminated Encephalomyelitis (ADEM) is a neurological disorder characterised by demyelination, where the immune system targets the Central Nervous System (CNS). This condition typically develops rapidly, with neurological symptoms appearing within days to weeks following viral infections or immunisations. Before the onset of neurological manifestations, patients often experience systemic symptoms such as fever, headache, malaise, and myalgias. The transition from the febrile phase of illness to neurological symptoms generally occurs with a latency period of 7 to 14 days. ADEM is commonly referred to as “post-infectious,” “para-infectious,” “post-exanthematous,” or “post-vaccinal” encephalomyelitis. Recognised as a potential cause of permanent neurological disability, ADEM frequently affects individuals early in life, underscoring the significance of understanding this disease entity, particularly in the context of routine immunisation practices. Herein, the authors present the case of a 28-year-old female, who presented with quadriparesis in a drowsy state following a febrile illness. Upon further evaluation, she was diagnosed with a co-infection of Influenza B and leptospirosis, confirmed by positive serological tests. Magnetic Resonance Imaging (MRI) of the brain revealed hyperintensities suggestive of ADEM in multiple areas of the brainstem and thalamus, while Cerebrospinal Fluid (CSF) examination showed an albumin-cytological dissociative picture, further supporting the diagnosis. Treatment comprised a pulse steroid regimen followed by oral steroid tapering. Subsequently, the patient demonstrated clinical improvement over the course of a week, with progressive enhancements observed during follow-up assessments. The present case highlights the importance of prompt recognition and management of ADEM, emphasising the role of corticosteroid therapy in achieving favourable patient outcomes.

وصف الملف: electronic resource

العلاقة: https://www.jcdr.net/articles/PDF/19497/70148_CETest[Ra1]_F(SS)_QC(AN_RDW_IS)_PF1(RI_DK_OM)_PfA_NC(KM)_PN(KM).pdf; https://doaj.org/toc/2249-782XTest; https://doaj.org/toc/0973-709XTest

الوصول الحر: https://doaj.org/article/440349ba7b374bacbf8afddd28e6f963Test

المؤلفون: Camelia Porey, Binaya Kumar Jaiswal

المصدر: Indian Spine Journal, Vol 7, Iss 1, Pp 112-116 (2024)

مصطلحات موضوعية: cervical myelopathy, cmct, electrocution myelopathy, mep, spastic quadriparesis, Orthopedic surgery, RD701-811

الوصف: High-voltage electrocution-induced neurological complications are often associated with dire consequences. The low-resistance neural pathway provides an easy gateway for the current propagation and subsequent injuries. We present a case of electrocution-induced high-cervical myelopathy resulting in quadriparesis with sensorimotor and autonomic involvement with a slow recovery course along with the subsequent imaging and electrophysiological finding suggestive of long-term degeneration of the central corticospinal tracts. On review of prior works of literature, few similar cases are seen with varied postulations of the pathophysiology of the injury. More frequent reporting of such cases, which often go undetected, should be done to increase awareness.

وصف الملف: electronic resource

العلاقة: http://www.isjonline.com/article.asp?issn=2589-5079;year=2024;volume=7;issue=1;spage=112;epage=116;aulast=PoreyTest; https://doaj.org/toc/2589-5079Test; https://doaj.org/toc/2589-5087Test

الوصول الحر: https://doaj.org/article/e9378188f19445e8b8ad06a02f4acd23Test

المؤلفون: Abraham M. Ittyachen, Anjely Sukumaran, Ancy Peter, Binitha Baby, Dawn Anthony

المصدر: The Egyptian Journal of Internal Medicine, Vol 36, Iss 1, Pp 1-5 (2024)

مصطلحات موضوعية: Hyperkalemia, ECG changes, Quadriparesis, Dialysis, Kerala, Internal medicine, RC31-1245

