Spinal Cord Series and Cases最新文献

{"title":"Bilateral tibial fractures associated with powered exoskeleton use in complete spinal cord injury – a case report & literature review","authors":"John Mahon, Lily Nolan, David O’Sullivan, Mark Curtin, Aiden Devitt, Colin G. Murphy","doi":"10.1038/s41394-024-00635-4","DOIUrl":"https://doi.org/10.1038/s41394-024-00635-4","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>Powered robotic exoskeleton (PRE) physiotherapy programmes are a relatively novel frontier which allow patients with reduced mobility to engage in supported walking. Research is ongoing regarding their utility, risks, and benefits. This article describes the case of two fractures occurring in one patient using a PRE.</p><h3 data-test=\"abstract-sub-heading\">Case</h3><p>We report the case of a 54 year old man who sustained bilateral tibial fractures while using a PRE, on a background of T10 AIS A SCI. The initial session was discontinued due to acute severe bilateral knee swelling after approximately 15 min. The patient attended their local hospital the following day, where radiographs demonstrated bilateral proximal tibial fractures. The patient was treated with manipulation under anaesthetic and long-leg casting for five weeks, at which point he was stepped down to hinged knee braces which were weaned gradually while he remained non-weight bearing for 12 weeks. The patient was investigated with DEXA scan and was diagnosed with osteoporosis. He was liaised with rheumatology services and bone protection was initiated. Fracture healing was achieved and weight-bearing precautions were discontinued, however this period of immobilisation led to significant spasticity. The patient was discharged from orthopaedic services, with ongoing rehabilitation and physiotherapy follow-up.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>PRE assisted physiotherapy programmes are a promising concept in terms of rehabilitation and independence, however they are not without risk and it is important that both providers and patients are aware of this. Furthermore, SCI patients are at increased risk for osteoporosis and should be monitored and considered for bone protection.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"173 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140610296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute spinal cord injury serum biomarkers in human and rat: a scoping systematic review","authors":"Sina Shool, Saeed Rahmani, Mohammad Amin Habibi, Seyed Mohammad Piri, Mahmoud Lotfinia, Delara Jashnani, Sina Asaadi","doi":"10.1038/s41394-024-00636-3","DOIUrl":"https://doi.org/10.1038/s41394-024-00636-3","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Study design</h3><p>Scoping systematic review.</p><h3 data-test=\"abstract-sub-heading\">Objectives</h3><p>To summarize the available experimental clinical and animal studies for the identification of all CSF and serum-derived biochemical markers in human and rat SCI models.</p><h3 data-test=\"abstract-sub-heading\">Setting</h3><p>Tehran, Iran.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>In this scoping article, we systematically reviewed the electronic databases of PubMed, Scopus, WOS, and CENTRAL to retrieve current literature assessing the levels of different biomarkers in human and rat SCI models.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>A total of 19,589 articles were retrieved and 6897 duplicated titles were removed. The remaining 12,692 studies were screened by their title/abstract and 12,636 were removed. The remaining 56 were considered for full-text assessment, and 11 papers did not meet the criteria, and finally, 45 studies were included. 26 studies were human observational studies comprising 1630 patients, and 19 articles studied SCI models in rats, including 832 rats. Upon reviewing the literature, we encountered a remarkable heterogeneity in terms of selected biomarkers, timing, and method of measurement, studied models, extent, and mechanism of injury as well as outcome assessment measures.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>The specific expression and distribution patterns of biomarkers in relation to spinal cord injury (SCI) phases, and their varied concentrations over time, suggest that cerebrospinal fluid (CSF) and blood biomarkers are effective measures for assessing the severity of SCI.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"100 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140601644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trend differences in cervical spinal cord injuries before and after the coronavirus disease 2019 pandemic","authors":"Hirotaka Fukushima, Chikara Ushiku, Shoshi Akiyama, Shinji Saito, Hiroki Wakiya, Kenji Okuno, Mitsuru Saito","doi":"10.1038/s41394-024-00633-6","DOIUrl":"https://doi.org/10.1038/s41394-024-00633-6","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Study design</h3><p>Cross-Sectional Study.</p><h3 data-test=\"abstract-sub-heading\">Objectives</h3><p>To investigate the changes in the characteristics of cervical spinal cord injuries (CSCI) before and after the coronavirus disease 2019 (COVID-19) pandemic among patients transported to our hospital in Japan.</p><h3 data-test=\"abstract-sub-heading\">Setting</h3><p>Hospital with an emergency center in Chiba, Japan.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Patients eligible for the study were those transported within 24 h of injury and diagnosed with cervical spinal cord injury between January 2018 and December 2021 at our hospital. Medical records were retrospectively examined to investigate the number and characteristics of patients with CSCI. The clinical variables of patients with CSCI were compared according to the time of admission as related to the COVID-19 pandemic: 2018-19 (before) or 2020-21 (after).