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Transient Quadriplegia

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1. Transient Quadriplegia

Transient Quadriplegia Transient Quadriplegia Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Transient Quadriplegia Transient (...) Quadriplegia Aka: Transient Quadriplegia , Cervical Cord Neuropraxia From Related Chapters II. Epidemiology : 1.3% per 10,000 athletes III. Risk Factors IV. Mechanism Neck Hyperextension Neck Axial Loading V. Symptoms Bilateral burning pain or s Strength loss in the affected extremities Mild weakness to complete paralysis Sensation loss in the affected extremities VI. Imaging Imaging is required to exclude other causes See VII. Management Treat as if any persistent neurologic deficit See Transient

2018 FP Notebook

2. Intraspinal hypotension syndrome presents as transient quadriplegia. (PubMed)

Intraspinal hypotension syndrome presents as transient quadriplegia. Intracranial hypotension can be a complication of epidural anaesthesia. Pure clinical spinal hypotension manifesting as acute transient quadriplegia following epidural anaesthesia is a severe, life-threatening complication that have not been described before. This complication can be solved with an epidural blood patch; thus, it should be familiar to doctors across all specialities.

2016 British Journal of Neurosurgery

3. Transient Cardiomyopathy and Quadriplegia Induced by Ephedrine Decongestant (PubMed)

Transient Cardiomyopathy and Quadriplegia Induced by Ephedrine Decongestant Ephedrine decongestant products are widely used. Common side effects include palpitations, nervousness, and headache. More severe adverse reactions include cardiomyopathy and vasospasm. We report the case of an otherwise healthy 37-year-old woman who presented with acute-onset quadriplegia and heart failure. She had a normal chest radiograph on admission, but developed marked pulmonary edema and bilateral effusions (...) to excessive use of decongestants. Her symptoms resolved completely with supportive care and appropriate heart-failure management. An echocardiogram 2 weeks after admission showed improvement of the left ventricular ejection fraction to 0.33. Ten months after the event, the patient was entirely asymptomatic and showed further improvement of her ejection fraction to 0.45. To our knowledge, ours is the first report of spinal artery vasospasm resulting in quadriplegia in a human being after ephedrine

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2015 Texas Heart Institute Journal

4. Delayed Transient Post-Traumatic Quadriplegia (PubMed)

Delayed Transient Post-Traumatic Quadriplegia Transient neurological deficit following cervical trauma have been reported following sports injuries, and has been referred to as cervical cord neurapraxia. The so-called "whiplash injuries" following minor motor vehicle collisions usually do not produce any neurological deficit. Here we report the case of a whiplash type of injury presenting with a delayed onset neurological deficit, which was followed by rapid and complete recovery. The patient

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2015 Oman medical journal

5. Case 1: Transient quadriplegia in a teenager (PubMed)

Case 1: Transient quadriplegia in a teenager 25414576 2014 11 21 2019 02 26 1205-7088 19 9 2014 Nov Paediatrics & child health Paediatr Child Health Case 1: Transient quadriplegia in a teenager. 459-61 Ilyas Mohammed M Division of Paediatric Neurology, Carman and Ann Adams, Department of Paediatrics, Children's Hospital of Michigan. Wickland Jessica J Wayne State University School of Medicine. Sivaswamy Lalitha L Division of Paediatric Neurology, Carman and Ann Adams Department of Paediatrics

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2014 Paediatrics & child health

6. Spontaneous spinal epidural hematoma mimicking transient ischemic attack: A case report. (PubMed)

department with 2 episodes of transient right hemiparesis in 5 hours. Two days later, above symptom reappeared and progressed to quadriplegia, dyspnea, and uroschesis quickly. The neurological examination showed tetraplegia and hypalgesia below the C2 level, but neither facial palsy nor aphasia was found.The patient was initially misdiagnosed as TIA and treated with antiplatelet therapy. But during the hospital day, the cervical magnetic resonance imaging showed a dorsal epidural hematoma extending from (...) Spontaneous spinal epidural hematoma mimicking transient ischemic attack: A case report. Spontaneous spinal epidural hematoma (SSEH) is a rare but highly disabling neurological emergency. The initial presentations are variable. Most patients of SSEH present with paraplegia or tetraplegia clinically, but recurrent hemiparesis with complete spontaneous recovery, mimicking transient ischemic attack (TIA), is a very rare initial presentation of SSEH.A 71-year-old female presented to the emergency