الوصف: Abstract Background Hyperkalemia is an electrolyte abnormality with potentially life-threatening consequences. But all cases of hyperkalemia need not be symptomatic either. The feared consequence of hyperkalemia is that on the heart, it can induce fatal arrhythmias; rarely, it can present with neuromuscular signs. Most cases of hyperkalemia can be attributed to a single cause. Rarely, it can be multifactorial. Case presentation From the province of Kerala in India, we describe an elderly gentleman with severe hyperkalemia, who presented with quadriparesis. He had ECG changes consistent with hyperkalemia. Diverse causes were involved at the same time for the hyperkalemia. An uncommon cause observed was a diet rich in tropical fruits. As he did not respond to conservative (medications) measures, he had to be dialyzed. With dialysis, there was a rapid neurological recovery, and the potassium levels had improved. Conclusions In patients presenting with ascending paralysis, especially old people with morbidities, one differential diagnosis to be considered is hyperkalemia. Once hyperkalemia is confirmed, in addition to medications and illnesses, the preceding diet should also be enquired, especially the intake of fruits. In all, a good history in such a case is without a doubt imperative.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2090-9098Test

الوصول الحر: https://doaj.org/article/b1849d007c9c43a6a56afaa47802143dTest

المؤلفون: Feroze Mir, Waseem Dar, Arjimand Yaqoob, Maqbool Wani, Ravouf Asmi, Mushtaq Wani

المصدر: The Egyptian Journal of Neurology, Psychiatry and Neurosurgery, Vol 59, Iss 1, Pp 1-7 (2023)

مصطلحات موضوعية: Campylobacter jejuni, GBS, AIDP, Quadriparesis, IVIg, Plasmapheresis, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571

الوصف: Abstract Background Guillain–Barre Syndrome (GBS) is a common differential diagnosis of acute-onset flaccid quadriparesis with or without bulbar involvement. Various illnesses precede GBS, respiratory illness being the most common. Campylobacter jejuni is the single most common organism found associated with GBS. The aim of the present study was to determine the prevalence of Campylobacter jejuni positivity in different subtypes of GBS. Methods Sixty patients of GBS were tested for serological evidence of Campylobacter jejuni and compared with 60 age and sex matched controls. Results Mean age of cases was 39.58 (± 14.76 years) and that of controls was 35 (± 12.31 years). Preceding illness was present in 38% cases. Respiratory tract illness was present in 9 (15%) cases, while as GI illness was present in 8 (13%) cases. AIDP was the most common variant accounting for 65% of cases, followed by AMAN (18.3%). Among cases, 24 (40%) tested positive for Campylobacter jejuni antibody whereas only 12 (20%) tested positive for antibody among controls. The difference was statistically significant between cases and controls (p value = 0.003). There was no statistically significant difference in antibody positivity and preceding illness among different variants of GBS (p value = 1.0). Conclusion Campylobacter jejuni infection is a frequent preceding illness in GBS patients, although it may be asymptomatic. There is however no relation between different subtypes of GBS and C. jejuni infection.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1687-8329Test

الوصول الحر: https://doaj.org/article/a5bc9131648e4065a1670250bae1fdd6Test

المؤلفون: abdul hafeez bughio, Dr muslim Ali lakhiar, Dr . Awais Bashir Larik

المصدر: Annals of Abbasi Shaheed Hospital and Karachi Medical & Dental College, Vol 28, Iss 03, Pp 142-148 (2023)

مصطلحات موضوعية: myelopathy, non traumatic compressive myelopathy, paraparesis, quadriparesis, Medicine (General), R5-920, Dentistry, RK1-715

الوصف: Objective: To determine the frequency of etiological factors of non-traumatic compressive myelopathies. Methods: This is tertiary care Hospital based descriptive cross sectional study conducted at Neurology department of Liaquat University of medical and health Sciences, Jamshoro / Hyderabad after approval of departmental ethical committee from 22th October 2020 to 21st April 2021. Study data was collected after informed consent from all cases. All cases fulfilled inclusion criteria were selected and included in study and data was recorded on preformed proforma. Data was analyzed on SPSS 21 and results were formulated accordingly. Results: In this study 163 patients were included to assess the etiological factors of non-traumatic compressive myelopathy and the results were analyzed. Out of theses 163 subjects who had nontraumatic compressive myelopathies, the etiological and demographic features revealed that, 106 (65%) were male & 57 (35%) were female patients, having a 1.85:1 male to female ratio. The study population’s age ranged from 20 to 60 years, and the mean age SD was 47.6 ± 11.2 years. One hundred and eleven 111 (68.1%) patients had paraparesis while fifty two 52 (31.9%) had Quadriparesis. Most common cause of non-traumatic compressive myelopathy was Tuberculosis spine 35(21.5%) followed by demyelinating Myelitis 30 (18.4%) spinal secondaries 24 (14.8%), disc prolapse was noted in 22(13.5%), multiple myeloma 12 (7.3%) cervical spondylosis 10(6.1%), spinal epidural abscess 8(4.9%), transverse myelitis 4(2.5%) while ossification of the posterior longitudinal ligament as 3(1.8%) patients. Conclusion: Tuberculosis of spine followed by demyelinating Myelitis were most common causes of non-traumatic compressive myelopathies. It is of prime importance to identify those risk factors and contributing states that prone the population for the development of such disabling ailments to address the burden of diseases and to optimize the management’s strategies for this already compromised patients.