</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The total number of patients with CSCI from 2018 to 2021 was 108, with 57 before the COVID-19 pandemic and 51 after the COVID-19 pandemic. The number of severe cases with an injury severity score (ISS) of &gt;16 decreased after COVID-19 (<i>p</i> &lt; 0.05). Falls on level surfaces were the most common cause of injury both before and after COVID-19. Although the ranking of traffic accidents decreased after COVID-19, among those, the number of bicycle injuries tended to increase.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>The number of serious cases with an ISS &gt; 16 decreased, presumably because of the decline in high-energy trauma due to the background decrease in the number of traffic accidents.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"300 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140601639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic technology (ROBERT®) to enhance muscle strength in the hip flexor muscles following spinal cord injury: a feasibility study","authors":"S. L. Sørensen, I. Poulsen, L. A. Harvey, F. Biering-Sørensen, J. F. Nielsen","doi":"10.1038/s41394-024-00630-9","DOIUrl":"https://doi.org/10.1038/s41394-024-00630-9","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Study design</h3><p>Feasibility study.</p><h3 data-test=\"abstract-sub-heading\">Objective</h3><p>To determine the feasibility of conducting a large trial designed to determine whether the ROBERT^® can be used to increase the strength of the hip flexor muscles after spinal cord injury (SCI). The ROBERT^® is a robotic device that provides assisted active movement while supporting the weight of the leg. Focus was on recruitment capability, suitability, and acceptability of the intervention and outcome measure.</p><h3 data-test=\"abstract-sub-heading\">Setting</h3><p>Specialised SCI centre in Denmark.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>All first-time admitted patients were screened to assess participant recruitment capability. Four people with SCI &lt; 3 months tested a protocol consisting of 60 repetitions of hip flexion in supine conducted with the assistance of the ROBERT^® three times a week for 4 weeks. Feasibility was assessed based on adherence to the protocol and completion rate and from the participants’ perspectives. Maximal voluntary contraction (MVC) was accessed at baseline and four weeks.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The recruitment rate was 8% (7 months). The four participants completed 44 out of 48 sessions (92%). No adverse events occurred. One physiotherapist was required to set-up and supervise each session. The active exercise time varied from 7.5 to 17 min. The participants found the ROBERT^® a good supplement to their usual rehabilitation. We were able to measure MVC in even very weak hip flexor muscles with a dynamometer MicroFET2 fixed to a frame.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>The ROBERT^® was feasible and acceptable. The participants perceived it as a supplement, not a replacement to usual physiotherapy. However, recruitment to the study was slow.</p><h3 data-test=\"abstract-sub-heading\">Trial registration</h3><p>ClinicalTrials.gov NCT05558254. Registered 28th September 2022.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"49 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140601667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of spontaneous giant pneumorrachis presenting with cauda equina syndrome: a case report","authors":"Anuj Gupta, Mayukh Guha, Kuldeep Bansal","doi":"10.1038/s41394-024-00631-8","DOIUrl":"https://doi.org/10.1038/s41394-024-00631-8","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>Pneumorrachis is presence of air in the epidural space. It could be the result of trauma, barotrauma, iatrogenic or spontaneous. The pneumorrachis per se is an underdiagnosed entity as most of the patients are asymptomatic or have subclinical symptoms. The spontaneous occurrence of pneumorrachis has been reported in literature but giant spontaneous occurrence causing cauda equina syndrome has not been reported so far.</p><h3 data-test=\"abstract-sub-heading\">Case presentation</h3><p>We report a case of 56-year-old male patient who came to our OPD on wheelchair with complains of difficulty in walking for 6 months with dribbling of urine for 2 months with on and off back pain. His perianal sensation was reduced with absent voluntary anal contraction. Imaging revealed giant air pockets in the spinal canal of L5-S1 extending upto L4-L5. It was managed surgically wherein laminectomy without fusion was done. The patient responded well to the treatment.</p><h3 data-test=\"abstract-sub-heading\">Discussion</h3><p>There are many causes of pneumorrachis described in literature. Most of the cases of pneumorrachis are asymptomatic and incidentally diagnosed. With the improvement in radio-diagnostic modalities, the diagnosis of pneumorrachis can be easily established. When symptomatic, they can be managed conservatively. Those presenting with neurological deficit may require surgical intervention or other invasive intervention.