Cervical spinal cord injury presenting with refractory orthostatic hypotension: a case report

Servikal ve üst torakal spinal kord yaralanmalarında sempatik sistemin vücuttaki yaygın inervasyonunun zarar görmesi ve parasempatik kraniyal inervasyonun korunması nedeniyle karşılanamayan parasempatik sistem etkisi ve sempatik sistemin bozukluğu, bazı hastalarda dirençli ortostatik hipotansiyona neden olabilmektedir. Medikal tedavi mineralokortikoidler ve adrenerjik ajanlardan oluşmakla birlikte, abdominal yastık ve kompresyon cihazı gibi farmakolojik olmayan yöntemler de kullanılabilmektedir. Bu yazıda, beşinci servikal vertebra kompresyon kırığı sonrası dirençli ortostatik hipotansiyon gelişen 21 yaşında bir erkek olgu sunuldu. Olgu mineralokortikoid tedavisi ile kuadriseps ve tibialis anterior kaslarına elektriksel stimülasyon ile tedavi edildi. Bu tedavinin sonuçları ve ortostatik hipotansiyonun tedavi stratejileri literatür verileri ışığında tartışıldıIn case of cervical and upper thoracic spinal cord injuries, refractory orthostatic hypotension may result from unmeet parasympathetic system influences and sympathetic system impairment due to the diffuse destruction of the sympathetic innervation of the body and the preservation of parasympathetic cranial innervation in certain patients. Pharmacological treatments include mineralocorticoids and adrenergic agents, while non-pharmacological methods such as abdominal pads and compression devices can be used. Herein, we report a 21-year-old male case of refractory orthostatic hypotension following a fifth cervical vertebra compression fracture. The case was treated with mineralocorticoid therapy in conjunction with electrical stimulation to the quadriceps and tibialis anterior muscles. The results of the treatment and treatment strategies of orthostatic hypotension are discussed in the light of literature dat

Ondört Yaşındaki Kız Hastada Lumbar Disk Herniasyonu

Lomber disk hernisi çocuklarda nadir görülen bir hastalıktır. Çocuk ve adolesanlarda genellikle hikayelerinde ağrı başlangıcından önce travma ya da spor yaralanmaları öyküsü mevcuttur. Çocuklarda her iki cinsiyet arasında lomber disk hernisi sıklığı açısından fark saptanmamıştır. Segmental olarak disk herniasyonunun yeri açısından erişkin ve çocuklarda fark yoktur. Vakamızda 14 yaşında kız hasta bir yıldır olan bel ağrısı ve bacak ağrısı şikayetiyle kliniğimize başvurdu. Manyetik rezonans görüntülemede L5-S1 düzeyinde belirgin posterosantral disk protrüzyonu mevcuttu. Uygulanan konservatif tedavi sonrası ağrılarında belirgin azalma elde edilmiştir.Lumbar disc herniation is a rare disease in children. Children and adolescents with symptomatic lumbar disc herniation have a history of trauma or sports injury before pain begins. There is no difference in the frequency of disc herniation between the gender in children. The segmental placement of disc herniation in children is similar to that seen in adults. A girl aged 14 years presented to our clinic complaining of a one-year low back pain and pain was radiating to the right leg. There was a significant posterocentral disc protrusion at the L5-S1 level on magnetic resonance imaging (MRI). Complete symptomatic relief was achieved at the end of a course of conservative treatment

The efficacy of vestibular electrical stimulation on patients with unilateral vestibular pathologies

WOS: 000422785900006Objectives: This study aims to investigate the efficacy of vestibular electrical stimulation (VES) in unilateral vestibular lesions including benign paroxysmal positional vertigo (BPPV). Patients and methods: Between June 2007 and August 2007, a total of 19 patients diagnosed with BPPV were included in this study and they were randomized into two groups using the 1: 1 method. Ten patients were administered medical treatment plus VES (treatment group; 1 male, 9 females; mean age 55.8 years; range 27 to 74 years), whereas nine patients were only administered medicine (control group; 2 males, 6 females; mean age 54.9 years; range 34 to 73 years). Both groups received the same medical treatment throughout the study. Vestibular electrical stimulation was performed for 30 min long twice a day, three times a week; 12 sessions in total with 80 Hz high-frequency Transcutaneous Electrical Nerve Stimulation (TENS). Before and after the treatment, patients' severity of dizziness was assessed with Visual Analog Scale (VAS) and daily life activities with Dizziness Handicap Inventory (DHI), and their duration (sec) of single leg stance with eyes open and closed was recorded. Results: Compared to prior to the treatment, VAS-dizziness and DHI scores, and the duration of single leg stance on one foot with eyes open and closed at the end of the treatment showed statistically significant improvement in both groups; however, although VES provided a positive contribution, we did not find a statistically significant difference between the two groups. Conclusion: It can be concluded that VES has positive contribution to medical treatment of patients with dizziness due to unilateral vestibular lesions; however the results of this study should be further investigated with larger groups of patients