The Chiari-syndrome Type I being a malformation of the posterior cranial fossa often leads to syringomyelia. The disease becomes apparent in adolescence with kyphoscoliosis, headache, vertigo, ataxy, hearing loss, partial paralysis and other neurological disorders. The onset is typically characterized by dissociated anesthesia, due to the frequent localization of the syrinx in the neighborhood of the posterior column of the spinal cord. It is reported a case of an 15-years-old-girl suffering from intensive headache, recurrent left-sided paresthesias and progredient scoliosis. Somatosensory evoked potentials of left ulnar and tibial nerves revealed a complete loss of cortical response. Diagnostic imaging showed an Chiari-malformation I with herniation of cerebellar tonsils and secondary syringomyelia of the cervical spinal cord. After surgical treatment with posterior fossa decompression, C1 laminectomy and partial excision of cerebellar tonsils the patient had a clear improvement in symptoms. Postsurgical the width of cervical syrinx decreases. Now somatosensory evoked potentials of the left ulnar and tibial nerves show amplitude-reduced cortical responses with a normal latency.

No abstract

Enteroviruses are common with infections of the CNS, such as encephalitis and myelitis, but they may cause various diseases in different organ systems, particulary with fatal outcome. Pleconaril is a new orally acting antiviral drug with broad anti-picornavirus activity, which provides to treat rhinoviral and enteroviral infections. To explain the importance for clinical use, we report a case of severe enteroviral infections of the CNS, treated by Pleconaril. A 14 year old girl presented with a severe polio- like myelitis including flaccid paraparesis and urinary incontinence due to Coxsackievirus-infection. Because of prolonged course and virus persistence we treated with Pleconaril, after treatment a remarkable improvement could be noticed, continency and the ability to walk without aid were regained within a few weeks. With the development of new antiviral substances we are now given more opportunities to treat infectious conditions of the central nervous system. We suggest to include enteroviruses in diagnostic procedures since there is an effective treatment with the new drug Pleconaril available.

No abstract

No abstract