A 35 years old man with Quadriplegia
O/E: Patient physical finding images are as
Doctor’s Notes:
X-Ray images:
MRI Report & Images:
Old Discharge summery :
hereby i am presenting a video file link in which the patient problem is discussed.
To this see this video file so please click this link hereunder
35 year old man with sudden quadriparesis 3 months back found to be due to cervical spinal tuberculosis, decompressed neuro-surgically with minimal improvement of power but still bed ridden. http://hindiudhc15.blogspot.in/…/a-35-years-old-man-with-qu… What is intriguing is a peculiar diaphragmatic involuntary movement reflected in his abdominal muscles. (Inputs Abhijit, Nitin, Paritosh, Amy and others)
ReplyDeleteA 35 years old man with Quadriplegia
HINDIUDHC15.BLOGSPOT.COM|BY KULDEEP GUPTA
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Rakesh Biswas This is the video https://www.youtube.com/watch?v=3odw50reyuU&feature=youtu.be of his involuntary diaphragmatic movement taken today.
involuntary diaphragmatic movement
YOUTUBE.COM
Like · Reply · Remove Preview · 9 hrs
Rakesh Biswas Kaustav, Amy, Bhavik another write up?
Like · Reply · 1 · 9 hrs
Bhavik Shah I'd love to write this one!
If nobody else writes this up, I'll give it a try once I'm done with exams!
Unlike · Reply · 1 · 8 hrs
Amy Price Pyramidal tract upper neuron/lower neuron junction demylineated?? Does TB or surgery do this or could the inflammation from the surgery cause this and it will calm down?
Unlike · Reply · 1 · 5 hrs
Rakesh Biswas Thanks Bhavik and Amy. Looks like something i have never come across before and yet all the ingredients for a pot boiler are present (C3,C4 phrenic nerve root lesion etc). Would be good to hear from the experts (Arjun, Abhijit, Satendra any possibility of a diaphragmatic EMG establishing a correlation?) Do also take a look at the MRI of the spine (Dr Agamya, Dr Pathak).
Like · Reply · 58 mins
Rakesh Biswas Dr Rajendra, Prof Jain Will appreciate your inputs on this diaphragmatic curiosity.
Like · Reply · 56 mins
Rakesh Biswas Thanks Bhavik, Please go ahead and try to answer the query on correlation between the diaphragmatic movement (seen on video) and his cervical spinal cord lesion. This time we are not making this a global-health case report but a quick 'images in clinical medicine.' smile emoticon
Like · Reply · 41 mins
Rakesh Biswas Found something here:http://casereports.bmj.com/content/2012/bcr-2012-007393.full Can we get a fluoroscopy for this patient today Agamya?
Intermittent bursts of abdominal wall jerky movements: belly dancer's syndrome? -- Amin et al....
A 47-year-old Iraqi Kurdish woman presented with a 1-day history of sudden onset of frequent, intermittent and painful abdominal wall jerky movements, 6 days after undergoing haemorrhoidectmy. During sleep, these movements were absent. The postoperative period was uneventful and the patient was disc…
CASEREPORTS.BMJ.COM
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Rakesh Biswas Also something similar to our case here:http://apps.elsevier.es/watermark/ctl_servlet?_f=10...
Like · Reply · 8 mins
Rakesh Biswas Agamya I guess even USG of the diaphragm would reveal something spectacular here (Pokhraj?)
Like · Reply · 7 mins
Rakesh Biswas One of the chief problems right now with our patient is his inability to swallow the anti-tubercular drugs due to persistent vomiting (possibly related to his diaphragmatic flutter?). He is also retro virus positive. The images in Kuldeep's prepared UDHC blog-record reveals some onychomycosis that will be sent for fungal scrapings today