Episode 57 - Infections of the Spinal Cord and Peripheral Nervous System
May 31, 2023
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Discover insights on various infections affecting the spinal cord and peripheral nervous system, from VZV and EVV disorders to rare parasitic infections. Explore clinical aspects of Lyme disease, neurological disorders overview, and infectious myositis like trichinosis. Uncover muscle infections in influenza and bacterial abscesses, emphasizing the role of neurologists in diagnosis and treatment.
Understanding infections beyond meningitis and encephalitis is crucial for neurology residents.
Varicella-zoster virus can lead to various nervous system complications, highlighting its diverse impact.
Differentiating viral infections like herpes simplex from neuroinflammatory disorders is vital for accurate treatment.
Deep dives
Infections of the Nervous System: The Overlooked Aspects
Infections of the nervous system beyond meningitis and encephalitis are discussed, emphasizing the importance of understanding infections affecting different components of the nervous system.
Varicella-Zoster Virus-Induced Infections
Varicella-zoster virus is highlighted as a versatile pathogen that can cause myelitis, radiculitis, meningoencephalitis, and vascular complications, demonstrating the diverse effects of this virus on the nervous system.
Epstein-Barr virus is identified as a commonly detected virus in patients, potentially triggering conditions like acute disseminated encephalomyelitis or contributing to a myelitis-like presentation, emphasizing the need to consider viral associations.
Herpes simplex virus 2 is mentioned for its potential to cause lumbosacral radiculopathy, showcasing how viral infections can impact nerve roots, and hinting at differentiation from neuroinflammatory disorders to guide diagnosis and treatment decisions.
Syphilitic Meningomyelitis Overview
Syphilitic meningomyelitis is discussed as a manifestation of syphilis affecting the spinal cord, with insights into the characteristic MRI findings, diagnostic approach with VDRL testing, and successful treatment with penicillin, emphasizing the importance of recognizing this nineteenth-century infection in the modern era.
An overview of some common and important infections of the spinal cord and peripheral nervous system. With Drs. Aaron Bower, Harry Sutherland and Jeremy Moeller.
Note: This podcast is intended solely as an educational tool for learners, especially neurology residents. The contents should not be interpreted as medical advice.
References and Additional Reading: LoRusso S. Infections of the Peripheral Nervous System. Continuum (Minneap Minn). 2021 Aug 1;27(4):921-942. doi: 10.1212/CON.0000000000000981. Bhattacharyya S, Bradshaw MJ. Infections of the Spine and Spinal Cord. Continuum (Minneap Minn). 2021 Aug 1;27(4):887-920. doi: 10.1212/CON.0000000000001031. Grill MF. Infectious Myelopathies. Continuum (Minneap Minn). 2018 Apr;24(2, Spinal Cord Disorders):441-473. doi: 10.1212/CON.0000000000000597.
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