Clinical features of central isolated unilateral foot drop: A case report and review of the literature
| Autor: | Paul Leach, Ganesalingam Narenthiran, Jeremy P Holland |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
medicine.medical_specialty
Foot drop Neurology Upper motor neuron business.industry General surgery Case Report Upper motor neuron lesion Lower motor neuron meningioma Surgery medicine.anatomical_structure medicine Spastic Neurology (clinical) Neurosurgery medicine.symptom business spastic parasagittal Foot (unit) |
| Zdroj: | Surgical Neurology International |
| ISSN: | 2152-7806 2229-5097 |
| Popis: | When I was in training for the neurological sciences at the University of Illinois in the early 1960s, there was only one department that encompassed both neurology and neurosurgery. Therefore, my fellow residents and I were trained in both specialties and, after successful completion of the program, we could we have taken the board certification examination in either or both specialties. Years later, after the original Chairman of the Department, Eric Oldberg, retired, the department was divided into two: one Neurology and the other Neurosurgery. I elected to follow the route of Neurosurgery. In those days, the term “foot drop“ was exclusively reserved for the lower motor neuron variety of the problem whereas the upper motor neuron version was referred to as a spastic leg, wherein the antigravity muscles are more hyperactive than the others, resulting in the plantar thrust of the afflicted foot. When reviewing the literature on the topic as I analyzed this report, I found that from about 1975 or so, “foot drop” began appearing in the literature as applied to either form of plantar positioning of the foot, but that the central variety also had other findings associated with an upper motor neuron lesion, which led the authors of this report to seek a more central source in this case. So much from a historical and anatomical perspective. The meningioma in this thorough and well-referenced report has no perceptual edema around it, attesting, in part at least, to the slow growth of the lesion and the reason that the "drop foot" appeared to develop in conjunction with weakening of the lower extremities over a 5-year period. Peritumoral edema around the meningiomas may be related to the invading potential of such tumors[23] and the lack thereof, in this case, supports the authors’ decision of not to operate on the lesion, as requested by this elderly patient. Also, the presence of peritumoral edema carries a poorer prognosis for outcome, and is found more often in men than in women.[24,25] Hence, there are a number of lessons to be learned from this report. |
| Databáze: | OpenAIRE |
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