Neurogenic spinal arthropathy is quite frequent a finding in elderly patients. Peripheral neuropathy underlies this complication. As a matter of fact, impaired proprioception and sensitivity, which are often associated with lesions of the motor nerves, prevent the joint or bone segment submitted to repeated traumas from perceiving alarm sensations, especially pain. Thus, bone lesions follow, which present as bone erosions, fractures, and even more severe bone destruction. At first, tabetic neuropathy was held responsible for this condition. Then, neurogenic arthropathy was observed in diabetes, syringomyelia, and sometimes trauma. However, in the elderly patient, other conditions can cause peripheral neuropathy, which accounts for the high incidence of this disorder. The radiologic findings of the lumbar spine of 23 of 4,922 patients examined in our department 1989 to 1991 were suggestive of neurogenic spinal arthropathy. Clinical, laboratory and electromyographic findings confirmed the presence of neuropathy. Besides the neurogenic lesions described in 7 diabetic patients, these lesions are reported for the first time in 4 cases of multiple myeloma, in a case of Waldenström's macroglobulinemia, in 2 cases of vincristine-treated lymphoma, and finally in an alcohol abuser. Analgesic abuse was observed in 2 patients. In the extant cases, the pathogenesis of neuropathy remained unknown, even though "elderly neuropathy" is known to exist and to be underlain by vascular or degenerative conditions.
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Neurourol Urodyn
January 2025
Department of Neurology, Hochzirl Hospital, Zirl, Austria.
Introduction: Neurogenic bladder dysfunction is a prevalent condition characterized by impaired bladder control resulting from neurological conditions, for example, spinal cord injury or traumatic brain injury (TBI). Detrusor overactivity is a typical symptom of central nervous system damage. A lesion affecting the pontine neural network typically results in loss of tonic inhibition exerted by the pontine micturition center and causes involuntary detrusor contractions.
View Article and Find Full Text PDFCureus
December 2024
Internal Medicine, Merit Health Wesley, Hattiesburg, USA.
Anterior cord syndrome is a rare yet critical neurological condition that poses significant challenges in clinical management. We present the case of a 71-year-old male with a medical history of hypertension, uncontrolled type II diabetes mellitus, hypothyroidism, and end-stage renal disease requiring dialysis who presented to the emergency department with complaints of chills, back pain, abdominal pain, and vomiting episodes. Based on the severity of the patient's illness, it was decided that inpatient admission would be best.
View Article and Find Full Text PDFUrologie
January 2025
Neuro-Urologie, Schweizer Paraplegiker-Zentrum, Guido A. Zäch-Straße 1, 6207, Nottwil, Schweiz.
A spinal cord injury (SCI) leads to neurogenic lower urinary tract dysfunction (NLUTD), which, if left untreated, can result not only in urinary incontinence and an increased risk of urinary tract infections and kidney dysfunction but may also pose a vital threat to people with SCI. Comprehensive neurourological assessments, including patient history and combined video urodynamics, are essential to accurately classify dysfunction and establish therapeutic strategies. Treatment options include, among others, medications for detrusor regulation, intermittent catheterization, and, if necessary, surgical interventions from intradetrusor botulinum toxin A injections to sacral deafferentation.
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December 2024
Neurology, Hassan II University Hospital, Fez, MAR.
Hirayama disease, also known as non-progressive juvenile spinal muscular atrophy of the upper limbs, brachial monomelic amyotrophy, or benign focal atrophy, affects the C7 D1 myotomes; an electromyogram (EMG) shows neurogenic damage in the C7-C8-T1 territories. It causes weakness and amyotrophy of the distal upper limb. Although it usually occurs on one side only, bilateral symmetric cases of Hirayama disease have occasionally been described.
View Article and Find Full Text PDFPurpose: Neurogenic lower urinary tract dysfunction (NLUTD) is highly prevalent among patients with neurologic disorders. Some studies have demonstrated that implantable neuromodulation can improve symptoms of NLUTD. We seek to describe our experience with sacral and pudendal neuromodulation in patients with NLUTD.
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