[abstract] IDIOPATHIC TRANSVERSE MYELITIS AFTER RECREATIONAL HYPERBARIC EXPOSURE

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[abstract] IDIOPATHIC TRANSVERSE MYELITIS AFTER RECREATIONAL HYPERBARIC EXPOSURE

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Title: [abstract] IDIOPATHIC TRANSVERSE MYELITIS AFTER RECREATIONAL HYPERBARIC EXPOSURE
Author: Reed, WL; Porter, HO; Surber, DS; Guckeyson, CT
Abstract: BACKGROUND: Transverse myelitis is rapidly progressive neurological disorder which is associated with several etiologies, including multiple sclerosis, autoimmune disorders, infectious diseases, or may be idiopathiCASE PRESENTATION: A 33 year old male performed 2 air dives to depths of about 100 fsw (31 m). 6 hours after the exposure the patient reported gradual onset of sharp, pleuritic chest pain. Fifty hours following the hyperbaric exposure, the patient developed right sided facial paresthesias. Evaluation showed decreased sensation to all modalities in the area of the right fifth cranial nerve. The patient was treated with an extended US Navy Treatment Table 6. There was initial response to hyperbaric oxygen, with a near complete resolution of symptoms. In the 8 hours following treatment the subjective symptoms returned. The patient was returned for further hyperbaric treatment three days later. An MRI was purported to show multiple embolic foci consistent with gas embolism . He was again treated with hyperbaric oxygen on a Table 6. Review of the MRI showed that the embolic foci were digital artifacts. The patient had transient improvement of the sensory deficits during the treatment. He was noted to have dysarthria, sensory deficits in the right face, arm and leg. The preliminary diagnosis of transverse myelitis was made. The patient returned to hospital, and was treated as an inpatient. He eventually made a complete recoverCONCLUSIONS: This is the first description of idiopathic transverse myelitis mistaken for decompression illness. The HBO consultant should be reminded that the presence of a history of hyperbaric exposure should not preclude all other diagnosis. The highly unusual presentation, the 50 hour delay to the presence of neurological symptoms, the poor response to recompression and the slow progression of neurological signs despite recompression were all signs that the patient's symptoms were unrelated to the hyperbaric exposure.
Description: Undersea and Hyperbaric Medical Society, Inc. (http://www.uhms.org )
URI: http://archive.rubicon-foundation.org/3638
Date: 2006

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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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