وصف الملف: electronic resource

العلاقة: https://www.annals-ashkmdc.org/index.php/ashkmdc/article/view/662Test; https://doaj.org/toc/1563-3241Test

الوصول الحر: https://doaj.org/article/199b69b0a3d046b49ee563ee7ba1720fTest

المؤلفون: Sachin Wali, Shreyas Gutte, Shubham Yadav, Mohan Gurjar, Vimal K Paliwal, Vivek Singh, Afzal Azim, Banani Poddar

المصدر: Journal of Family Medicine and Primary Care, Vol 12, Iss 8, Pp 1724-1729 (2023)

مصطلحات موضوعية: chadox1 ncov-19 vaccine, guillain–barre syndrome, molecular mimicry, quadriparesis, stroke, vaccine-induced thrombotic thrombocytopenia, Medicine

الوصف: Following vaccination with adenoviral vector-based ChAdOx1 nCoV-19, serious neurological adverse events have been reported. Here we report two cases who presented with quadriparesis following the adenoviral vector-based ChAdOx1 nCoV-19 vaccine. A 55-year-old male patient presented with quadriparesis after 8 days of the second dose of ChAdOx1 nCoV-19 vaccination. Imaging showed features of stroke with right basilar artery thrombosis; he was started on anticoagulation following which the patient's neurological status improved and he was discharged during the 7th week of hospital stay. A 19-year-old male patient presented with quadriparesis after 16 days of the first dose of ChAdOx1 nCoV-19 vaccination. Cerebral spinal fluid and nerve conduction study was suggestive of Guillain–Barre syndrome (GBS). Two doses of intravenous immunoglobulin were given, following which the patient's neurological status improved and he was discharged in the 11th week of his hospital stay. Awareness of neurological adverse effects and emphasis on the underlying mechanism of vaccine-induced thrombotic thrombocytopenia (VITT) and molecular mimicry in patients presenting with quadriparesis following ChAdOx1 nCoV-19 vaccination is important.

وصف الملف: electronic resource

العلاقة: http://www.jfmpc.com/article.asp?issn=2249-4863;year=2023;volume=12;issue=8;spage=1724;epage=1729;aulast=WaliTest; https://doaj.org/toc/2249-4863Test

الوصول الحر: https://doaj.org/article/b05323eee8f6469786113d662aa69b12Test

المؤلفون: Metasebia W. Abebe, Samuel Equar Alem

المصدر: Burns Open, Vol 6, Iss 4, Pp 169-172 (2022)

مصطلحات موضوعية: Burn, Electrical injuries, Neurologic symptoms, Quadriparesis, Dermatology, RL1-803, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9

الوصف: Electrical burn injuries are injuries that can be of high or low voltage and result in variety of injuries ranging from skin burns to damage to internal organs including neurologic complications. Tissue damage can result directly from the current passing through the body or conversion of the electrical energy to heat energy as it is met with various levels of resistance within the different tissues in the body. Neurologic complications can be of early or late onset in electrical injuries and show variable levels of recovery over long period of time. We have presented here a patient that sustained high voltage electrical burn and developed late onset quadriparesis that significantly improved within a period of one week following the initiation of dexamethasone. Multidisciplinary approach and long term follow up of such patients is necessary to achieve best possible outcome

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2468912222000220Test; https://doaj.org/toc/2468-9122Test

الوصول الحر: https://doaj.org/article/c4321c8e36144f0a96f5c27497d98c9fTest

المؤلفون: Wei-Chen Chen, Hsien-Yi Chen, Te-I. Weng, Chun-Kuei Chen

المصدر: International Journal of Emergency Medicine, Vol 15, Iss 1, Pp 1-4 (2022)

