ABSTRACT
Background & Objectives: Multiple sclerosis (MS), neuromyelitis optica (NMO) and acute transverse myelitis (ATM) are common diseases in neurology; however their corresponding cervical spinal cord involvements are still ambiguous. The purpose of this study was to demonstrate the utility of diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) in identifying the injury in cervical spinal cord. Methods: Nine patients and nine healthy volunteers were enrolled in this study. Conventional sequences and DTI scan were performed on each participant. Results: The average fractional anisotrophy (FA) values of the cervical cord in patients with acute cerebral type MS, acute or stationary cerebrospinal type MS, acute NMO, or acute ATM were all significantly decreased relative to the control group (p <0.05). As to the cerebrospinal type MS, the changes in acute-stage patients were more apparent (p <0.05). The average FA value of the cervical cord in acute NMO was decreased more extensively, involving the normal-appearing spinal cord (p <0.05). In patients with MS or NMO, The lesions showed significantly hypointense on FA images and directionally encoded color (DEC) images, nevertheless the pathological areas on DTI images were no significantly different from those on routine sequences. On DTT, the fiber tracts in the lesion-involved regions were all sparser than that in control regions, nevertheless interruption or impairment of fiber tracts could only be noted in NMO patients. Bilateral differences of average FA values in the cervical cord was noted in one case with ATM and another case with MS (p <0.05), and the decrease of FA values was significant in the main side of clinical presentations. Conclusion: DTI and DTT may be a sensitive measure for early cervical injury in MS, NMO and ATM
Subject(s)
Spinal Cord DiseasesABSTRACT
Objective To clearify the features of an outbreak of Guillain-Barré syndrome (GBS) from Shuangyang district of Changchun city, Jilin province, China.Methods Serum samples obtained were tested serologically for antibodies to chlamydia, coxsackie virus, cytomegalovirus, and hepatitis B virus.Stool samples obtained were cultivated to search Campylobacterjejuni.Electrudiagnostic studies were done 1 day after onset to 10 days.Results Twenty-two patients (12 males and 10 females, aged 15-71 years) were from Shuangyang district, a suburb of Changchun, during a 2-week period in June to July 2007.An illness in the preceding 4 weeks was reported in 17 patients, 16 gave a history of diarrhoea, 1 patient had symptoms consistent with an "upper respiratory infection" and 1 patient had both.Limb weakness were the earliest symptoms.Respiratory assistance was needed by 3 patients.Tendon reflexes were lost as weakness developed.Eleven patients had raised concentrations of protein in the cerebrospinal fluid ((0.74±0.32) g/L), and the averaged cell count was 3×106/L There were 3 kinds of antibodies of hepatitis B virus positive above 17 GBS patients.Electrodiagnostic studies showed severe reductions in motor evoked amplitudes from distal stimulation in 12 patients.Sensory action potentials were normal.Conclusions The distinctive epidemiologicai, clinical and electromyography characteristics of these patients suggest that the disorder, different from acute inflammatory demyelinating polyneuropathy, is concordant with acute motor axonal neurupathy.The features of Shuangyang GBS was similar to those previously reported in several aspects.