RESUMO
Surfer's myelopathy is non-traumatic spinal cord injury which develops in beginner surfers. The patient was a 17-year-old female who developed severe paraplegia with bilateral sensory dysfunction below the groin and bladder/rectal dysfunctions after her first surfing lesson. A spinal-cord MRI performed six hours after onset revealed an intramedullary hyperintensity area from T8 to the conus medullaris on the T2 weighted images. Expansion of this hyperintensity area was observed on Day 3 and showed a reduction on Day 8. After providing intravenous methylpredonisolone, intravenous glycerol and intravenous edaravone, motor function and bladder/rectal functions began to improve after approximately three weeks. In this study, the expansion of the lesion in the early stages of the disease course was observed by sequential spinal MRI. Furthermore, a time lag between improvement according to imaging and improvement in symptoms was also observed.
Assuntos
Traumatismos em Atletas/diagnóstico por imagem , Imagem de Tensor de Difusão/métodos , Traumatismos da Medula Espinal/diagnóstico por imagem , Esportes Aquáticos , Adolescente , Traumatismos em Atletas/complicações , Traumatismos em Atletas/tratamento farmacológico , Edaravone/administração & dosagem , Feminino , Glicerol/administração & dosagem , Humanos , Infusões Intravenosas , Metilprednisolona/administração & dosagem , Paraplegia/tratamento farmacológico , Paraplegia/etiologia , Doenças Retais/tratamento farmacológico , Doenças Retais/etiologia , Doenças da Medula Espinal , Traumatismos da Medula Espinal/complicações , Traumatismos da Medula Espinal/tratamento farmacológico , Fatores de Tempo , Resultado do Tratamento , Doenças da Bexiga Urinária/tratamento farmacológico , Doenças da Bexiga Urinária/etiologiaRESUMO
A 69-year-old female developed subacute diplopia, right peripheral facial nerve palsy, bilateral upper and lower extremities dysesthesia and weakness 50 years after silicone injection for breast augmentation. Motor conduction study revealed prolonged distal latency and reduced amplitude in the median, ulnar, and peroneal nerves. Sensory conduction velocities were reduced in the median and ulnar nerves, and sensory potential in the sural nerve could not be recorded. While intravenous immunoglobulin therapy was ineffective, explantation of silicone breast implants improved her neurological symptoms. Histopathological study of axillary lymph node revealed foreign body granulomas and macrophages phagocyting silicone. The patient was diagnosed with human adjuvant disease presenting clinical features of Guillain-Barré syndrome. Human adjuvant disease should be considered in the patients with implants like silicone and neurological symptoms.
