BACKGROUND Extramedullary myelinolysis is a rare demyelinating disease, often caused by rapid increases in serum sodium concentration in patients with hyponatremia.Clinical manifestations are neuropsychiatric symptoms...BACKGROUND Extramedullary myelinolysis is a rare demyelinating disease, often caused by rapid increases in serum sodium concentration in patients with hyponatremia.Clinical manifestations are neuropsychiatric symptoms, limb weakness, and dysarthria. Because of its poor prognosis and high disability rate, it poses a huge burden on the global economy, societies, and families. This article reports rehabilitation in a patient with pituitary dysfunction combined with extramedullary myelinolysis.CASE SUMMARY A 27-year-old Chinese man developed anorexia, vomiting, and limb weakness and was diagnosed with pituitary insufficiency. He had low serum sodium, slow movement, muscle weakness, and muscle tone abnormalities after sodium supplementation, involuntary limb shaking, ataxia, and dysarthria. According to the symptoms and signs and imaging reports, he was diagnosed with extramedullary myelinolysis. After treatment with hormone therapy and neurotrophic drugs, motor and speech function did not improve, so he was treated in the rehabilitation department for 4 wk. The patient's physical status was improved substantially during his stay at the rehabilitation department.CONCLUSION Patients with extramedullary myelinolysis who actively participate in rehabilitation intervention can significantly improve their activities of daily living.展开更多
A case of“Hypopituitarism and pituitary apoplex induced by pituitary Adenomas”was collected in the Third Affiliated Hospital of Inner Mongolia medical University Geriatric Department.A rare and atypical disease as i...A case of“Hypopituitarism and pituitary apoplex induced by pituitary Adenomas”was collected in the Third Affiliated Hospital of Inner Mongolia medical University Geriatric Department.A rare and atypical disease as it is,delayed diagnosis and treatment is easily seen among those cases.Therefore,the paper aims to investigate the difference of clinical characteristics and treatment outcome of pituitary adenomas in elder patient through the case analysis.Clinically,patients with pituitary dysfunction may have life-threatening crisis so that timely diagnosis and aggressive treatment can be effective in reducing the pituitary crisis and reducing the misdiagnosis rate.展开更多
Background Rathke＇s cleft cyst （RCC） is one of the most common incidentally discovered sellar lesions, while symptomatic cases are relatively rare. Surgical treatment is recommended for symptomatic patients to drai...Background Rathke＇s cleft cyst （RCC） is one of the most common incidentally discovered sellar lesions, while symptomatic cases are relatively rare. Surgical treatment is recommended for symptomatic patients to drain the cyst content and to remove the capsule safely. The aim of this study was to clarify the clinical features, surgery considerations and therapy outcomes of symptomatic RCCs. Methods Totally 42 patients （19 males and 23 females） were retrospectively reviewed with the diagnosis of RCCs under surgery resection at the Affiliated Hospital of Medical College, Qingdao University between January 2005 and December 2010. Results Patients＇ age ranged from 6 to 67 years （mean of 41.6 years）. The duration of symptoms ranged from 4 days to 10 years. Headache （69%）, visual impairment （36%）, and pituitary dysfunction （10%） were the most common presenting symptoms. The maximum diameter of cysts ranged from 6.0 to 46.7 mm （mean of 20.07 mm）. Of the 42 patients, 36 underwent endonasal transsphenoidal approach and the others underwent transcranial approach. Thirty patients had a subtotal resection and decompression, while 12 patients had a total cyst resection. Cysts of 28 patients were lined by simple cubical or columnar epithelium, and cysts of 34 patients were filled by amorphous colloid material, that was the characteristic of RCCs. The majority of patients presented with a simple headache, and 93% of this group experienced a complete improvement after surgery. Twelve of 15 patients （80%） with preoperative visual deficits experienced an improvement in their vision after surgery. All of those patients with pituitary dysfunction experienced an improved endocrine status. The endocrinological complication usually was diabetes insipidus, and postoperative transient diabetes insipidus occurred in 13 （31%） patients without any permanent diabetes insipidus. The overall recurrence rate was 7% at a mean follow-up of 22 months （range 12-60 months）. Conclusions Surgical treatment is to drain the contents of the cyst and to remove the capsule as much as possible under the precondition that does not increase the complications. Biopsy and decompression procedures are recommended for most cases.展开更多