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"25 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140602165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case report of three people experiencing intractable autonomic dysreflexia following instillation of Uro-Tainer® Polyhexanide 0.02%","authors":"Louise C. Kelly, Joanne V. Glinsky, Lisa A. Harvey","doi":"10.1038/s41394-024-00626-5","DOIUrl":"https://doi.org/10.1038/s41394-024-00626-5","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>Historically, bladder washouts were used to instil therapeutic reagents directly into the bladder. This practice has expanded to include instillation of solutions that deal with catheter issues such as encrustation or formation of bio-film. They appear to provide a promising strategy for people with long term catheters. These products are readily available to purchase, but there is concern that people are using these solutions without a complete understanding of the purpose for the rinse and without clinical guidance to monitor response to treatment.</p><h3 data-test=\"abstract-sub-heading\">Case presentation</h3><p>These case studies include three people living with spinal cord injury (SCI) who developed severe autonomic dysreflexia (AD) when a catheter rinse was carried out using a particular solution. Each of the cases developed immediate and, in some cases, intractable AD requiring further intervention to resolve symptoms.</p><h3 data-test=\"abstract-sub-heading\">Discussion</h3><p>Catheter-associated urinary tract infection is a significant cause of morbidity and mortality in people living with SCI. Long-term catheters provide a vector for opportunistic micro-organisms to form bio-film and create an environment that promotes formation of struvite calculi, thus increasing the risk of chronic catheter blockage and urinary tract infection. Whilst these solutions are used to reduce these risks, they also pose additional risks to people susceptible to AD. These cases highlight the need for judicious patient selection and clinical oversight and management of adverse events when using catheter rinse solutions in certain people living with SCI. This is supported by a decision-making algorithm and a response to AD algorithm.</p><p>This case report was prepared following the CARE Guidelines (supplementary file 1).</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"11 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140602111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facilitation of neurological recovery in a complete spinal cord injury with NeuroAiD: case report","authors":"Muhamad Faizal Zainudin, Salmah Anim Abu Hassan, Nyein Yin Khin","doi":"10.1038/s41394-024-00632-7","DOIUrl":"https://doi.org/10.1038/s41394-024-00632-7","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>NeuroAiD (MLC601 &amp; MLC901)’s neuroprotective capabilities include limiting exaggerated calcium influx, decreasing excitotoxicity, reducing oxidative stress, and preventing glutamate-induced cell death. It has also been shown to facilitate synaptogenesis, neurogenesis, and neuroplasticity. However, its clinical efficacy has primarily been studied in the context of brain injuries, particularly stroke. NeuroAiD’s potential application in SCI remains largely untapped.</p><h3 data-test=\"abstract-sub-heading\">Case presentation</h3><p>A 34-year-old male presented with C4 complete tetraplegia. Following surgical decompression and initial inpatient rehabilitation, he started consuming MLC901 two capsules three times daily at month 4 post injury for 6 months. He regained considerable neurological recovery following the supplementation. Apart from the improvement in the neurological level of injury, the patient exhibited motor recovery beyond the initial zone of partial preservation up to 24 months post injury.</p><h3 data-test=\"abstract-sub-heading\">Discussion</h3><p>Our findings align with a recent animal study demonstrating MLC901’s potential to downregulate Vascular Endothelial Growth Factor (VEGF), a molecule known to increase vascular permeability and exacerbate tissue edema and infarction. In another animal study involving stroke-affected mice, MLC901 demonstrates the ability to promote neurological recovery by regulating the expression of proteins mediating angiogenesis, such as hypoxic inducible factor 1α, erythropoietin, angiopoietins 1 and 2, as well as VEGF. The anecdotal findings from this case report offer preliminary insights into NeuroAiD’s potential in facilitating recovery during post-acute and chronic phases of severe SCI, necessitating further exploration.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"76 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140601664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring knowledge and implementation gaps of activity-based therapy in centers lacking specialized spinal cord injury services: understanding therapists' perspectives.","authors":"Nicole Cesca, Chantal Lin, Zeina Abu-Jurji, Aaron Wexler, Jonas Mark, Shane McCullum, Rija Kamran, Brian Chan, Kristin E Musselman","doi":"10.1038/s41394-024-00619-4","DOIUrl":"10.1038/s41394-024-00619-4","url":null,"abstract":"<p><strong>Study design: </strong>Qualitative exploratory OBJECTIVES: Rehabilitation following spinal cord injury (SCI) is a life-long process involving healthcare in a variety of settings, including facilities lacking SCI-specific services (i.e., non-SCI-specialized centers). Activity-based therapy (ABT) is a neurorestorative approach involving intensive, task-specific movement practice below the injury level. This study explored the existing knowledge, perceptions, and implementation of ABT among physical and occupational therapists working in non-SCI-specialized centers.</p><p><strong>Setting: </strong>Canadian hospitals and community clinics DESIGN/METHODS: Semi-structured interviews were conducted with Canadian therapists who worked at non-SCI-specialized centers and treated at least one patient with SCI within the last 18 months. The Theoretical Domains Framework was used to develop interview questions that queried therapists' experiences in delivering SCI rehabilitation, their understanding of ABT and experience with its implementation. Interviews were audio-recorded, transcribed verbatim and analyzed using interpretive description.