Girdle Sensation Research Articles

Clinical spectrum of late symptomatic neurosyphilis in China: an 11-year retrospective study

ObjectivesThis study aimed to describe the clinical features of neurosyphilis in Chinese patients in an attempt to find clinical features that are helpful for the early identification of neurosyphilis.MethodsThis retrospective...

Severe aquaporin 4-IgG-positive neuromyelitis optica with disseminated herpes zoster in a pregnant woman successfully treated with intravenous immunoglobulin.

A 26-year-old, 17-week pregnant woman developed aquaporin-4-IgG-positive severe longitudinally extensive transverse myelitis during the course of disseminated herpes zoster and became quadriparetic. She was unresponsive to high-dose intravenous methylprednisolone but became able to walk without assistance after intravenous immunoglobulin. One and a half months later, left optic neuritis developed but her vision improved with intravenous immunoglobulin. The only sequela was left T5 girdle sensation, and she delivered a healthy baby. Intravenous immunoglobulin may be a rescue therapy in aquaporin-4-IgG-positive neuromyelitis optica attacks in pregnant women, especially those with severe infections.

Localized Girdle Sensation of Mid-Trunk (False Localizing Sign) in a Patient with Compressive Cervical Myelopathy

Patient with compressive cervical myelopathy sometimes present with localized girdle sensation in the mid trunk (called false localizing sign). This symptom often confuses physicians, but the clinical features and mechanism are still unclear. We present a male patient presented with localized girdle sensation in the middle trunk following fall. Later on diagnosis of compressive cervical myelopathy was made after MRI cervical spine.

Localized Girdle Sensation of Mid-Trunk (False Localizing Sign) in a Patient with Compressive Cervical Myelopathy

Patient with compressive cervical myelopathy sometimes present with localized girdle sensation in the mid trunk (called false localizing sign). This symptom often confuses physicians, but the clinical features and mechanism are still unclear. We present a male patient presented with localized girdle sensation in the middle trunk following fall. Later on diagnosis of compressive cervical myelopathy was made after MRI cervical spine.

Girdle Sensation Caused by Radiculitis due to Neurosarcoidosis.

A 46-year-old woman suffered from unbearable tightness in the chest and difficulty in closing her eyes for over 1.5 months. A neurological examination revealed V1, 2 and facial nerve palsies, absent patellar and Achilles tendon reflexes, a positive Lasegue sign and girdle sensation corresponding to the Th2-8 dermatomes. Blood tests, including measurements of the angiotensin-converting enzyme level, were all normal. Brain and spinal magnetic resonance imaging showed no intramedullary spinal lesions; however, remarkable gadolinium enhancement of the Th2-7 dorsal roots (Picture), both trigeminal nerve entries and right geniculate ganglion was noted. Non-caseating epithelioid cell granuloma formation

Current symptomatology in multiple sclerosis and neuromyelitis optica.

Several symptoms and signs are characteristic of multiple sclerosis (MS) such as Lhermitte's sign, Uhthoff's phenomenon and painful tonic seizure. Neuromyelitis optica (NMO) is another inflammatory disease of the central nervous system, and most of the opticospinal form of MS is thought to be NMO. This study aimed to investigate the frequencies of symptoms and signs, previously regarded as characteristic of MS, in NMO and MS patients. Consecutive Japanese NMO-plus patients [NMO (n = 30) or partial NMO (n = 18)] and MS patients (n = 128) seen at Chiba University Hospital between 2011 and 2012 were investigated for the frequencies of symptoms and signs characteristic of MS. Logistic regression analyses were used to identify factors that distinguished NMO-plus from MS. Univariate analyses revealed that tonic seizures, Lhermitte's sign, persistent pain, fatigue and girdle sensation were more frequent in NMO-plus patients than in MS patients. Multivariate logistic regression analysis showed that paroxysmal itching, Uhthoff's phenomenon, Lhermitte's sign and girdle sensation were more characteristic of NMO-plus than of MS. Several classical MS symptoms and signs are more frequent in NMO patients than MS patients, which may be caused by the differences in the severity of inflammation, and localization and extensiveness of demyelinated lesions.

