Anal and urethral sphincter electromyography in spinal cord injured patients.
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Biomedical subjects
Publications and source records attributed to E Berard.
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Hypercalcaemia would seem to be rare during immobilisation, whilst osteoporosis and hypercalciuria are constant. In fact, it often goes unnoticed. The case presented here confirms its predominance in the adolescent male. The reason for immobilisation seems to be irrelevant. The clinical symptoms are very variable: polydipsia, nausea, headache, apathy, anorexia. Blood calcium levels are raised, up to 14 mg%. This hypercalcaemia is due to very marked bone loss in adolescents, secondary to hyper-resorption and a temporary stoppage in osseous formation. The differential diagnosis from primary hyperparathyroidism is sometimes difficult but is aided by laboratory and histological findings. The essential is to consider the possibility of immobilisation hypercalcaemia in the presence of any suggestive symptoms in an immobilised adolescent. Treatment includes a return to weight bearing, adequate water intake and the administration of phosphorus, calcitonin, furosemide, and corticosteroids.
Out of 180 cervical cord syndromes (traumatic, neoplastic and vascular) studied we examined the prognosis of rehabilitation in 31 central cord syndromes dating back from 6 months at the least or 6 years at the most.
Hormonal dosages and testicular biopsy are discussed in paraplegic patients of several neurological levels. There are no absolute biological criteria but histology showed slowing of spermatogenesis.
Up to date, we have carried out 100 external sphincterotomies, of which 65 only concerned traumatic spinal cord injuries.
A study of 1000 neurologic bladders has shown us that a well-balanced working of the bladder must be keenly searched for, and that sphincterotomy must be early indicated, and even performed several times if necessary. So 100 sphincterotomies performed on male patients, out of 730 cases, have shown us that their one-and-only risk, incontinence, depended chiefly of the condition of the detrusor, therefore on the short or long evolution of the sclerosis of the external sphincter, which is only one out of all the possible impediments.
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Concerning the case history of an infant of diabetic mother, the authors analyse the possible relationship between a VATER association and a poorly controlled diabetes mellitus in the early weeks of pregnancy. Caudal regression syndrome, the most frequently observed malformation noted in infants of diabetic mothers and VATER association are the results of an "AXIAL MESODERMAL DYSPLASIA". Furthermore, the factors causing VATER association occur before the seventh week of pregnancy like those responsible for the anomalies observed in infants of diabetic mothers. It is possible that a poorly controlled diabetes mellitus before conception and in the early weeks of pregnancy could favour the appearance of VATER association.
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