Multiple sclerosis and related disorders
-
Mult Scler Relat Disord · Jul 2018
Case ReportsAutonomic dysreflexia following acute myelitis due to neuromyelitis optica.
Cardiovascular autonomic dysfunction is a relatively common secondary complication of tetraplegia. In addition to low baseline arterial blood pressure, tetraplegics can develop sudden-onset hypertensive episodes associated with a variety of symptoms and signs (so-called autonomic dysreflexia). Unfortunately, this potentially life-threatening medical entity is often overlooked and mismanaged. With this, a case of typical presentation of autonomic dysreflexia in an individual with acute severe cervical spinal cord impairment due to neuromyelitis optica (NMO) is reported and discussed. ⋯ This case report illustrates a clinically relevant, but still under-recognized cardiovascular autonomic complication of severe, cervical or high-thoracic spinal cord impairment due to NMO. In addition to low baseline blood pressure and orthostatic hypotension, the patient developed episodes of autonomic dysreflexia during the acute stage after tetraplegia. Autonomic dysreflexia requires early diagnosis and proper treatment in order to prevent severe complications or death. Greater awareness of this potentially life-threatening cardiovascular emergency of spinal cord impairment is needed among patients, caregivers, and healthcare professionals, including neurologists.
-
Mult Scler Relat Disord · Jul 2018
Phase sensitive reconstruction of T1-weighted inversion recovery in the evaluation of the cervical cord lesions in Multiple Sclerosis; is it similarly eligible in 1.5 T magnet fields?
In primary studies with 3 T Magnets, phase sensitive reconstruction of T1-weighted inversion recovery (PSIR) have showed ability to depict the cervical multiple sclerosis (MS) lesions some of which may not be detected by short tau inversion recovery (STIR). Regarding to more availability of 1.5 T MRI, this study was designed to evaluate the eligibility of PSIR in 1.5 T for detection of spinal cord MS lesions. ⋯ This study shows that in the setting of a 1.5 T magnet field, STIR significantly has a superiority over both of the PSIR reconstructions (i.e. real and magnitude) for the detection as well as the boundary definition of the cervical cord lesions of MS. These results have a good relevance to clinical practice by using MRI scanners and sequences routinely available, however, it is discrepant with other reports performed by 3 T Magnet fields.