Abstract Ten years after placement of a spinal cord stimulator (SCS) and resolution of pain, this patient presented with progressive paraplegia, worsening thoracic radicular pain at the same dermatome level of the electrodes, and bowel and bladder incontinence [ncbi.nlm.nih.gov]

Clonus Present Absent 6. Mass reflex Absent May be present 7. Bladder Precipitancy Automatic bladder 7. [slideshare.net]

On ED presentation, the patient was noted to be unable to ambulate secondary to pain. [hindawi.com]

• Fever

  (2) of the BStMG 2002, on the same basis as disabled persons resident or ordinarily resident in Austria. et Hoida laste eest varjatud ja kättesaamatus kohas en Patient has at least 1 of the following signs or symptoms with no other recognized cause: fever [et.glosbe.com]

  A 10-year-old boy was admitted with a 1-month history of progressive back pain and low fever for 7 days as well as sudden onset of paraplegia for 1 day. [ncbi.nlm.nih.gov]

  You have a fever. You have trouble urinating or urinate less than usual. Your abdomen is swollen and firm. You have blood in your urine or bowel movement. You have questions or concerns about your condition or care. [drugs.com]

  He had no recent illness, fever, or trauma. On examination there was subjective sensory disturbance below T10 with sacral sparing, lower limb pyramidal weakness (4+/5), hypertonia, hyperreflexia, and an upgoing left planter response. [thelancet.com]

  We add a new family to the literature with 3 affected members and a remarkable phenotype of purely fever-induced ataxia with myokymia. [ng.neurology.org]

• Short Stature

  stature and dysmorphic features. [orpha.net]

  stature dystonia (involuntary muscle contractions) ataxia (impaired balance and coordination) Some children may also have facial differences that can include: high palate wide nasal bridge bulbous nose wide mouth protruding tongue short philtrum (the [childrenshospital.org]

  These include: Hoyeraal–Hreidarsson syndrome – very short stature, bone marrow failure, immunodeficiency, underdeveloped cerebellum idiopathic aplastic anaemia (anaemia due to bone marrow failure) myelodysplasia (bone marrow failure) idiopathic pulmonary [dermnetnz.org]

• Weight Gain

  gain due to reduced activity level Pressure sores Skin irritations Infections or lesions on the site of injury Treatment of Paraplegia Spinal cord injuries are not curable but surgery can reduce the swelling, lesions and pain at the site of injury. [healthproductsforyou.com]

  Mental health symptoms Weight gain Susceptibility to secondary infections Pain Thompsons Spinal Injury Claims The paraplegia and tetraplegia spinal injury solicitors at Thompsons are here to help you with all aspects of a compensation claim, including [thompsons-scotland.co.uk]

  Someone with paraplegia may also experience: chronic pain a rapid heartbeat high blood pressure reduced bladder and bowel function sexual dysfunction weight gain Challenges of quadriplegia Quadriplegia affects the body from the neck down, which can significantly [medicalnewstoday.com]

  Gastrointestinal disease— In severe cases among young children, telomere disorders can cause isolated problems in the gut, including bloody diarrhea and insufficient weight gain and physical growth called failure to thrive.These symptoms often appear [hopkinsmedicine.org]

• Fishing

  DCEG investigators in the Clinical Genetics Branch (CGB) showed that telomere length, as measured by flow cytometry-FISH was both sensitive and specific for distinguishing DC from healthy individuals and from those with other IBMFS. [dceg.cancer.gov]

  […] epilepsy problems with balance, co-ordination and speech (ataxia) eye problems – such as damage to the retina (retinopathy) and damage to the optic nerve (optic neuropathy) dementia ichthyosis – a condition that causes widespread and persistent thick, dry "fish-scale [nhs.uk]

  Clinical diagnosis may be confirmed by telomere length testing by multicolor flow cytometry fluorescence in situ hybridization (flow-FISH), and genetic testing. [orpha.net]

