Clinical Vignette A 53-year-old man had a history of occasional severe episodes of low back pain radiating down his buttock and posterior left thigh; it had begun with an athletic injury at age 17. Typically he experienced exacerbations, which lasted…
Clinical Vignette A 42-year-old woman presented with a 2-week history of increasingly severe neck pain with radiation to the back of her right upper arm. In retrospect she had developed acute right medial scapular pain 4 weeks earlier after carrying…
The spinal cord may be affected by a broad spectrum of disorders, some of them directly damaging the cord (intramedullary), others affecting the cord indirectly due to pathologies involving the extramedullary region, including the intradural and extradural spaces. Some of…
Knowledge of spinal cord neuroanatomy is integral to the understanding, diagnosis, and management of spinal cord disorders. The spinal cord syndrome depends on site, process, and extent of spinal cord damage. A myelopathy is defined as any disorder that impairs…
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Clinical Vignette A 65-year-old man presented with subacute onset of severe, unexplained orthostatic dizziness and light-headedness. Over the next 2 months, he developed dry mouth, dry eyes, urinary hesitancy, erectile dysfunction, and severe constipation. His previous medical history was unremarkable.…
Paraneoplastic neurologic disorders are seen when antitumor immunologic responses, primarily antibodies, directed against antigens expressed in the cancer, attack neural cells (neurons or glia) also expressing these antigens. Based on the neurologic presentation and the antibody profile, there are numerous…
The most common spinal cord tumors are metastatic extradural lesions most commonly occurring in patients with already identified systemic cancers. Their presentation is often relatively acute, usually associated with focal back and/or radicular pain. On occasion, these lesions are the…
Clinical Vignette A 47-year-old self-employed father presented to the emergency department having difficulty discriminating coins in his pocket. He had been skiing that day and was concerned enough to seek medical attention on his way home. His general health was…
Immunocompromised hosts are susceptible to a wide range of neurologic infections, which include both opportunistic infections and those typically found in normal hosts. The risk for particular infections is related to a number of factors including the type of immune…