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2017 Medicine

7. Transient quadriplegia after fluoroscopic-guided selective cervical nerve root block in a patient who received cervical interbody fusion -A case report- (PubMed)

Transient quadriplegia after fluoroscopic-guided selective cervical nerve root block in a patient who received cervical interbody fusion -A case report- Selective cervical nerve root block is executed for patients who have symptoms of cervical radiculopathy for diagnostic and therapeutic purposes. However several catastrophic complications caused by this procedure have been reported including neurological complications. A 43-year-old male received a C5 selective cervical nerve root block

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2010 Korean journal of anesthesiology

8. Dominant-Negative Mutations in alpha-II Spectrin Cause West Syndrome with Severe Cerebral Hypomyelination, Spastic Quadriplegia, and Developmental Delay. (PubMed)

Dominant-Negative Mutations in alpha-II Spectrin Cause West Syndrome with Severe Cerebral Hypomyelination, Spastic Quadriplegia, and Developmental Delay. A de novo 9q33.3-q34.11 microdeletion involving STXBP1 has been found in one of four individuals (group A) with early-onset West syndrome, severe hypomyelination, poor visual attention, and developmental delay. Although haploinsufficiency of STXBP1 was involved in early infantile epileptic encephalopathy in a previous different cohort study (...) was further screened in six unrelated individuals with WS and hypomyelination, but no mutations were found. Recombinant mutant (mut) and wild-type (WT) alpha-II spectrin could assemble heterodimers with beta-II spectrin, but alpha-II (mut)/beta-II spectrin heterodimers were thermolabile compared with the alpha-II (WT)/beta-II heterodimers. Transient expression in mouse cortical neurons revealed aggregation of alpha-II (mut)/beta-II and alpha-II (mut)/beta-III spectrin heterodimers, which was also observed

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2010 American Journal of Human Genetics

10. CRACKCast E041 – Head Injury

disruption, cellular edema, and cerebral edema No therapies to date show promise in consistently preventing secondary neurologic injury What are the secondary systemic insults? The final neurologic outcome is heavily affected by subsequent secondary brain injuries [1] Hypotension Systolic BP < 90 mmHg Potentiates ischemia and infarction Doubles the mortality from head injury and worsens outcomes! [2] Hypoxia PaO2 < 60 mmHg Due to: Transient or prolonged APNEA (brainstem compression or traumatic apnea (...) pupils Cerebellar-Tonsillar herniation Due to cerebellar tonsils herniating through the foramen magnum Cerebellar mass or large central vertex mass Signs: Sudden resp / cardio collapse, pinpoint pupils, flaccid quadriplegia ( corticospinal tracts are compressed) Describe the pathophysiology of uncal herniation and the typical presentation. See Rosen’s Figure 41-5 in Head Injury Chapter Signs: Anisocoria, ptosis, impaired EOMs, sluggish pupil on the IPsilateral side A dilated, non-reactive pupil

2016 CandiEM

11. Venous Thromboembolism (VTE)

) Prior history of venous thromboembolism Advanced age (>70) Presence of a central venous catheter Malignancies, most commonly of the lung, pancreas, colorectal, kidney, and prostate Surgery (especially orthopedic) Trauma Pregnancy Oral contraceptive containing estrogen Hormone replacement therapy with estrogen Obesity Immobilization • Hospitalization • Prolonged travel • Limb immobilization (casting) • Stroke with movement deficit • Spinal cord injury; quadriplegia/paraplegia Inherited thrombophilias (...) with unprovoked or “idiopathic” VTE have a significantly increased risk, and should be considered as patients with a continuing risk factor). Patients with continuing risk factors for thrombosis, such as active malignancy, immobility, or hypercoagulable states, are at higher risk, while patients who experience thrombosis under transient circumstances (e.g., post-operatively) are at lower risk of recurrence. In general, patients with a first episode of venous thrombosis should receive 3 months of full-dose

