A very interesting case of a young female aged 17 who presented with sudden onset of Flaccid Quadriparesis with Bladder Bowel Involvement since the beginning and weakness was fully evolved in 1 hour....On examination, there was a sensory level at C4 below which all superficial n deep reflexes were lost including complete sensory loss...power was 0/5 in all limbs....comment on her MRI Spine and discuss the cause for her condition
T1 w images shows cord swelling fron C5 to C7 .T2W images shows intramedullary T2 hyperintense signal C567.2nd set of film the lesion from c3 to c7 (2 nd set 2nd row 2nd film from above down ). Acute transverse myelopathy. Post or parainfectious demylination with cord edema. Spinal cord infarction has to exclude
Yes findings are suggestive of spinal cord swelling intra medullary from c4 to c7 Absolutely agree with dr Manorma Rajan D/d ms or demylenation and infarction
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Syringomyelia(C5-C7) Surgical intervention Refer to Neurogeon for necessary management and treatment.
Acute tranverse myelitis Reapid progression is more in favour of myelitis rather than myelopathy. Acute traumatic lesion ....must be rule out.
Transverse myelitis in shock
May be cervical spine involving.
Check vep to ruleout neuromyelitis optica
Do aquaporin antibodies also
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7year female pt with history of gradual weakness in both lower limb with spasticity blader bowel involved since 1 year, transfer to us from pediatric department after MRI
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A 17yrs old male presented with A/h/o fall due to slip at the farm 10days back.H/o LOC present.Patient was able to walk for 10day,Now developed weakness for one day,Breathing difficulty with bladder n bowel involvement with sensory loss below C5.initially he was treated at someother hospital then transferred to our hospital. Significant findings during physical examination at the time of admission - Conscious,Alert,Oriented GCS - 13/15 Tenderness present cervical spine All 4 limbs power grade 0/5(Quadriplegia) P/R - 49/mt,BP - 110/70mmhg,Spo2 - 96% Diagnosis and Opinion please??
Dr. Prashant Ved1 Like12 Answers - Login to View the image
MRI lumbar region of a female , around 35 years, presented with bilateral lower limb weakness, sensation also lost on b/l lower limbs, bladder sensation also lost. Evolution of illness took just 3 days to complete. Patient is being treated with corticosteroid and is improving.
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25 year old male , no h/o trauma presented with sudden onset loss of sensations in b/l lower limbs and unable to move b/l lower limbs . no h/o fever , no neck rigidity .
Dr. Mohamed Shoaib1 Like44 Answers - Login to View the image
Interesting case. Today evening 27yr male presented to me in my ER with a/h/o electric shock while working on velding machine.(high voltage) -H/o LOC + for 5-10 mins. O/E -Concious but confused.. Occ responding to VR. Moving his eyes and head (with difficulty) -GCS E4M2V2-3,,, - B/L Pupil 3/3mm LR+ -BP 92/51mmhg -HR 78/min -SPO2 98% -NO external injuries,, no entry and exit wound. Muscle power -Right UL 1/5 Right LL 1/5 -left UL 1/5 Left LL 1/5 Complete sensory loss in all limbs. Kindly give ur opinion regarding approach to this patient.. And possibilities. (Electrolyte abnormalities has already been treated in my ICU)
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