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A - possibly - unusual case of spinal cord injury

Manfredi VENTURA mventura at resulb.ulb.ac.be
Fri Jul 5 06:49:39 EST 1996


In article <31b5d6f6.781273 at news.mclink.it>, amoroso at mclink.it says...
>
>[I post the following request on behalf of a friend of mine and
>the neurologist who attends her. This probably looks like an
>unusual case. I am _not_ a physician. But I seem to understand
>that, although the injuries described below usually force the
>patient on a wheelchair, this did not - luckily - happen to my
>friend. 
>
>I posted this article to bionet.neuroscience twice in the last
>few weeks. But I received no reply at all. So, any help, comment
>or opinion will be highly appreciated, particularly references to
>other relevant resources on the net - e.g. Web sites, mailing
>lists, etc. I will gladly take care of forwarding to my friend
>and her physician any message or information posted to this group
>or directly sent to me. Thanks,
>
>
>Paolo Amoroso]
>
>===============================================================
>1st Department of Rehabilitative Medicine - Milan, Italy (Head:
>Dr. Mario Raineri, MD.)
>
>The patient
>-----------
>Gender: female
>Age: 32
>
>Accident dated:
>--------------
>February 11, 1987
>
>She had:
>-------
>* head contusion
>* cervical distortion and contusion
>* lumbo-sacral contusion
>
>Symptoms
>--------
>* headache
>* difficulties in spacial perception
>* difficulties in musical perception
>* dizziness and malaise
>* paraesthesia to hands, difficulties in closing the hand to
>fist, paraesthesia to trunk, especially to back inferior and
>lumbar region
>* asthenia, especially to left limbs and hypocinesia
>* fatigue when walking, pyrotic sensation and pain in
>lumbo-sacral region spreading back to lower limbs, especially on
>the left
>* areflessic neurological bladder needing bladder voiding by
>means of external pression
>
>Examinations
>------------
>HEAD ASPECT: cortical area - mild hypo perfusion of right
>temporal area; subtentorial area: mild hypo perfusion of right
>cerebellum
>
>URODYNAMIC EX.: areflexic bladder
>
>SACRAL EVOKED POTENTIALS: bilaterally absent. Probable lesion of
>2nd motoneuron confirming the bladder situation
>
>ELECTROMYOGRAPHY: radicular peripheral neurological sufferance in
>lower limbs at L4-L5-S1 with a maximum on the left
>
>NEUROLOGICAL EX.: hypoestesia in left radial area, in left
>perineal area, in vulvar region and at the top of left tight,
>especially medially. Mild Lasegue on the left.
>
>Questions
>---------
>* Relation between contusions and Herpes Zoster
>* Relation between head contusion and difficulties in spacial and
>musical perception on the ground of vascular disturbances
>exhibited in right brain by ASPECT.
>===============================================================
>
>-- 
>Paolo Amoroso <amoroso at mclink.it>

Dear Mr. "Amoroso"

I do not understand the first question: do the patient have an active infection 
by herpes?  Is she suffering from encephalitis?  Why does this virus appear at 
the end of your request (without previous warning or hint?
Lacking some important data (e.g.the results of the neurological examination), 
it is impossible to help you for the etiology and the prognosis of the motor 
and the sensory symptoms exhibited by your friend.  It seems that there is 
peripheral and maybe a central (medullar) component to her complains.

About the second question:  it is well known that some areas mediating the 
perception of components of music are located in the right hemisphere, even if 
it depends of the previous learning of music (music is not organised in the 
brain in a similar fashion for a professional musician as for anybody).  
Visuospatial abilities are also organised mainly in the R. hemishere but 
especially in the parietal lobe.  The results of the SPECT can probably explain 
the cognitive deficits of your friend but it would be interesting to have  the 
results of a CT or better of a MRI of her brain and more details about the 
accident and her (complete) cognitive evaluation.




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