Combined Femoral Neuropathy and Obturator Neuropathy in Rheumatoid Arthritis with Cervical Subluxation after Operation
Resource
JOURNAL OF REHABILITATION MEDICINE ASSOCIATION REPUBLIC OF CHINA v.31 n .2 pp.113-118
Journal
JOURNAL OF REHABILITATION MEDICINE ASSOCIATION REPUBLIC OF CHINA
Journal Volume
v.31
Journal Issue
n
Pages
113-118
Date Issued
2003
Date
2003
Author(s)
KAO, CHEN-LIN
WANG, YEN-HO
CHENG, SHUN-PING
NA, YU-CHIN
CHOU, CHEN-LIANG
Abstract
Rheumatoid arthritis is a chronic inflammatory disease. Although it primarily affects joints, systemic involvement is frequent. Lung, skin, blood, cardiovascular system and nerve are often affected. Indeed, involvement of the peripheral nervous system may occur with a variety of clinical patterns. A 67-year-old woman suffered from rheumatoid arthritis for 10 years with regular medical control. Due to bilateral distal parts of hands and feet numbness, and gait disturbance for about 2 months, she was diagnosed of rheumatoid arthritis with C1-C2 subluxation by neurosurgeon. C1-C2 posterior spinal fusion was performed. But, the patient felt left lower extremity weaker than right one then. The muscle strength of left knee extension and thigh adduction was poor and hip flexion was good. Paresthesia was found over left anterior medial thigh and hypesthesia was found over distal part of four limbs. Electrodiagnosis showed severe left femoral and obturator neuropathy and mild peripheral sensory neuropathy. Pelvic CT scan showed no hematoma nor tumor. After rehabilitation, the patient could ambulate independently for 15 meters without device and with a regular cane for longer distance. peripheral sensory neuropathy. Pelvic CT scan showed no
Subjects
rheumatoid arthritis
C1-C2 subluxation
posterior spinal fusion
femoral neuropathy
obturator neuropathy