ABSTRACT
Elsberg syndrome is a typically infectious syndrome that may cause acute or subacute bilateral lumbosacral radiculitis and sometimes lower spinal cord myelitis. Patients often present with various neurological symptoms involving the lower extremities, including numbness, weakness, and urinary disturbances such as retention. A 9-year-old girl with no significant past medical history presented with altered mental status, fever, urinary retention, and anuria and was found to have encephalomyelitis. An extensive diagnostic workup led to ruling out possible etiologies until identifying Elsberg syndrome. In this report, we describe a case of Elsberg syndrome caused by West Nile virus (WNV). To the best of our knowledge, this is the first reported case of its kind in the pediatric population. Utilizing PubMed and Web of Science databases, we reviewed the literature to describe the neurogenic control of the urinary system in correlation to a multitude of neurologic pathologies.
ABSTRACT
A 17-year-old female with sickle cell disease status post a recent stem cell transplant and on tacrolimus developed an acute expressive aphasia, dysphagia, and drooling. Brain MRI revealed diffuse restricted diffusion involving the bilateral corona radiata and areas of white matter in the right cerebral hemisphere most consistent with toxic leukoencephalopathy. Tacrolimus serum concentration was high at 19.3 ng/ml (ref 9-12 ng/ml) for which tacrolimus was discontinued. She was neurologically back at baseline 2 days later with the tacrolimus level improving to 8.2 ng/mL. Following discontinuation and the declining trend of her tacrolimus levels the patient returned to her neurologic baseline and was subsequently switched to mycophenolate mofetil for GVHD immunosuppression.
ABSTRACT
An ongoing question in neuroscience is how the peripheral nervous system can repair itself following an injury or insult whereas the central nervous system has a profoundly limited ability for repair. The recent and rapid advancement of our understanding of the gene expression and corresponding biochemical profiles of Schwann cells, within the distal segments of injured peripheral nerves, has helped elucidate the potential mechanisms underlying the unique ability for these cells to enable regeneration of peripheral nerve tissue. Meanwhile, with a new understanding and appreciation for the capabilities of the peripheral nervous system, we are beginning to unlock the potential for neural regeneration and repair within the central nervous system. The aim of this review is to briefly outline the historical advancements that lead to the recent concept of utilizing peripheral nerve tissue grafts or Schwann cell culture implants to serve as repair mechanisms for the central nervous system in the clinical setting of spinal cord injury, multiple sclerosis, and neurodegenerative disorders such as Parkinson's disease.
