Increasing irritability with sudden onset of flaccid weakness

Patel, Hema; Garg, Bhuwan P.

doi:10.1016/s1071-9091(96)80008-8

Cited by 13 publications

(9 citation statements)

References 24 publications

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“…The diagnosis of SSEH requires extensive laboratory testing for coagulation disorders, as well as CTA imaging. SSEH is rare in infants; only 20 cases have been reported in the literature (Table 1) 2,[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] . To our knowledge, this is the first report of SSEH in an infant with developmental disabilities.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Spinal Epidural Hematoma in an Infant with Developmental Disabilities

Mukai

Miyagi

Koyama

et al. 2018

Spine Surg Relat Res

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Introduction: Spontaneous spinal epidural hematomas (SSEHs) are rare in childhood, especially in infants. Case Report: We present the case of a 17-month-old-boy with trisomy 21 and a large SSEH. He was hospitalized for acute onset paraplegia after 6 days of irritability. Nine days after symptom onset, magnetic resonance imaging (MRI) of the spine revealed an extensive epidural hematoma between C7 and T5 causing severe spinal cord compression. After a coagulation disorder was ruled out (12 days after onset), he underwent emergency hemilaminectomy with evacuation of the hematoma. His neurologic impairment gradually improved, and 4 months after surgery he was back to his neurologic baseline. At 18 months after surgery, he was walking independently, although he had some developmental disabilities due to trisomy 21. Conclusions: Only 20 cases of SSEH in infancy have been previously reported, and this is the first report of SSEH in an infant with developmental disabilities. Because of the non-specific symptoms and difficulty obtaining MRIs in infants, particularly in those with developmental disabilities, the diagnosis and treatment of SSEH may be delayed. However, early diagnosis with MRI and early evacuation of SSEH in patients with severe neurological impairments is important for good outcomes. Attention must be paid to postoperative spinal deformity in infants.

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Section: Discussionmentioning

confidence: 99%

Spontaneous Spinal Epidural Hematoma in an Infant with Developmental Disabilities

Mukai

Miyagi

Koyama

et al. 2018

Spine Surg Relat Res

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show abstract

“…Traumatic haemorrhages are most common in the cervical region (Patel et al 1998). Cases without known predisposing factors are referred to as spontaneous (Tewari et al 1992, Patel andGarg 1996). Although the pathogenesis of SSEH is unclear, the bleeding is mostly believed to be venous in origin.…”

Section: Discussionmentioning

confidence: 99%

“…Cases without known predisposing factors are referred to as spontaneous (Tewari et al 1992, Patel andGarg 1996). Illnesses such as whooping cough (Jackson 1963) and voiding (Cooper 1967) and activities such as weightlifting Patel and Garg (1996). Lack of valves in the epidural venous plexus makes the area especially vulnerable to any intrinsic change in pressure.…”

Section: Discussionmentioning

confidence: 99%

Clinical course of spontaneous spinal epidural haematoma mimicking Guillain-Barré syndrome in a child: a case report and literature review

Çakır

Karaarslan

Usul

et al. 2004

Dev Med Child Neurol

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We describe a 9-year-old female with thoracic epidural haematoma. The clinical course simulated Guillain-Barré syndrome (GBS) so intravenous immunoglobulin therapy was started at the paediatric clinic. Magnetic resonance imaging (MRI) 3 days after admission showed thoracic epidural haematoma between T2 and T8. An emergency laminectomy was performed and the patient's neurological symptoms began to improve immediately after surgery and she made a full recovery during the 2 weeks of follow-up. Time is a very important factor in achieving reversibility of symptoms of compressive cord lesions, such as spinal epidural haematoma, and MRI is mandatory for patients with progressive paraplegia, even though the signs and symptoms might suggest GBS.

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“…Lack of valves in the epidural venous plexus makes the area especially vulnerable to any intrinsic change in pressure. Illnesses such as whooping cough (Jackson 1963) and voiding (Cooper 1967) Patel and Garg (1996). (Rao et al 1966) and even trumpet playing (Davis et al 1997), which can cause prolonged Valsalva and sudden fluctuation in intra-abdominal and intrathoracic pressure, have been described preceding the neurological symptoms.…”

Section: Discussionmentioning

confidence: 99%

Clinical course of spontaneous spinal epidural haematoma mimicking Guillain‐Barré syndrome in a child: a case report and literature review

Çakır¹,

Karaarslan²,

Usul³

et al. 2004

Develop Med Child Neuro

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We describe a 9‐year‐old female with thoracic epidural haematoma. The clinical course simulated Guillain‐Barré syndrome (GBS) so intravenous immunoglobulin therapy was started at the paediatric clinic. Magnetic resonance imaging (MRI) 3 days after admission showed thoracic epidural haematoma between T2 and T8. An emergency laminectomy was performed and the patient's neurological symptoms began to improve immediately after surgery and she made a full recovery during the 2 weeks of follow‐up. Time is a very important factor in achieving reversibility of symptoms of compressive cord lesions, such as spinal epidural haematoma, and MRI is mandatory for patients with progressive paraplegia, even though the signs and symptoms might suggest GBS.

show abstract

Increasing irritability with sudden onset of flaccid weakness

Cited by 13 publications

References 24 publications

Spontaneous Spinal Epidural Hematoma in an Infant with Developmental Disabilities

Spontaneous Spinal Epidural Hematoma in an Infant with Developmental Disabilities

Clinical course of spontaneous spinal epidural haematoma mimicking Guillain-Barré syndrome in a child: a case report and literature review

Clinical course of spontaneous spinal epidural haematoma mimicking Guillain‐Barré syndrome in a child: a case report and literature review

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