Bilateral anterior opercular syndrome and partial Kluver–Bucy syndrome are associated with bilateral middle cerebral artery lesions. The combination of these two syndromes has only been reported in a child with limbic encephalitis. In this case, a 44-year-old woman with bilateral middle cerebral artery infarction, which occurred 2 years prior, could walk independently. However, she showed automatic-voluntary dissociation and anarthria with preserved writing skills. She also presented hypersexuality, hypermetamorphosis, and memory disturbances. Here, we report a case of an adult stroke patient who suffered from bilateral anterior opercular syndrome accompanied by partial Kluver–Bucy syndrome.
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Piriformis syndrome (PS) is an uncommon neuromuscular disorder caused by the piriformis muscle (PM) compressing the sciatic nerve (SN). The main symptom of PS is sciatica, which worsens with certain triggering conditions. Because the pathophysiology is poorly understood, there are no definite diagnostic and therapeutic choices for PS. This case report presents a young woman who mainly complained of bilateral leg weakness. Electromyography revealed bilateral sciatic neuropathy and magnetic resonance imaging confirmed structural lesions causing entrapment of the bilateral SNs. After a laborious diagnosis of bilateral PS, she underwent PM releasing surgery. Few PS cases present with bilateral symptoms and leg weakness. Therefore, in such cases, a high level of suspicion is necessary for accurate and prompt diagnosis and treatment.
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Rehabilitation in patients with bilateral upper extremity amputation presents a considerable problem for prosthetic training. This is a report of a bilateral transhumeral amputee and a bilateral transradial amputee admitted for intensive prosthetic rehabilitation. They underwent bilateral upper extremity amputation due to electric burn. They were successfully fitted with conventional body-powered prostheses. The problems in rehabilitation of adult bilateral upper extremity amputees were discussed and the patients' compliance was assessed. In our two cases, good acceptance and functional benefit were noted. Thus, we suggest that multidisciplinary approach including prosthetists with full discussion should be a very important factor for specialized comprehensive prosthetic training of multiple complexed amputee.
The location of pelvic portion of the femoral nerve between the iliacus and psoas muscles makes the nerve particularly vulnerable in hemorrhage within iliacus. We report a uncommon case of bilateral femoral neuropathy resulting from unilateral retroperitoneal hematoma. A 28-year-old man developed zero-trace grade of muscular weakness on both knee extensor muscles, numbness over bilateral anteromedial thighs and medial lower legs, tenderness of both hip adductor muscles after stab wound at left abdominal region. Abdominal computerized tomographic finding showed hematoma of left psoas muscles. Electromyographic examination revealed no motor unit action potentials in both iliopsoas, vastus medialis and adductor longus muscles. Nerve conduction study noted no compound motor action potentials of both femoral nerves. The fascial walls and laminae of the pouches in the lower abdominal wall tend to reinforce the rigidity of the fibrous arch over the femoral nerve in the intermuscular groove. This neuropathy is suggested, when the pouches are filled with blood, would further increase pressure on the subjacent nerves, especially bilateral femoral nerves.
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