Chiari malformation type 1 presenting as unilateral progressive foot drop: a case report and review of literature.
Chiari malformation type 1 presenting as unilateral progressive foot drop: a case report and review of literature.
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DOI：
10.1186/s12887-018-1028-8
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发表时间：
2018-02-07
期刊：
影响因子：
2.4
通讯作者：
Mettananda S
中科院分区：
文献类型：
--
作者：
Jayamanne C;Fernando L;Mettananda S
足下垂是一种致残性临床疾病，其原因多种多样，需要进行详细的评估以确定确切的病因。在这里，我们报告了一个非常罕见的原因足下垂的儿童，如果不及早认识到，可能会导致多种并发症。一个6岁的小女孩因行走困难和左脚下垂1个月而就诊。在检查中，她的背屈肌和跖屈肌的肌肉力量减少，左侧膝关节痉挛减少，踝关节痉挛消失。左侧L4和L5皮节感觉缺失。左侧腹浅反射消失，右侧保留。神经传导及肌电图检查显示足下垂的神经根或脊髓原因。这些结果促使对脊柱和大脑进行MRI检查，发现基亚里畸形1型，脊髓空洞从颈髓交界处延伸到脊髓圆锥。这个病例强调了广泛考虑足下垂鉴别诊断的重要性，以及包括浅表反射在内的完整神经系统检查在诊断中的价值。及时诊断有助于早期神经外科转诊和干预，这是一个重要的预后因素。
Foot drop is a disabling clinical condition with multiplicity of causes, which requires detailed evaluation to identify the exact aetiology. Here, we report an extremely rare cause of foot drop in a child, which if not recognized early, could lead to multiple complications. A 6-year-old girl presented with difficulty in walking and left sided foot droop for1-month duration. On examination she had reduced muscle power in dorsiflexors and plantar flexors and diminished knee and absent ankle jerk in the left side. Sensory loss was noted in L4 and L5 dermatomes on the left side. Superficial abdominal reflex was absent on the left side while preserved in the right. Nerve conduction and electromyography revealed nerve root or spinal cord cause for the foot drop. These results prompted ordering MRI spine and brain which revealed Chiari malformation type-1 with holocord syrinx extending from the cervicomedullary junction to conus medullaris. This case highlights the importance of considering broad differential diagnosis for foot drop and value of the complete neurological examination including superficial reflexes in arriving at a diagnosis. Prompt diagnosis helped to early neurosurgical referral and intervention which is an important prognostic factor.
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DOI：
10.1097/00131402-200203000-00006
发表时间：
2002-03-01
影响因子：
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通讯作者：
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