• Journal of Korean Neurosurgical Society
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• v.55 no.2
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• pp.106-109
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• 2014

A case of an iatrogenic spinal arteriovenous fistula with progressive paraplegia in a young woman is reported. The fistula was eventually created after repetitive lumbar punctures performed in the process of spinal anaesthesia. Her symptoms were progressed to paraplegia over a period of 2 years. The digital subtraction angiography demonstrated a single-hole fistula, involving the anterior spinal artery and vein. The lesion was occluded by embolization with immediate improvement. The potential mechanism is discussed.

• Journal of Korean Foot and Ankle Society
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• v.8 no.1
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• pp.111-113
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• 2004

In neurogenic equinovarus deformity, surgical intervention such as tendon transfer or osteotomy can be expected to improve symptoms. However, in rare cases of hereditary spastic paraplegia, the deformity and paralysis gradually progress. So limited operation and early post-operative rehabilitation are preferred to aggressive operation. We would like to report our clinical experience with one case of hereditary spastic paraplegia patient with reference review. A 40 year-old male, given tendon transfer of ankle and foot and tendo achilles lengthening 10 years ago, complained about aggravated spastic paraplegia which resulted in dynamic equinovarus and limited walking ability since his operation. Family history showed limited walking ability of his father with gradually progressing spastic paralysis and he was diagnosed as hereditary spastic paraplegia type I. We had performed a limited operation such as tendo achilles and tibialis posterior lengthening to induce plantigrade standing and walking with crutch. As a result, the patient was able to maintain a stabilized standing posture and walk after the operation. Hereditary spastic paraplegia presents with a progressive paralysis which limits rehabilitation after tendon transfer, and the symptoms can be aggravated. Therefore, considering potential hereditary neurogenic disorders in paients with equinovarus deformity and performing limited operative procedures seem to be important.

• The Korean Journal of Pain
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• v.7 no.1
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• pp.106-112
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• 1994

This report documents a case of paraplegia which apparently occurred following epidural injection of triamcinolone (40 mg) and 0.125% bupivacaine(10 ml). The patient's condition was progressive until she experienced paraplegia and dissociative sensory loss below T5(Rt) and T10(Lt) dernatomes, along with urinary and fecal incontinence lasting 24 hours. CT and MRI were normal. Three months after the onset of paraplegia, the patient could only slightly move her legs. After 8 months of the initial paraplegia, she was able to walk with assistance, and to perceive pinrick sensation in her right leg, and tingling in her left leg. She could also void and defecate. At 16 months, paraplegia and sensory loss were slightly recovered. The cause for this paraplegia is still unknown, but it may be from exacerbation of preexisting disease, acute transverse myelitis, anterior spinal artery syndrome, or neurotoxicity.

• Annals of Clinical Neurophysiology
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• v.7 no.2
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• pp.138-140
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• 2005

Strumpell, in 1880, was the first to describe familial case of spastic paraplegia characterized by progressive weakness and spasticity of the lower limbs with little or no involvement of the upper extremities. This syndrome is heterogeneous in inheritance, age of onset, severity and associated signs. We present one family with autosomal dominant hereditary spastic paraplegia (HSP) due to SPG4 (spastin) gene mutation which is confirmed by genomic DNA isolated from peripheral blood.

• Dementia and Neurocognitive Disorders
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• v.21 no.2
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• pp.79-82
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• 2022

• Journal of Korean Neurosurgical Society
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• v.30 no.1
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• pp.95-98
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• 2001

Acute intraabdominal aortic obstruction ends in progressive fatal course or severe permanent disability unless it is diagnosed and treated promptly. However, the incidence of such disease is very rare, so there is very little chance for a neurosurgeon to encounter a patient with acute intraabdominal aortic obstruction. The authors present a case of 62-year-old man with severe low back pain and acute paraplegia caused by acute intraabdominal aortic obstruction.

• Annals of Clinical Neurophysiology
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• v.8 no.2
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• pp.193-195
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• 2006

Acute paraplegia attributable to disc herniation is known to occur most frequently at the thoracic level. A 50-year-old male presented with progressive limb weakness and hypoactive deep tendon reflexes. On the basis of clinical features and neurological findings, the diagnosis of Guillain-Barre syndrome was suspected. Spinal MRI showed cervical disc herniation. He underwent emergency surgery consisting of removal of herniated disc and anterior fusion. We emphasize that there is a possibility of acute progression of paralysis secondary to nontraumatic enlargement of cervical disc herniation.