2014 University of Michigan Health System

12. West Nile Virus: Just How Bad Is It?

infections, especially in the elderly and immunocompromised, are characterized as West Nile encephalitis. These infections result in a [5]. Finally, the most devastating disease variant is West Nile acute flaccid paralysis (WNP), which accounts for approximately 10% of neuroinvasive disease [5]. Interestingly, WNP is not a transient demyelinating process, as seen with infection-mediated Guillain-Barré syndrome; rather, the paralysis is due to irreversible anterior horn neuronal damage consistent (...) with poliomyelitis [3]. The extent of paralysis can range form monoplegia to quadriplegia with neuromuscular respiratory failure, which results in mortality rates ranging from 10-50% [5]. In addition to short-term morbidity and mortality, neuroinvasive West Nile disease is associated with persistent fatigue, weakness, ataxia, and cognitive dysfunction in nearly 50% of survivors in long-term follow-up studies [5]. Although the probability of severe disease is <1% of the relatively small number of total West Nile

2014 Clinical Correlations

14. Chiropractic care for children: Controversies and issues

community. However, not all chiropractors agree, and some may be influenced by the free distribution of chiropractic newsletters that sometimes present erroneous antivaccination information. A complete discussion on chiropractic and immunization can be found in a recent article in Pediatrics . The safety of chiropractic in paediatrics In adults, after chiropractic manipulation, minor complications, such as mild pain or discomfort, slight headache or fatigue, are quite common, but are usually transient (...) 1999;24:785-94. Zimmerman AW, Kumar AJ, Gadoth N, Hodges FJ 3rd. Traumatic verterebrobasilar occlusive disease in childhood. Neurology 1978;28:185-8. Shaffir Y, Kaufman BA. Quadriplegia after chiropractic manipulation in a child with congenital torticollis. J Pediatr 1992;120:266-9. Trurow V. Chiropractic manipulation for children. Arch Pediatr Adolesc Med 1997;151:527-8. Nickerson H, Silberman TL, Theye FW, Rushing DA. Chiropractic manipulation in children. J Pediatr 1992;121:172. Fontaine L. Faut-il

2012 Canadian Paediatric Society

16. Management of Pediatric Cervical Spine and Spinal Cord Injuries

upper cervical spinal cord injuries. All were associated with cephalic deliveries requiring rotational maneuvers with forceps. All but 1 child was apneic at birth with quadriplegia. There is no description of post-injury spinal column or spinal cord management, medical or surgical, in their report. Rossitch and Oakes described 5 neonates with birth-related spinal cord injuries. They reported that incorrect diagnoses were made in 4. They consisted of Werdnig-Hoffmann syndrome, occult myelodysplasia (...) that the presentation of apnea with flaccid quadriplegia following cephalic presentation with forceps manipulation is the hallmark of upper cervical spinal cord injury. Absence of respiratory effort within the first 24 hours of life is associated with dependence upon long-term mechanical ventilation. It appears reasonable to treat these neonates with spinal immobilization for a presumed cervical spinal injury. The method and length of immobilization remains arbitrary. Odontoid Epiphysiolysis The neurocentral

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2013 Congress of Neurological Surgeons

