Spinal epidural abscess is a medical and/or surgical emergency that may result in paralysis if not diagnosed and treated in a timely manner. It has been known that Staphylococcus aureus is the most common pathogen and that the posterior thoracic epidural space is a more vulnerable site. However, cervical epidural abscess is uncommon. We have recently experienced a patient with an epidural abscess secondary to acute osteomyelitis of the cervical spine caused by E. coli inary and sphinctor distrubances. Variegate porphyria showed facial diplegia.
Emergencies ; Epidural Abscess* ; Epidural Space ; Humans ; Osteomyelitis* ; Paralysis ; Porphyria, Variegate ; Spine* ; Staphylococcus aureus

We report two cases of porphyric peripheral neuropathy in a 19-year-old male with variegate porphyria and in a 39 year-old male with intermittent acute prophyria. Clinically, there were sensory, motor disturbance and autonomic symptoms including decreased sweating, urinary and sphinctor distrubances. Variegate porphyria showed facial diplegia and positive family history inherited by autosomal dominent trait. Intermittent acute porphyria was combined-with SIADH. Both cases were expired due to respiratory failure. Nerve conduction studies were carried out in two cases and both cases showed slow motor, sensory nerve conductlon velocity ,and significant low CMAPs(Compound Muscle Action Potentials). Sural nerve biopsy was carried out in a variegate prophyria compared with one normal control. Decreased large myelinated fibers was found. In nerve fiber teased study. 8.5% of nerve fibers showed axonal degenration and only 2.3% of the segmental demyelination. There findings are suggesting that the porphyric neuro might be the axonal type.and severe neuropathy in a sign of poor prognosis.
Adult ; Axons ; Biopsy ; Demyelinating Diseases ; Humans ; Inappropriate ADH Syndrome ; Male ; Myelin Sheath ; Nerve Fibers ; Neural Conduction ; Peripheral Nervous System Diseases ; Porphyria, Acute Intermittent ; Porphyria, Variegate ; Prognosis ; Respiratory Insufficiency ; Sural Nerve ; Sweat ; Sweating ; Young Adult