RESUMO
We describe a case of tetraparesis in a 33-year-old woman following neck manipulation performed by a traditional confinement mid-wife. An MRI of the cervical spine revealed a fracture of the second cervical vertebra with atlanto-axial subluxation that resulted in cord compression.
Assuntos
Massagem/efeitos adversos , Medicina Tradicional/efeitos adversos , Quadriplegia/etiologia , Compressão da Medula Espinal/etiologia , Adulto , Feminino , Humanos , Imageamento por Ressonância Magnética , Malásia , Gravidez , Resultado da Gravidez , Quadriplegia/diagnóstico , Compressão da Medula Espinal/diagnósticoRESUMO
This is a cross sectional study of 40 patients diagnosed with chronic rhinosinusitis using the Lanza Kennedy diagnostic criteria based on nasal endoscopy (NE), and on computer tomography (CT) of the paranasal sinuses. The purpose of the study is to demonstrate the effectiveness and limitations of CT, and NE in the assessment of chronic rhinosinusitis. This study shows that CT was superior in detecting OMC involvement, presence of concha bullosa, paradoxical turbinate and nasal septal deviation. NE was better at detecting polyps.
Assuntos
Endoscopia , Rinite/diagnóstico por imagem , Rinite/patologia , Sinusite/diagnóstico por imagem , Sinusite/patologia , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Doença Crônica , Estudos Transversais , Humanos , Reprodutibilidade dos Testes , Rinite/etiologia , Sinusite/etiologiaRESUMO
Secondary paroxysmal dyskinesias (PxD) have been previously reported in patients with multiple sclerosis, lacunar infarcts, head trauma, metabolic disorders such as hyperglycaemia, hypocalcaemia, migraine and central nervous system (CNS) infections. The causative lesions typically involve the basal ganglia structures, medulla and rarely the spinal cord. We report two patients who presented with paroxysmal dyskinesias as the only manifestation of subcortical white-matter ischaemia. Patient 1 presented with 3-year history of paroxysmal kinesigenic dyskinesia (PKD) and patient 2 with 6-month history of paroxysmal nonkinesigenic dyskinesia (PNKD). All investigations, including CSF oligoclonal bands were negative, except for a brain MRI which showed multiple, non-enhancing subcortical white matter lacunar infarcts. Therefore, subcortical white matter ischaemia should also be included in the differential diagnosis of PxD.