ABSTRACT
Transverse myelitis is a focal inflammatory disorder of the spinal cord characterized by motor, sensory, and autonomic dysfunction. A 41-year-old man with transverse myelitis and no pre-existing neurologic disease presented with hypesthesia, numbness, weakness in the both lower extremities, back pain, decreased libido, constipation, and dysuria. A MRI test showed intramedullary high signal intensity between T4 and T8 on a T2-weighted image. After high-dose intravenous methylprednisolone and oral prednisolone therapy, he showed facial swelling and acneiform eruption. Therefore, we injected 40 mg methylprednisolone via an epidural route. A 7-dose serial treatment improved most symptoms. A follow up MRI showed radiological improvement. We report a case of transverse myelitis treated by epidural steroids.
Subject(s)
Adult , Humans , Acneiform Eruptions , Back Pain , Constipation , Dysuria , Follow-Up Studies , Hypesthesia , Libido , Lower Extremity , Methylprednisolone , Myelitis, Transverse , Prednisolone , Spinal Cord , SteroidsABSTRACT
Behcet's disease is a chronic relapsing vasculitis characterized by recurrent aphthous oral and genital ulcers with uveitis. Multiple organs can be involved. Entero-Behcet's disease is often uncontrollable, relapsing, and can cause acute intestinal bleeding, fistula formation, or perforation. Corticosteroids, immunosuppressors, and colchicines are used to treat Entero-Behcet's disease with varying degree of success. Thalidomide may also be feasible. We present a 29-year-old male Entero-Behcet's patient suffering from abdominal pain, diarrhea, and back pain. He did not respond to prior treatments, but responded to thalidomide.
Subject(s)
Adult , Humans , Male , Abdominal Pain , Adrenal Cortex Hormones , Back Pain , Diarrhea , Fistula , Hemorrhage , Stress, Psychological , Thalidomide , Ulcer , Uveitis , VasculitisABSTRACT
BACKGROUND: Sevoflurane anesthesia may show emergence agitation and delirium in children, compared to other inhalation agents. Therefore, we studied the effect of low dose sevoflurane on recovery time and emergence agitation in children. METHODS: We studied 50 patients who were planned for surgery under general anesthesia, aged between 2 and 8 years. They were randomly divided into two groups. Patients of group S were anesthetized with sevoflurane 2.5-3 vol%, whereas those of group R were given sevoflurane 1.2-1.5 vol% and continuous intravenous infusion of remifentanil 0.1-0.2microgram/kg/min. All patients received N2O:O2 50:50 during maintenance of anesthesia. After the surgery, the anesthesiologist recorded recovery time and determined agitation score using 5-point scoring scale in both groups. Agitation score, incidence of emergence agitation and recovery time were compared with each other between the two groups. RESULTS: The agitation scores were 2.72 +/- 0.98 and 2.64 +/- 0.95 in S and R groups, respectively, showing statistical insignificance. The incidence of emergence agitation score 4 or 5 was not significantly different, either. The recovery time was statistically shorter in R group (P<0.05). CONCLUSIONS: Compared with sevoflurane inhalation anesthesia alone, the use of sevoflurane and remifentanil in combination provided shorter recovery time, but no effect on emergence agitation.