مصطلحات موضوعية: Local anesthetic systemic toxicity, Vocal cord cyst-removal surgery, Lipid emulsion, Quadriparesis, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9

الوصف: Abstract Background A well-known anesthetic, lidocaine is the most widely used local anesthetic. Local anesthetic systemic toxicity (LAST) is a life-threatening event with common and prominent presentations of central nervous system (CNS) toxicity and cardiovascular toxicity. The most frequent and prominent early warning signs and symptoms of LAST are central nervous system symptoms. While rare, cases quadriparesis after the administration of lidocaine has been reported. Case presentation In this paper, we report a very rare case of quadriparesis after local anesthesia administration for vocal cord cyst-removal surgery, which dramatically improved after treatment. LAST can occur during various routes of lidocaine administration, such as local spray. A possible mechanism of our case could be the local diffusion of lidocaine to the spinal cord, which caused the symptoms to mimic anterior cord syndrome. Conclusions Our case presented a favorable outcome following the administration of intravenous lipid emulsion (ILE) for non-over dose local anesthetic drug induced spinal cord inhibition symptoms. These findings highlight the need for further research on the use of ILE to reverse LAST and other adverse effects of local anesthetics.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1865-1372Test; https://doaj.org/toc/1865-1380Test

الوصول الحر: https://doaj.org/article/9160f6c9b59d4939bad2794e64790553Test

المؤلفون: Sandeep Velicheti, R. Rajakulasingam, K. Kalyan, G. Rajesh, R. Botchu

المصدر: Journal of Orthopaedic Reports, Vol 1, Iss 1, Pp 20-23 (2022)

مصطلحات موضوعية: Spine, Histiocytosis, Paralysis, Quadriparesis, Rosai Dorfman Disease, Orthopedic surgery, RD701-811

الوصف: Background: Rosai Dorfman Disease (RDD) is histiocytosis associated with lymphadenopathy. Spinal involvement is uncommon and seen in 1%. Most of the spinal lesions are extradural and intradural extramedullary. Intramedullary RDD is extremely rare. Case report: We report a rare case of quadriparesis in 24 year old male due to intramedullary RDD of cervicothoracic region and review the literature. Conclusion: The rare cases of intramedullary RDD should be included in the differential diagnosis of young patient presenting with quadriparesis or paraparesis.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2773157X22000169Test; https://doaj.org/toc/2773-157XTest

الوصول الحر: https://doaj.org/article/af9dfb12d3aa4a98802c6df17a4e3b51Test

المؤلفون: Zardo, Franciele, Paludo, Tatiane, Mattos, Brenda Tubelo Pereira de, Frata, Bruna, Ling, Chen Chai, Cechetti, Fernanda

المصدر: Fisioterapia em Movimento. January 2022 35

مصطلحات موضوعية: Cerebral palsy, Electromyography, Muscles, Physical therapy modalities, Quadriparesis

الوصف: Introduction: Children and adolescents with spastic quadriparesis have a worse selective motor control, and studies with this population are still very scarce. The same is true with scientific evidence of one of the methods most used as a physiotherapeutic treatment in this population, the Bobath Concept. Objective: To evaluate spine erector muscles activation, gluteus medius and gluteus maximus, through the handling of the Bobath Concept and the sustained kneeling posture in subjects with a diagnosis of severe cerebral palsy; and to compare muscle activation with a reference group, in order to increase the reliability of this study. Methods: A cross-sectional study was carried out with 38 children and adolescents with cerebral palsy, classified by GMFCS at levels IV and V, and 20 healthy participants, aged between 3 and 18 years. They were submitted to the handling of the Bobath Concept and to the sustained kneeling posture, with muscle activation obtained by electromyography. Results: We observed significant muscle activation during handling in side-sitting, with weight transfer and without the help of another therapist, and in the sustained kneeling posture, for the erector of the spine and gluteus medius. Conclusion: The evidence from this study suggests that both the handling in side-sitting and the sustained kneeling posture cause significant muscle activation in the erector of the spine and gluteus medius for severe quadriparesis subjects, GMFCS IV and V, which can contribute to the improvement of postural control and decision-making in physical therapy practice.

وصف الملف: text/html

الوصول الحر: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0103-51502022000100215Test