Mindful Medulla

Guillain-Barré Syndrome vs Acute Transverse Myelitis  Both Transverse myelitis and Guillain-Barre syndrome are immunologically caused polyneuropathies with significant clinical implications. Although no precise genetic risk loci have been identified as of yet, both are believed to have a hereditary tendency. Both are regarded as autoimmune diseases, but the exact causes are not yet known. Both may be brought about by molecular mimicry, especially from vaccinations and infectious agents, but it is obvious that host factors and co-founding host responses will affect the natural history  and susceptibility to disease. The symptoms of GBS, an acute inflammatory immune-mediated polyradiculoneuropathy, include discomfort, tingling, and increasing weakness as well as autonomic dysfunction. In acute inflammatory demyelinating polyneuropathy, immune destruction occurs specifically at the myelin sheath and associated Schwann-cell components; in acute motor axonal neuropathy, however, th...

 Nothnagel Syndrome        The clinical characteristics of malignancies involving the quadrigeminal bodies were outlined by Austrian physician Nothnagel in his monograph, Localization of Diseases of the Brain (1879). He limited his talk to neoplasms since he believed they were more specific to this area than cerebrovascular infarctions.  Hermann Nothnagel presented a 2 year old child who had dilated pupils, significant gait ataxia, and a vague bilateral ophthalmoparesis. After an autopsy, it was discovered that the patient had hydrocephalus and a sarcoma that had invaded all 4 colliculi, the pineal gland, and the cerebellum dorsally. Nothnagel came to several conclusions following a through examination of the literature 1) tumors involving the inferior colliculi can cause bilateral oculomotor paralysis of varying degrees in each eye, and 2) lesions of the superior colliculi may be linked to abnormal pupillary responses and visual loss without papilledema or...