  It may be possible to distinguish dyskeratosis congenita by flow-FISH analysis due to the very short telomeres compared to age-matched controls. [dermnetnz.org]

• Wheelchair Bound

  Patients with progressive HSP are often wheelchair-bound by the age of 70 years. Patients with HSP have a normal life-expectancy. Epidemiology References:[1][2][3] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]

  ‘For example, a person with paraplegia who is wheelchair-bound may be working successfully on a full-time basis as an accountant and therefore not meet the Social Security Administration's definition of disabled.’ [lexico.com]

  Jellema et al9 reported in 2004 a series of 44 treated patients and mentioned 13 patients who were wheelchair-bound at the time of treatment. [ahajournals.org]

  Browsing Articles by Date Published: December 25, 2018 | Category: News | Spinal Cord Injury: Paraplegia Don’t ever call me ‘wheelchair bound’. My wheelchair doesn’t bind me – it liberates me! [spinalcordinjuryzone.com]

• Fecal Incontinence

  Impotence and various degrees of urinary and fecal incontinence are very common in those affected. [psychology.wikia.com]

  Paraplegia is the complete loss of any sensory or motor function in the lower extremities and usually involves loss of use of both legs, urinary and fecal incontinence, impotence, and loss of pelvic function. [jamescoulterlaw.com]

• Constipation

  If they have inability to pass urine or stool then catheter may have to be put into the urinary bladder to decompress the bladder and enemas may required if there is constipation. [pediatriconcall.com]

  It is well appreciated that an extreme sedentary lifestyle from paralysis, contributes to many secondary medical problems such as diabetes and insulin resistance, obesity, constipation, poor blood pressure regulation, cardiovascular disease, reduced quality [rewalk.com]

  Higher the injury site greater will be the loss of sensation Pain, electrical sensations and other intermittent feelings also called phantom sensations may occur Loss of sexual function, libido or fertility Incontinence or Constipation due to decreased [healthproductsforyou.com]

  Instead, treatment is aimed at problems associated with paraplegia, such as blood clots and constipation. To prevent blood clots, the patient is given special stockings to wear on the legs. A blood clot is a thick mass of blood. [medfriendly.com]

  Other treatment may include a high-bulk diet and the administration of suppositories to prevent constipation. paraplegia Neurology Complete paralysis, paresthesias, loss of sensation and control of voluntary movement in legs, post spinal cord injury or [medical-dictionary.thefreedictionary.com]

• Hypertension

  We report a not yet described clinical situation of a young patient (51 years) admitted to the emergency care department for treatment of systemic arterial hypertension of difficult control with 4 antihypertensive medication classes. [ncbi.nlm.nih.gov]

  Paroxysmal Hypertension in Spinal Cord Injuries. New England J. Med. 239 : 291 (1948). CrossRef Google Scholar 12. Gilberti, B. J. ; Goldfein, J. ; & Rovenstine, E. A. Hypertension during Anesthesia in Patients with Spinal Cord Injuries. [link.springer.com]

• Decompression Sickness

  sickness(b)Myelitis(i)Viral(ii)Bacteria(iii)Parasitic(iv)Parainfection(c)Demyelinating(i)Multiple sclerosis(ii)Acute disseminated encephalomyelitis(3)Nonspinal disorders(a)Guillain-Barre syndrome(b)Hyperkalemic or hypokalemic paralysis(c)Tick paralysis [hindawi.com]

• Muscle Spasticity

  Treatment is mainly supportive, with skeletal muscle relaxants, botulinum toxin, and physiotherapy for muscle spasticity. HSP may be nonprogressive (childhood-onset) or progressive (adult-onset). [amboss.com]

  Hereditary Spastic Paraplegia (HSP) is a group of rare, inherited neurological disorders. Their primary symptoms are progressive spasticity and weakness of the leg and hip muscles. [sp-foundation.org]

