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Acute quadriplegia: An interesting case with etiological and pathophysiological disparity


 Department of Internal Medicine, BLK Super Speciality Hospital, New Delhi, India

Correspondence Address:
Vivek Pal Singh,
Department of Internal Medicine, BLK Super Speciality Hospital, Pusa Road, New Delhi - 110 005
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/INJMS.INJMS_47_19

Acute quadriplegia is a neurological emergency infrequently encountered in clinical practice. Localization of acute quadriplegia ranges from central nervous system, spinal cord, anterior horn cells, peripheral nerve, neuromuscular junction, and rarely muscles. Important etiologies of acute quadriplegia are cerebrovascular accident, trauma, demyelination, channelopathies, metabolic disturbances, and toxins. An astute physician can easily localize the neurological lesion, however, when there are confounding investigations particularly when the investigations are gold-standard for the etiologies under diagnostic consideration, it becomes difficult to attribute the cause of quadriplegia to a particular disease process. Then, the diagnosis is entirely clinical and depends on the type of clinical response obtained after the treatment of patients. We report a case of acute quadriplegia whose investigations favored both demyelination and metabolic derangement. Good clinical outcome was achieved when one of the etiologies was entertained for treatment for obvious reasons.


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    -  Singh VP
    -  Khullar J
    -  Garg A
    -  Vardani A
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