文摘BACKGROUND Extramedullary myelinolysis is a rare demyelinating disease, often caused by rapid increases in serum sodium concentration in patients with hyponatremia.Clinical manifestations are neuropsychiatric symptoms, limb weakness, and dysarthria. Because of its poor prognosis and high disability rate, it poses a huge burden on the global economy, societies, and families. This article reports rehabilitation in a patient with pituitary dysfunction combined with extramedullary myelinolysis.CASE SUMMARY A 27-year-old Chinese man developed anorexia, vomiting, and limb weakness and was diagnosed with pituitary insufficiency. He had low serum sodium, slow movement, muscle weakness, and muscle tone abnormalities after sodium supplementation, involuntary limb shaking, ataxia, and dysarthria. According to the symptoms and signs and imaging reports, he was diagnosed with extramedullary myelinolysis. After treatment with hormone therapy and neurotrophic drugs, motor and speech function did not improve, so he was treated in the rehabilitation department for 4 wk. The patient's physical status was improved substantially during his stay at the rehabilitation department.CONCLUSION Patients with extramedullary myelinolysis who actively participate in rehabilitation intervention can significantly improve their activities of daily living.
文摘A case of“Hypopituitarism and pituitary apoplex induced by pituitary Adenomas”was collected in the Third Affiliated Hospital of Inner Mongolia medical University Geriatric Department.A rare and atypical disease as it is,delayed diagnosis and treatment is easily seen among those cases.Therefore,the paper aims to investigate the difference of clinical characteristics and treatment outcome of pituitary adenomas in elder patient through the case analysis.Clinically,patients with pituitary dysfunction may have life-threatening crisis so that timely diagnosis and aggressive treatment can be effective in reducing the pituitary crisis and reducing the misdiagnosis rate.
文摘Background Rathke＇s cleft cyst （RCC） is one of the most common incidentally discovered sellar lesions, while symptomatic cases are relatively rare. Surgical treatment is recommended for symptomatic patients to drain the cyst content and to remove the capsule safely. The aim of this study was to clarify the clinical features, surgery considerations and therapy outcomes of symptomatic RCCs. Methods Totally 42 patients （19 males and 23 females） were retrospectively reviewed with the diagnosis of RCCs under surgery resection at the Affiliated Hospital of Medical College, Qingdao University between January 2005 and December 2010. Results Patients＇ age ranged from 6 to 67 years （mean of 41.6 years）. The duration of symptoms ranged from 4 days to 10 years. Headache （69%）, visual impairment （36%）, and pituitary dysfunction （10%） were the most common presenting symptoms. The maximum diameter of cysts ranged from 6.0 to 46.7 mm （mean of 20.07 mm）. Of the 42 patients, 36 underwent endonasal transsphenoidal approach and the others underwent transcranial approach. Thirty patients had a subtotal resection and decompression, while 12 patients had a total cyst resection. Cysts of 28 patients were lined by simple cubical or columnar epithelium, and cysts of 34 patients were filled by amorphous colloid material, that was the characteristic of RCCs. The majority of patients presented with a simple headache, and 93% of this group experienced a complete improvement after surgery. Twelve of 15 patients （80%） with preoperative visual deficits experienced an improvement in their vision after surgery. All of those patients with pituitary dysfunction experienced an improved endocrine status. The endocrinological complication usually was diabetes insipidus, and postoperative transient diabetes insipidus occurred in 13 （31%） patients without any permanent diabetes insipidus. The overall recurrence rate was 7% at a mean follow-up of 22 months （range 12-60 months）. Conclusions Surgical treatment is to drain the contents of the cyst and to remove the capsule as much as possible under the precondition that does not increase the complications. Biopsy and decompression procedures are recommended for most cases.
