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Spinal cord lesion by minor trauma as an early sign of multiple system atrophy

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dc.contributor.authorBrum, Marisa
dc.contributor.authorReimão, Sofia
dc.contributor.authorSousa, Djalma
dc.contributor.authorde Carvalho, Rui
dc.contributor.authorFerreira, Joaquim J
dc.date.accessioned2021-12-02T12:11:53Z
dc.date.available2021-12-02T12:11:53Z
dc.date.issued2016
dc.descriptionCopyright: © 2016 Brum, Reimão, Sousa, de Carvalho and Ferreira. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.pt_PT
dc.description.abstractMultiple system atrophy (MSA) is characterized clinically by parkinsonism, cerebellar, autonomic, and corticospinal features of variable severity. When the presentation is only parkinsonism, the disease might be difficult to differentiate from Parkinson's disease (PD). We present a case of an 80-year-old man with previous diagnosis of PD. One year after the diagnosis, he had a whiplash cervical trauma due to a tricycle accident caused by a hole in the road. This low-energy trauma caused an unstable C4-C5 cervical fracture with spinal cord injury, which required surgical decompression and stabilization. Neurological examination showed marked postural instability, no rest and postural tremor, finger tapping slowed on the right, spastic tetraparesis (ASIA D) - predominantly on the left side, brisk deep tendon reflexes in the upper and lower extremities, and bilateral extensor plantar response. He also presented with vertical gaze restriction, mild hypometria in horizontal saccades, moderate dysphagia, and dysphonia. As atypical parkinsonism was suspected, he underwent an MRI that revealed conjunction of findings suggestive of parkinsonian-type MSA. In our case, we hypothesize that the loss of postural reflexes, as an early manifestation of MSA, did not allow the patient to have an effective reaction response to a low-energy trauma, resulting in a more severe injury. With this case report, we speculate that the severe spinal lesions caused by minor accidents can be an early sign of postural instability, which may lead to clinical suspicion of neurodegenerative disorder manifested by postural reflexes impairment.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationFront Neurol. 2016 Mar 14;7:33pt_PT
dc.identifier.doi10.3389/fneur.2016.00033pt_PT
dc.identifier.eissn1664-2295
dc.identifier.urihttp://hdl.handle.net/10451/50237
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherFrontierspt_PT
dc.relation.publisherversionhttps://www.frontiersin.org/journals/neurology#pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectAtypical parkinsonismpt_PT
dc.subjectEarly signpt_PT
dc.subjectMultiple system atrophypt_PT
dc.subjectSpinal cord lesionpt_PT
dc.subjectTraumapt_PT
dc.titleSpinal cord lesion by minor trauma as an early sign of multiple system atrophypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.titleFrontiers in Neurologypt_PT
oaire.citation.volume7pt_PT
person.familyNameBrum
person.familyNameReimão
person.familyNameFerreira
person.givenNameMarisa
person.givenNameSofia
person.givenNameJoaquim J
person.identifier1624753
person.identifier.ciencia-idCB19-3E68-EBCB
person.identifier.ciencia-id7D15-5CD6-6159
person.identifier.orcid0000-0001-5715-9010
person.identifier.orcid0000-0002-8822-3166
person.identifier.orcid0000-0003-3950-5113
person.identifier.scopus-author-id7403252466
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublicationc83ed327-df3e-4420-9e27-73026509c5f5
relation.isAuthorOfPublication72ade4b9-4353-45ce-9334-eddd2a2045c0
relation.isAuthorOfPublication54d84fe7-2cbd-4ddc-bce2-0ff2bd7c4cc9
relation.isAuthorOfPublication.latestForDiscoveryc83ed327-df3e-4420-9e27-73026509c5f5

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