</p><p><strong>Results: </strong>Four physical therapists and three occupational therapists, from diverse settings (i.e., acute care, inpatient rehabilitation, long-term care, outpatient rehabilitation, rural outpatient clinic) participated. Three themes were identified: (1) Available knowledge, resources and therapy time in non-SCI-specialized centers challenge ABT implementation, (2) How current therapy practices in non-SCI-specialized centers align with ABT and (3) Desire for ABT knowledge. Although participants were not familiar with the term ABT, it was identified that they were unknowingly incorporating some components of ABT into their practice. Participants expressed a keenness to learn more about ABT.</p><p><strong>Conclusion: </strong>Current knowledge and implementation of ABT in non-SCI-specialized centers is limited. Tailoring ABT education to therapists at non-SCI-specialized centers may increase ABT implementation.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"10 1","pages":"14"},"PeriodicalIF":1.2,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10957876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140185633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Priorities, needs and willingness of use of nerve stimulation devices for bladder and bowel function in people with spinal cord injury (SCI): an Australian survey.","authors":"Vanesa Bochkezanian, Kelsey J Henricksen, Benjamin J Lineburg, Louis A Myers-Macdonnell, Dennis Bourbeau, Kim D Anderson","doi":"10.1038/s41394-024-00628-3","DOIUrl":"10.1038/s41394-024-00628-3","url":null,"abstract":"<p><strong>Study design: </strong>Anonymous online survey OBJECTIVES: To investigate the priorities, needs and willingness to adopt nerve stimulation devices for managing neurogenic bladder and bowel function in people with spinal cord injury (SCI) living in Australia.</p><p><strong>Setting: </strong>Online survey of people living with SCI in Australia.</p><p><strong>Methods: </strong>This anonymous online survey used Qualtrics and was advertised via standard communication channels, such as advocacy groups representing the SCI community in Australia, social media, attending SCI sporting events and by word-of-mouth.</p><p><strong>Results: </strong>Responses from 62 individuals (32% female, 68% male) were included. Bladder emptying through urethra without catheter was the highest priority for bladder function. Reducing time required for bowel routines and constipation were the top priorities regarding bowel function. The highest concern for internal/implanted devices was the 4% chance of device surgical removal, while wearing wires under the clothes was the main concern for external devices. 53% of respondents were willing to trial an implanted nerve stimulation device, while 70% would trial an external device to improve and gain independence in bladder and bowel function.</p><p><strong>Conclusion: </strong>The findings of this study highlighted the potential role in which nerve stimulation can have in addressing bladder and bowel dysfunction in people with SCI, and have also identified that there was a need for Australian physiotherapists to evaluate their role in bladder and bowel dysfunction. Results from this study can help guide further research in nerve stimulation devices for bladder and bowel dysfunction in people with SCI.</p><p><strong>Sponsorship: </strong>n/a.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"10 1","pages":"15"},"PeriodicalIF":1.2,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10957911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140185634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parainfectious Brown-Sequard syndrome associated with Mycoplasma pneumoniae in an adult patient: a case report.","authors":"Michail Papantoniou, Konstantinos -Vasileios Tsatinas, Maria Gryllia","doi":"10.1038/s41394-024-00627-4","DOIUrl":"10.1038/s41394-024-00627-4","url":null,"abstract":"<p><strong>Introduction: </strong>Acute transverse myelitis (ATM) refers to a rare severe acquired spinal cord inflammation, with a challenging diagnostic work-up and treatment.</p><p><strong>Case presentation: </strong>We report the case of a 42-year-old patient who presented with loss of temperature and pain sensation beneath the C5 dermatome in her left side and reported a history of a possible respiratory tract illness 10 days ago. Within 2 days, clinical worsening was noted, compatible with Brown-Sequard syndrome. Spinal magnetic resonance imaging revealed a T2 sequence abnormal signal from level C4 to T3 and cerebrospinal fluid (CSF) studies showed only a mild pleocytosis mononuclear type. Extensive CSF and blood tests revealed only high Mycoplasma pneumoniae IgM and IgG titers. Treatment with high-dose intravenous methylprednisolone and oral azithromycin were administrated and the patient recovered completely within two months.</p><p><strong>Discussion: </strong>We would like to highlight the importance for physicians to consider M. pneumoniae in their differential diagnosis as a potential cause when encountering patients with symptoms of ATM and inflammatory Brown-Sequard syndrome.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"10 1","pages":"13"},"PeriodicalIF":0.7,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10943185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140140853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}