  Spasticity primarily affects muscles of leg extension (quadriceps), knee flexion (hamstrings), hip adduction (bringing the knees together, thigh adductor muscles), and muscles that extend the feet (gastrocnemius-soleus [Achilles tendon]). [rarediseases.org]

• Muscle Cramp

  Uncontrolled muscle cramps may cause spasms of the extensors and flexors in the legs. These can range from tembling legs to fully extended knees, hips and feet. [paravan.de]

  There are three main features of FSP: the legs become stiff (spasticity) and there is a variable amount of weakness (paraplegia), and muscle cramps and spasms can also be present. [contact.org.uk]

  Pure HSP: Pure HSP has the following symptoms: gradual weakening and stiffening of the legs balance difficulties muscle cramps in the legs high foot arches change in sensation in the feet urinary problems, including urgency and frequency erectile dysfunction [healthline.com]

  Exercise can help the patient to retain or improve muscle strength, minimize atrophy of the muscles caused by disuse, increase endurance, reduce fatigue, prevent spasms and cramps, and maintain or improve ROM. [emedicine.medscape.com]

• Irritability

  Spinal angiolipomas are rare epidural tumours that are usually revealed by chronic symptoms of medullar irritation. We report a case of acute paraplegia caused by spontaneous bleeding revealing a thoracic angiolipoma. [ncbi.nlm.nih.gov]

  […] feelings also called phantom sensations may occur Loss of sexual function, libido or fertility Incontinence or Constipation due to decreased bladder and bowel control Depression and mood swings Weight gain due to reduced activity level Pressure sores Skin irritations [healthproductsforyou.com]

  Dust, mold, dander from livestock and other respiratory irritants should be avoided, especially if your spinal cord injury results in decreased function of diaphragm or lung capacity. [nasdonline.org]

  This dangerous condition can occur when an irritation or pain below the level of injury sends a signal that fails to reach the brain, producing a reflex action that can constrict blood vessels. [robertnkatz.com]

  The high calcium content of milk also may foster stone formation, and carbonated drinks irritate the bladder. A wide variety of liquids can be most effective in avoiding the formation of stones. Gastrointestinal Complications. [medical-dictionary.thefreedictionary.com]

• Unable to Walk

  Many of these people were paralyzed and were unable to walk. To enable someone to move in their environment, the doctors would typically prescribe wheelchairs. [blogs.biomedcentral.com]

  The disorders are progressive and may lead to patients being unable to walk, and more. [sp-foundation-org.presencehost.net]

• Spastic Paralysis

  To any one interested in the physiologic implications of lesions of the spinal cord and the general problem of spastic paralysis few subjects can be more fascinating. [jamanetwork.com]

  paralysis of of the preserved or absent remaining LL Lower abdominal reflexes are Spastic paralysis of lower limbs Diminution or loss of knee jerk absent Sensory along the inguinal Ankle reflex exaggerated, Spastic paralysis of lower limbs region Plantar [slideshare.net]

  paralysis and spastic paraplegia caused by HTLVI infection). [orpha.net]

• Paresthesia

  Paresthesia Paresthesia in lower extremity can recognized in pure HSP.. Paresthesia Paresthesia in lower extremity can recognized in pure HSP.. Sensory neuropathy and Ulcers Found in complicated HSP. [medicaljoyworks.com]

  & n. paraplegia Neurology Complete paralysis, paresthesias, loss of sensation and control of voluntary movement in legs, post spinal cord injury or disease par·a·ple·gi·a (par'ă-plē'jē-ă) Paralysis of both lower extremities and, generally, the lower [medical-dictionary.thefreedictionary.com]

  In patients complaining of a history of increasing low back pain, bladder dysfunction, weakness, or paresthesias of the lower limbs, Jaeger et al. [ 20 ] strongly recommended postponing the procedure. [j-neurooncology.imedpub.com]

  Symptoms include: gradual weakening and stiffening of the legs back pain that may radiate down the legs paresthesia, or burning or prickling feelings urinary or bowel function problems erectile dysfunction inflammatory skin conditions, such as dermatitis [healthline.com]

