Myotonic dystrophy presenting as new-onset hand weakness and recurrent pneumonia in a patient with paraplegia: a case report.

We describe a previously independent T11 paraplegic patient who had delayed-onset hand weakness and recurrent pneumonia caused by myotonic dystrophy. A man in his late thirties suffered a thoracic spinal cord injury (SCI) from a gunshot wound at the age of 17 years, with resultant T11 American Spinal Injury Association class A paraplegia. He lived independently until the age of 36 years when he was hospitalized multiple times for pneumonia.

Successful pregnancy in a patient with spinal muscular atrophy and severe kyphoscoliosis.

Pregnancy imposes a load on the respiratory system that is usually easily assumed because of alterations in the thoracoabdominal architecture. It is presumed that the respiratory mechanical disadvantage of severe kyphoscoliosis and the muscle weakness of spinal muscular atrophy impede these adaptations sufficiently to preclude a successful gestation. We report the case of a successful pregnancy in a woman with spinal muscular atrophy, severe uncorrected scoliosis, and the lowest spirometric values reported in the literature without the use of ventilatory support.

Impact of respiratory complications on length of stay and hospital costs in acute cervical spine injury.

Context: Respiratory complications are frequent in patients with acute cervical spinal injury (CSI); however, the importance of respiratory complications experienced during the initial hospitalization following injury is unknown.

Objective: To determine if respiratory complications experienced during the initial acute-care hospitalization in patients with acute traumatic cervical spinal injury (CSI) are more important determinants of the length of stay (LOS) and total hospital costs than level of injury.

Design: A retrospective analysis of an inception cohort for the 5-year period from 1993 to 1997.