• Journal of the Korean Orthopaedic Association
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• v.56 no.2
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• pp.178-182
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• 2021

Spinal hematomas are a rare but serious complication that is typically observed in the epidural space. Spinal subdural hematomas are a dangerous clinical situation because of their potential to cause significant compression of the neural elements and can be mistaken easily for spinal epidural hematomas. This paper reports a case of a severe whole lumbar subdural hematoma after a simple epidural injection that was treated with surgical decompression with excellent clinical results.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.2
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• pp.105-108
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• 2021

Background : Hyperornithinemia-hyperammonemia-homocitrullinuria (HHH) syndrome is a rare, autosomal recessive metabolic disorder which is caused by genetic mutations that disrupt the urea cycle. It is characterized by variable clinical presentation and the age of onset. Patients may present with gait disturbance and progressive paraplegia and muscle tightness in the lower extremities. The use of botulinum toxin in metabolic disease has rarely been discussed. We describe a case of a 14-year-old-boy with HHH syndrome, who presented with a several - month history of gait disturbance and lower extremity weakness. Case presentation : A 14-year old male had a history of recurrent upper respiratory tract infections, occasional vomiting, loss of appetite, and general weakness, all of which started since he was 10 months old. He was diagnosed with HHH syndrome at one year of age. At the age of 14, he was referred for the assessment and treatment of his gait disturbance and aggravated weakness of the lower extremities. Brain MRI, electrodiagnostic study and blood test were performed to exclude any lesions related to neurologic dysfunction. Botulinum toxin type A were injected into muscles of adductor longus, adductor magnus, lateral and medial hamstring, and lateral and medial gastrocnemius muscle heads under needle electromyography guidance to reduce lower limb spasticity. Intensive physical therapy including gait training and stretching exercise of adductor and calf muscles were also provided. After intensive physical therapy and botulinum toxin injection to reduce lower limb spasticity, he was able to ambulate for 20 meters independently without any walking aids. There were no adverse events after the injection. Conclusion : Botulinum toxin injection is a safe and effective therapy for patients with HHH syndrome who suffer from gait disturbance.

• Physical Therapy Korea
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• v.6 no.2
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• pp.56-66
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• 1999

The purpose of this study focused how to show physiological responses comparing exercise group and non exercise group for progressive maximal wheelchair ergometer exercise loading in complete paraplegia. It also examined the various factors which would be influenced physiological responses. Sixteen subjects have been investigated in this study, and the subjects are divided into two groups as follows: 1) exercise group (7 subjects) 2) non exercise group (9 subjects). Each test was terminated by physical exhaustion and/or an inability to maintain a flywheel velocity. The results were as follows: 1) No difference was noted in pulmonary function test between two groups. 2) $\dot{v}$ Emax value during maximal exercise was significantly different between the groups (p<0.05). The mean $\dot{v}$ Emax of exercise group was $69.67{\ell}/min$, non exercise group was $41.47{\ell}/min$. 3) $\dot{v}$ $O_2max$(${\ell}/min$) value during maximal exercise was significantly different between the groups (p<0.05). The mean $\dot{v}$ $O_2max$(${\ell}/min$) of exercise group was $1.72{\ell}/min$, non exercise group was $1.15{\ell}/min$. 4) $\dot{v}$ $O_2$ max(ml/kg/min) value during maximal exercise was significantly different between the groups (p<0.05). The mean $\dot{v}$ $O_2max$($ml/kg{\cdot}min$) of exercise group was $25.99ml/kg{\cdot}min$, non exercise group was $18.61{\ell}/min$. 5) Maximal heart rate(HRmax) value during maximal exercise was significantly different between the groups (p<0.05). The mean HRmax of exercise group was 180.43 beats/min, non exercise group was 175.00 beats/min. 6) $\dot{v}\;E/\dot{v}\;O_2$ value during maximal exercise was not significantly different between the groups (p>0.05). The mean $\dot{v}\;E/\dot{v}\;O_2$ of exercise group was $36.36{\ell}/{\ell}\;O_2$, non exercise group was $45.46{\ell}/{\ell}\;O_2$. Considering the results which explore the exercise group with paraplegia has shown the maximal aerobic power compared with non exercise group, regular and consistent physical training is highly assumed as a main factor to improve cardiopulmonary fitness.