• Dysautonomia

  One patient (6.3%) presented dysautonomia during pregnancy. The cesarean rate was 47% (the indication was in any case an obstetrical reason). Among vaginal deliveries, four (44%) required an instrumental extraction. [ncbi.nlm.nih.gov]

   Dysautonomia is common and is suggested by tachycardia, arrhythmia, labile BP ,bladder dysfunction and impaired thermoregulation  Diagnosis depends on clinical features, electrophysiology(NCV) - absent f wave ,reduced compound muscle action potential [slideshare.net]

• Urinary Urgency

  Patients present with upper motor neuron palsy of bilateral lower limbs, gait abnormalities, and urinary urgency/urge incontinence. Dorsal column dysfunction is usually mild. [amboss.com]

  Bowel urgency is less common but may occur. Medications such as oxybutynin may reduce urinary urgency. If urinary urgency is severe or accompanied by difficulty initiating urination, consultation with a urologist is recommended. [rarediseases.org]

  Other common symptoms of HSP are urinary urgency and frequency, hyperactive reflexes, difficulty with balance, clonus, Babinski’s sign, diminished vibration sense in the feet, muscle spasms, and congenital foot problems such as pes cavus (high arched [sp-foundation.org]

• Urinary Retention

  Immediately after LP, the patient remarked a sudden worsening in muscular balance of his inferior limbs and a worsening of urinary retention. This fact was the clue to the SDAVF diagnosis. [ncbi.nlm.nih.gov]

  CASE REPORT Case 1 A 33-year-old man, complaining of dorsal thoracic pain for 2 months, was admitted to the emergency unit with paraplegia for 4 days and urinary retention with partially preserved tactile and painful sensitivity in lower limbs. [scielo.br]

  Approximately 12 hrs post-Caesarian section, the patient started to complain of mild paresthesia in both feet and calves, and over the next 12 hrs she presented with complete paraplegia and anesthesia from L1, including urinary retention and absent anal [j-neurooncology.imedpub.com]

• Urinary Incontinence

  A 57-year-old male 8 days after uneventful OPCAP presented with severe lower extremity pain and sudden fecal and urinary incontinence, followed by the absence of pulsations in the lower limbs and paraplegia, during 20-minute period. [ncbi.nlm.nih.gov]

  incontinence or retention 2     Total incontinence or persistent retention 3 The optimal treatment for each patient was selected after discussion between neurosurgical and neuroradiological staff. [ahajournals.org]

  In case of urinary incontinence, frequent change of bed-sheets.  Care of the bladder: If there is retention, use parasympathomimetic drugs. If this fails, use a catheter to evacuate the bladder.  II. Physiotherapy 59.  III. [slideshare.net]

• Kidney Failure

  Harms Safety endpoints related directly to MIS 2 ACE include kidney failure, respiratory failure and embolic events (also from debris). [bmjopen.bmj.com]

The patient’s hospital course including a workup for a hypercoagulable state revealed no clear etiology for embolus formation. [hindawi.com]

(See Prognosis, Presentation, Workup, Treatment, and Medication.) The most useful classifications now are based on the mode of inheritance and genetic linkage. [medscape.com]

While this adds considerable challenges in the diagnostic workup, certain specific complicating features may guide the differential diagnosis between the different HSPs. [scielo.br]

• Nephrolithiasis

  […] of traditional risk factors for CKD such as advanced age, diabetes, hypertension, and cardiovascular disease, individuals with paraplegia have elevated incidence of recurrent and chronic urinary tract infections, neurogenic bladder dysfunction, and nephrolithiasis [intechopen.com]

Early endovascular treatment can reverse this type of situation. [ncbi.nlm.nih.gov]

ASIA E which is the restoration of all neurologic function.[1] Treatment[edit] Individuals with paraplegia can range in their level of disability, requiring treatments to vary from case to case. [en.wikipedia.org]

Treatment Talk with your doctor about the best treatment plan for you. [wkhs.com]