Acute Flaccid Quadruparesis In A Young Male: A Case Report

A 28year old normotensive euthyroid male presented with recurrent lower motor neuron type of weakness without any sensory or autonomic involvement, with preserved reflexes. Systemic examination was significant for a mild hepatosplenomegaly. Investigations revealed persistent hypokalemic, hyperchloremic, normal anion gap metabolic acidosis with deranged liver functions. Urine pH was 6.0 even after an oral ammonium-chloride loading test. A case of Type I Renal Tubular Acidosis (RTA) was diagnosed. A search for the etiology revealed bilateral Kayser-Fleischer (KF) ring, with low serum ceruloplasmin levels and high urinary copper , confirming it to be Wilson's Disease (WD). A 28 year-old male farmer was admitted with weakness of all the four limbs. To start with, the weakness involved the lower limbs and then progressed rapidly to involve the upper limbs making the patient bed–bound within the next day. The weakness involved both proximal and distal group of muscles and was associated with significant flaccidity but without fasciculations, sensory abnormalities or diurnal variation. There was no history suggestive of alteration of higher functions, cranial nerve or sphincter involvement and of radicular pain or girdle sensation. Weakness was not preceded by vaccination, respiratory tract infection or diarrhoea and was not associated with food intake, exercise or change of temperature. He denied unexplained sweating, tremors, heat intolerance, prolonged vomiting, diabetes, hypertension or any drug intake over a prolonged period of time. The patient had 2 such similar attacks in the past, but those were milder, subsided spontaneously and didn't require hospitalization. His personal and family history was noncontributory. The patient had a normal higher function, and normal vitals with blood pressure of 110/80mm Hg. The neurological examination revealed marked hypotonia and weakness in all four limbs, the power being 1/5 in the lower and 2/5 in the upper limbs. There was no cranial nerve involvement, sensory impairment and no abnormality in any of the superficial or deep reflexes. Plantar reflexes were bilaterally flexor and coordination could not be tested. Both the lobes of liver were palpable 3c.m below the costal margin with firm consistency. He had a mild splenomegaly without any venous prominence and clinical evidence of free fluid in the abdomen. The complete blood count, serum urea and creatinine were normal but the fasting plasma glucose was 182mg/dl and the post-challenge plasma glucose was 214mg/dl. The liver function test revealed the following: Bilirubin-0.9mg/dl, AST-168U/L, ALT-58U/L, Albumin-2.2gm/dl and Globulin-4.1gm/dl. The serum sodium, potassium, chloride and bicarbonate were 140mEq/L, 2.8mEq/L,108.1mEq/L and 20.4mEq/L respectively. The arterial blood gas analysis suggested mild metabolic acidosis with normal anion gap. A provisional diagnosis of hypokalemic paralysis was considered and the electrolyte deficit was corrected with oral and intravenous potassium supplementation. The patient improved completely but a repeat estimation after 4 days showed a persistent hypokalemia (K=2.7meq/L) and metabolic acidosis. Measured calcium (9.1mg/dl) and magnesium (1.9mg/dl) were within normal limits. He had a normal thyroid profile. Serum HIV serology, Serum electrophoresis , Creatine Kinase, Aldolase, Porphobilinogen, Cerebrospinal fluid study and Electrophysiological studies were all normal. 24 hours urinary potassium excretion was 242.76mEq. Acute Flaccid Quadruparesis In A Young Male: A Case Report 2 of 4 Plasma and urinary osmolality were 296.76mosm/kg and 482.2mosm/kg respectively. Estimated transtubular potassium gradient(TTKG) came out to be 15.25. To proceed with the diagnosis of a case of hypokalemia, we followed the algorithm given in Figure 1(1). A potassium excretion >15mmol/day and a TTKG of more than 4 narrowed our possibilities further. A diagnosis of renal tubular acidosis (RTA) was made and oral NH4Cl test (0.1gm/kg) revealed worsening of acidosis(7.377 to 7.289) with a urinary pH of 6.

Girdle Sensation Masquerading as Splanchnopathy in Neurosarcoidosis

Girdle Sensation Masquerading as Splanchnopathy in Neurosarcoidosis

Clinical features of the localized girdle sensation of mid-trunk (false localizing sign) appeared in cervical compressive myelopathy patients.

