[abstract]MULTIPLE SCLEROSIS PRESENTING AS SPINAL CORD DCS: A CASE REPORT

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[abstract]MULTIPLE SCLEROSIS PRESENTING AS SPINAL CORD DCS: A CASE REPORT

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Title: [abstract]MULTIPLE SCLEROSIS PRESENTING AS SPINAL CORD DCS: A CASE REPORT
Author: Kojima Y; Enomoto M; Togawa S; Kaburaki H; Horie M; Yagishita K
Abstract: BACKGROUND: Decompression sickness (DCS) and multiple sclerosis (MS) have some overlapping features. Both can present with a variety of neurological findings and show similar MRI findings. We describe here a case that was initially diagnosed with DCS but later with MS. MATERIALS AND METHODS: The patient was a 32-year-old male beginner diver. Dive profiles: three dives a day (Days 1 and 3) within no-deco limits, maximum depth 36.4 meters. He felt discomfort in his lower limbs (Day 2), flew back home (Day 7), and experienced difficulty urinating (Day 8). He went see a doctor and was diagnosed with DCS and treated with a U.S. Navy Treatment Table 5 (Day 12), but his symptoms worsened. He was referred to our facility (Day 19). Neurological examination revealed bilateral lower-limb weakness (MMT2-4) and bladder-rectal disorder. MRI (Day 12) revealed a T1 iso, T2 high-intensity lesion in the spinal cord of Th11-12, as well as spinal cord swelling. We diagnosed him with severe spinal cord DCS, and although it had been more than a week since symptom onset, we treated him with TT6. RESULTS: He was treated by TT6 and TT6A several times over one month, but his symptoms did not improve satisfactorily. MRI (Day 35) showed the growth of the abnormal lesion. Steroid pulse treatment was added, and his symptoms and MRI findings improved. However, after five months, he had difficulty standing, and the MRI findings had worsened. Although this symptom improved, he had difficulty walking two months later. Furthermore, MRI revealed a new abnormal lesion in the thoracic spinal cord. Steroid pulse treatment improved his symptoms and MRI findings. He was ultimately diagnosed with MS. SUMMARY: This case was atypical for severe spinal cord DCS for the following points: 1. Gradual disease progression. 2. Insufficient response to HBO2 treatment. Atypical DCS requires differential diagnosis.
Description: Undersea and Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society, Inc.
URI: http://archive.rubicon-foundation.org/10857
Date: 2013

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  • UHMS Meeting Abstracts
    This is a collection of the published abstracts from the Undersea and Hyperbaric Medical Society (UHMS) annual meetings.

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