References:[2][5][9] Treatment Prognosis Hereditary spastic paraplegia Summary Epidemiology Etiology Pathophysiology Clinical features Pure HSP (Uncomplicated HSP) Complicated HSP Diagnostics Treatment Prognosis [amboss.com]

Understanding these terms can help you communicate more effectively with your doctors, enabling you to better understand your prognosis. Many spinal cord injury survivors are confused by the distinction between quadriplegia, tetraplegia, paraplegia. [spinalcord.com]

Prognosis Prognosis depends on the phenotype (pure/complex form), genotype, and is highly variable due to incomplete penetrance and variable gene expression. [orpha.net]

Spinal cord injuries: Practice essentials, background, anatomy, pathophysiology, etiology, epidemiology, prognosis, patient education. [Internet] 10 August 2017. Available from: http://www.emedicine.com/pmr/topic182.htm. Accessed March 2018. [icf-casestudies.org]

The presentation is often not as clinically obvious as those of traumatic etiology; therefore a high index of clinical suspicion is needed to rapidly assess the various possible etiologies. [hindawi.com]

METHODS: We present a 68-year-old male with a progressive paraparesis of unknown etiology over the course of 12 months. [ncbi.nlm.nih.gov]

References:[2][5][9] Treatment Prognosis Hereditary spastic paraplegia Summary Epidemiology Etiology Pathophysiology Clinical features Pure HSP (Uncomplicated HSP) Complicated HSP Diagnostics Treatment Prognosis [amboss.com]

[…] tuberculosis, syphilis, poliomyelitis, malaria, septic meningomyelitis and abscess; (4) simple degeneration or myelomalacia, accompanying diseases of the hematopoietic system and thrombosis; (5) exogenous toxins, such as lead and alcohol; (6) unknown etiology [jamanetwork.com]

Epidemiology References:[1][2][3] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]

The first covers the epidemiology and psychological conditions associated with paraplegia, the second discusses surgical management and common rehabilitation interventions; the third medical complications and special musculoskeletal issues, while the [intechopen.com]

Spinal cord injuries: Practice essentials, background, anatomy, pathophysiology, etiology, epidemiology, prognosis, patient education. [Internet] 10 August 2017. Available from: http://www.emedicine.com/pmr/topic182.htm. Accessed March 2018. [icf-casestudies.org]

Dr Marion is a professor in the Department of Health Care and Epidemiology, Faculty of Medicine, UBC. [bcmj.org]

Summary Epidemiology HSP is estimated to affect 1 in 20 000 individuals in the general population of Europe, with variable frequencies in distinct populations (from 1.3 to 9/100 000 individuals). [orpha.net]

This case raises questions about the pathophysiology of muscle ruptures in highly functional patients with hereditary spastic paraplegia (HSP) who have only minor spasticity and no significant muscle shortening. [ncbi.nlm.nih.gov]

References:[2][5][9] Treatment Prognosis Hereditary spastic paraplegia Summary Epidemiology Etiology Pathophysiology Clinical features Pure HSP (Uncomplicated HSP) Complicated HSP Diagnostics Treatment Prognosis [amboss.com]

Spinal cord injuries: Practice essentials, background, anatomy, pathophysiology, etiology, epidemiology, prognosis, patient education. [Internet] 10 August 2017. Available from: http://www.emedicine.com/pmr/topic182.htm. Accessed March 2018. [icf-casestudies.org]

Physiotherapy and various assistive technology, such as a standing frame, may aid in preventing these complications. [psychology.wikia.com]

Author information 1 Preventive Cardiovascular Research Centre Kermanshah, Kermanshah University of Medical Sciences, Kermanshah, Iran. 2 Preventive Cardiovascular Research Centre Kermanshah, Kermanshah University of Medical Sciences, Kermanshah, Iran [ncbi.nlm.nih.gov]

Prevention of pressure sores is an important priority. [medical-dictionary.thefreedictionary.com]