頁籤選單縮合
題 名 | Spinal Cord Infarct Presenting as Brown-Sequard Plus Syndrome: A Case Report |
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作 者 | Kao, Chuen-der; Lee, Yi-chung; Chen, Jen-tse; Guo, Wan-yuo; Liao, Kwong-kum; | 書刊名 | Acta Neurologica Taiwanica |
卷 期 | 9:2 民89.06 |
頁 次 | 頁145-150 |
分類號 | 415.945 |
關鍵詞 | Brown-sequard syndrome; Spinal cord; Evoked potentials; |
語 文 | 英文(English) |
英文摘要 | Brown-Sequard syndrome usually a manifestations of as compressive myelopathy. A 71-year-old man was admitted because of lower body numbness and right leg weakness in on the morning of September 27, 1999. There He had was a history of coronary disease but no recent trauma. On physical examination, there was a monoparesis of the lower right lower limb and a sensory impairment below the level of T4-6. Sensory examination showed that “proprioception” was affected bilaterally, to a greater degree in the paretic limb. Pain and thermal sensations was were relatively slightly affected on the left limb. Spinal magnetic resonance imaging (MRI) showed an abnormally high signal lesion in the posterior and right lateral parenchyma of the spinal cord at the levels of T4 and T5 with on T2-weighted images. Motor evoked potentials with transcranial magnetic stimulation (TMS) showed prolonged central conduction times and reduced amplitudes of the compound muscle action potentials on the right, while somatosensory evoked potentials of the tibial nerves showed decreased cortical potentials following stimulation at the right ankle. Sympathetic skin responses to TMS showed significantly lower amplitude over the right sole. Based on clinical grounds examination results and MRI findings, spinal cord infarction was diagnosed. Bladder function, motor control and sensory perception improved 6 weeks laterafter admission. The patient was regained the abileity to walk without support recently. Multiple modalities of electrophysiological testing helped in ascertaining the degree and extent of spinal cord infarction while supporting the clinical impression of the Brown-Sequard syndrome. |
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