Acute necrotic myelitis and perivenous encephalomyelitis associated with hypertension and renal infection

Abstract

About five months later she knocked her back at a local fairground but did not complain afterwards. Eleven days later she felt weakness in both legs, was unable to walk, and fell to the floor.On admission to hospital there was flaccid paraplegia of both legs, with loss of sensation below the sixth thoracic level, followed by urine retention and neck stiffness. A myelogram on the third day did not show evidence of spinal block. The patient was transferred to a neurosurgical unit (Mr. G. K. Tutton) on the fourth day: the sensory level had now reached the second thoracic segment; the patient was fully conscious with pain and stiffness in the back of the neck and 'pins and needles' in both arms. There was flaccid paraplegia of both legs with absence of tendon and plantar reflexes. Abdominal reflexes were absent and there was urinary Received for publication 21 April 1967. incontinence. Speech was not slurred; cranial nerve functions were normal; the optic discs were blurred. Weakness of the arms was not demonstrated. Temperature and respiration rate were normal; the pulse rate was 100 per minute and the blood pressure 210/150 mm.

Acute Disseminated Encephalomyelitis: Current Understanding and Controversies

“…Only two well-documented cases of perivenous demyelination limited to the brainstem are reported in the literature. 55,56 We are not aware of any reports of focal supratentorial lesions with well-documented perivenous pathology. On the contrary, most cases of focal supratentorial demyelination reveal confluent demyelination, which is pathologically more consistent with MS pathology, although some have argued these may be intermediate lesions along an ADEM-to-MS spectrum.…”

Acute Necrotic Myelopathy in Association with Lymphoma Cells of the Reticulo-Endothelial System, Acute Torticollis, and Recurrent Cardiac Arrest

“…Damage to nervous tissue in these conditions has long been thought to result from some type of hypersensitivity reaction between the myelin and antigen of the infecting organism or vaccines. Perivascular antigen-antibody reac tion with resultant demyelination and edema would be of sufficient de gree to compress vessels and cause secondary ischemic necrosis [18,22].…”