Cervical compressive myelopathy patients sometimes show localized girdle sensation in the mid trunk (so-called false localizing sign). This symptom often confuses physicians, but the clinical features and mechanism of this symptom are still unclear. We investigated the clinical features and possible mechanism. In each of five cases of cervical compressive myelopathy disease with and without mid-truncal girdle sensation, the clinical features, degree and shape of cord compression were analysed. The girdle sensation was expressed as a vague or burning sensation, and was localized with a width of 3 or 4 dermatomes from the T3 to T11 level. There was no correlation between the appearance of the girdle sensation and etiology and level of cervical cord compression. Pyramidal tract signs and disturbance of superficial sensation were observed in all cases. Furthermore, on axial MRI, the midline ventral surface of the cervical cord was remarkably compressed in cases with girdle sensation, as if the compressive lesion entered the anterior medial fissure of the cervical cord. From these findings, this false localizing sign may be caused by severe compression of midline ventral structure of the cervical cord. Ischemia of the thoracic watershed zone of the anterior spinal artery from the compression of the anterior spinal artery at the cervical level might also be considered to be a possible cause.

Cortical somatosensory potentials evoked by magnetic stimulation of thoracic and lumbar roots.

We applied twin coil magnetic stimulation to thoracic and lumbar roots to evaluate the posterior column function in 50 normal subjects and 34 patients with neurologic disorders. In all nine patients with cervical myelopathy, there were abnormal somatosensory evoked potentials (SEPs) with stimulation of upper thoracic levels. In 14 patients with thoracic or lumbar myelopathy, there were normal SEPs with stimulation of spinal roots above the lesions and abnormal SEPs with stimulation below the lesions. In a patient with girdle sensation between T-3 and T-6, the peak latencies of P2 were significantly delayed with stimulation of T-2 and T-4, but peak latencies were normal with T-6, T-10, and L-3 stimulation. Ten patients with polyneuropathy had normal SEPs recorded with thoracic and lumbar root stimulation. SEPs by twin coil stimulation at thoracic and lumbar root levels are useful in detecting lesions of spinal cord or roots and for following their clinical course noninvasively.

A contribution to pathogenesis of the gastric crisis; a case report of the spinal syphilis which showed painful abdominal girdle sensation and peristaltic unrest of stomach and intestine.

Summary1. We are reporting here a case of spinal lues, which showed clinically an attack of gastric crisis (peristaltic unrest and abdominal distress) accompanied simultaneously with hypersensibility (girdle pain sensation).2. The autopsy findings revealed that the pathological changes are found in the spinal cord, meninges and spinal root fibers extending between the 5.‐10. thoracic segments. Nerve fibers in the sglanchnic nerve are also found partly degenerated. These findings correspond exactly to the clinical symptoms of motor and sensory disturbances.3. There is no change in the vagus nerve, so the cause of the gastric crisis can not be attributed to lesion of the vagus nerve.We would rather ascribe the crisis symptom to the lesin of the posterior root of the spinal cord. We believe that the lesion of the Fosterior roots causes simultaneous appearance of sensory irritation (girdle pain) and peristaltic unrest of the stomach.

LOCOMOTOR ATAXIACOMPLICATED BY THROMBOSIS OF THE PONTILE ARTERIES, WITH REPORT OF CASE.

W. R. M., male, admitted to St. Anthony's Hospital June 5, 1899, aged 45, traveling salesman, born in New York, in Colorado fifteen years. Family history negative. Previous History.—Had the usual diseases of childhood, after which he enjoyed good health until he was fifteen years of age, when he met an accident, fracturing his right leg. At 20 years of age he contracted gonorrhea. When 40 years old he suffered from severe pains in the legs, which were sharp, shooting and momentary in character and were influenced by changes in the weather. About the same time he noticed that his gait was gradually becoming unsteady and at the present time he is unable to walk in the dark without falling. Three years ago he complained of a girdle sensation, also difficulty in starting his urine to flow, although while asleep the urine dribbles from him. During this year, while alighting