RESUMO
The lesion of the accessory spinal nerve is often of iatrogenic origin. We report the case of an injury after a right jugulocarotid lymph node biopsy. A 30-year-old patient was referred for the treatment of right cervical lymphadenopathy suspected of tuberculosis. After the intervention and confirmation of tuberculosis diagnosis, the patient presented a functional impotence of the right shoulder and swarming of the right hand. The clinical examination found an active limitation of the shoulder, and a wasting of the upper bundle of the right trapezius muscle and the sternocleidomastoid. The EMG showed axonotmesis of the accessory spinal nerve and the MRI an amyotrophy of the trapezius with denervation edema. A simple rehabilitation has been scheduled. Damage of the accessory spinal nerve most often occurs after local surgery. EMG is essential for diagnosis. Rehabilitation is the first therapeutic option. Surgery can be considered if it fails. The surgeons must consider the protection of the accessory spinal nerve in case of cervical lymph node surgery.
Assuntos
Traumatismos do Nervo Acessório/etiologia , Linfonodos/patologia , Nervo Acessório/patologia , Doenças do Nervo Acessório/diagnóstico , Doenças do Nervo Acessório/etiologia , Traumatismos do Nervo Acessório/diagnóstico , Adulto , Biópsia/efeitos adversos , Humanos , Doença Iatrogênica , Masculino , Atrofia Muscular Espinal/diagnóstico , Atrofia Muscular Espinal/etiologia , Pescoço , Tuberculose dos Linfonodos/diagnóstico , Tuberculose dos Linfonodos/patologiaAssuntos
Encefalomielite Aguda Disseminada/diagnóstico por imagem , Encefalomielite Aguda Disseminada/etiologia , Adulto , Encéfalo/diagnóstico por imagem , Doença de Crohn/complicações , Encefalomielite Aguda Disseminada/tratamento farmacológico , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Medula Espinal/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto JovemRESUMO
Pemphigoid gestationis is a skin-specific autoimmune disorder that can sometimes present as the cutaneous manifestation of a multiorgan disease due to potentially common pathogenic mechanisms. We report a severe form of pemphigoid gestationis in a 32-year-old primigravida woman, who presented at 22 weeks of gestation with headaches and blurred vision, later developing encephalitis, intrauterine fetal demise and dilated cardiomyopathy.
Assuntos
Cardiomiopatia Dilatada/etiologia , Encefalomielite Aguda Disseminada/etiologia , Morte Fetal/etiologia , Penfigoide Gestacional/diagnóstico , Adulto , Cardiomiopatia Dilatada/diagnóstico , Encefalomielite Aguda Disseminada/diagnóstico por imagem , Feminino , Humanos , Imageamento por Ressonância Magnética , Penfigoide Gestacional/patologia , GravidezRESUMO
This corrects the article on p. 310 in vol. 13, PMID: 28748681.
