Acute severe autonomic dysreflexia during spinal cord intramedullary tumor resectione

Background and Importance: Acute autonomic system impairment can be dangerous and life-threatening, and a clinician should be aware of its occurrence possibility. According to the anatomy of this system, spinal cord lesions could disturb its function. There are many reports of autonomic dysreflexia in spinal cord i njuries especially spinal cord trauma

Case Presentation: A 28 year-old man with an eight month history of gradual numbness in his extremities referred to our university hospital. Neurologic examination revealed mild spastic motor weakness in all limbs and increased deep tendon reflexes

Conclusion: Acute and dangerous autonomic dysreflexia during spinal cord surgery is a rare condition that neurosurgeons and anesthesiologists should be ready for immediate diagnosis and treatment of this condition

Hemiparkinsonism-hemiatrophy syndrome

The syndrome of hemiparkinsonism-hemiatrophy is an uncommon form of secondary Parkinsonism that presents with unilateral body Parkinsonism plus variable atrophy on the same side. Diagnosis of this syndrome needs a complete past medical history taking, as well as assessment of the familial history, clinical examination and complete paraclinical tests. The response to medical therapy has been variable in various researches. This case showed a good response to the addition of a dopamine agonist to levodopa therapy

Epidemiology and characteristics of Guillain-Barre syndrome in the northwest of Iran

Little is known about the incidence of Guillain-Barre syndrome [GBS] in Iran. We determined the incidence and evaluated prognostic factors for GBS in a prospective, population-based study. We evaluated and followed all patients with a diagnosis of GBS admitted to three referral neurology centers in East Azerbaijan province over a 1-year period [2003]. Clinical and electrophysiological characteristics of cases were reviewed and analyzed. A total of 76 patients were found, corresponding to a crude annual incidence rate of 2.11/100 000 population. Six patients [7.9%] died acutely within 21 days from the onset of the disease. Acute mortality was due to respiratory involvement, sepsis and acute autonomic system dysfunction. The persistence of disability after the acute phase was related to axonal involvement [OR=3.19, 95%CI, 1.65 to 6.16]. There was a significant correlation between a history of diarrhea and a further need for mechanical ventilation [P<0.05]. Mechanically ventilated patients had a low GBS disability score on discharge compared with patients not mechanically ventilated [P=0.05]. The incidence rates of GBS in our province is similar to that in other countries. Acute mortality in GBS was mostly due to poor respiratory care of patients and infective complications, but disability and probably late mortality were due to axonal nerve injury