17. The Diagnosis and Management of Traumatic Atlanto-occipital Dislocation Injuries

patients treated with external immobilization alone excluding traction, 4 worsened transiently (3 Type I, 1 Type II). , , , , All 4 of these patients subsequently underwent craniocervical fixation and fusion. Of the remaining 8 patients managed with external immobilization alone, 3 were unstable after 6 to 22 weeks of immobilization (1 Type I, 2 Type II). Of these 3 patients with persistent instability despite external immobilization, 2 presented with quadriplegia and 1 was neurologically normal. All 3 (...) normal (1 Type I, 1 Type III, 2 other type). , Two of those 4 patients originally reported as normal developed a monoparesis (1 Type 1, 1 other type). , Neither recovered completely. Eight of the remaining 12 patients had neurologic abnormalities from the outset, 5 of whom worsened. Four of the 5 transiently worsened, including 1 Type I injury patient with quadriparesis and Cranial Nerve IX, X, and XII palsies who improved but was spastic at last follow-up. One patient with a Type I injury developed

2013 Congress of Neurological Surgeons

18. The Acute Cardiopulmonary Management of Patients With Cervical Spinal Cord Injuries

interval, 0.17-13.77). SUMMARY Patients with acute cervical SCI frequently develop hypotension, hypoxemia, pulmonary dysfunction, and cardiovascular instability, often despite initial stable cardiac and pulmonary function. These complications are not limited to patients with complete SCI. Life-threatening cardiovascular instability and respiratory insufficiency may be transient and episodic and may be recurrent in the first 7 to 10 days after injury. Patients with the most severe neurological injuries (...) cord injuries . Chest . 1990 ; 97 ( 6 ): 1446 – 1452 . 14. McMichan JC , Michel L , Westbrook PR Pulmonary dysfunction following traumatic quadriplegia: recognition, prevention, and treatment . JAMA . 1980 ; 243 ( 6 ): 528 – 531 . 15. Amar AP , Levy ML Pathogenesis and pharmacological strategies for mitigating secondary damage in acute spinal cord injury . Neurosurgery . 1999 ; 44 ( 5 ): 1027 – 1039 ; discussion 1039-1040. 16. Dolan EJ , Tator CH The effect of blood transfusion, dopamine, and gamma

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2013 Congress of Neurological Surgeons

19. Initial Closed Reduction of Cervical Spinal Fracture-Dislocation Injuries

spinal fracture dislocation injuries derived from combined case series published in the literature to that point; > 1200 patients were treated with closed reduction, 80% (approximately) successfully. The reported neurological complication rate, permanent and transient combined, was low. Four additional retrospective series and 3 case reports dealing specifically with closed reduction were identified in the current review that were not part of the original guideline publication, adding another 195 (...) was not successful in any patients with a fracture dislocation injury ≥ 5 days old (n = 5). One patient had a transient neurological deterioration. Traction up to 36 kg was employed. Koivikko and colleagues successfully reduced cervical fracture dislocation injuries in 62 of 85 patients (73%) they treated with craniocervical traction. Their 2004 report cited 1 patient who experienced neurological deterioration following successful reduction. The temporal association of the deterioration with the closed reduction

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2013 Congress of Neurological Surgeons

20. Sports Participation Disqualifiers

sports Acute or Enlarged Fragile during infection (e.g. ) May be stable if due to does not contraindicate participation but positive status should be documented exertional sickling may occur with dehydration, heat with increased sudden death risk Risk of Syndrome Suspected or confirmed (until cleared) -induced ventricular dysrhythmia Left ventricular systolic ejection fraction <50% No contact or s (below level of ribs) (Acute OR Chronic stable) Cervical or (e.g. , transient upper extremity weakness (...) or quadriplegia) In addition, in swimming, no diving starts, stroke or butterfly s (e.g. , some forms of von willebrand's syndrome) Recent or post- findings Single (Consider Flack Jacket) V. Approach: Special Situations See Bethesda guidelines Single Eye or Best corrected vision worse than 50/20 No wrestling ball Hockey Basketball Soccer Poorly controlled disorder No archery, riflery, swimming, weight lifting or sports involving heights (e.g. rock climbing) Poorly controlled No participation (esp. high

2018 FP Notebook

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