Sumeera Matee

Bilateral spontaneous anterior shoulder dislocation: A missed orthopedic injury mistaken as proximal neuropathy

A number of orthopedic injuries can occur during epileptic seizures. Anterior shoulder dislocation is one such orthopedic injury that is quite rare. The shoulder dislocation may injure the brachial plexus. Besides seizures, the nerves can also be damaged by anticonvulsive therapy. Muscle wasting following a seizure can misguide a clinician to investigate only neural or muscular pathologies. We report here an individual with epilepsy who was referred to us for electrodiagnostic evaluation of proximal muscle wasting related to a suspected proximal neuropathy. He was found to have a normal electrodiagnostic evaluation and later on discovered to have had bilateral shoulder dislocation on X-rays. This report advocates a thorough clinical appraisal, radiographs, and electrodiagnostic evaluation in a case with muscle wasting following a seizure.

Spinal cord injury secondary to front rolls as part of military physical training: A case report

OBJECTIVE To report an unusual case of cervical spinal cord injury. STUDY DESIGN Case report of a 23 year old soldier who sustained spinal cord injury in front rolls during a military training program. SETTINGS Spinal Cord Injuries Unit, Armed Forces Institute of Rehabilitation Medicine (AFIRM), Rawalpindi, Pakistan. CASE REPORT A 23 year old soldier, who voluntarily joined a military training program, suffered spinal cord injury in doing front rolls resulting in tetraplegia and incontinence for bowel and bladder corresponding to the injury level of C5 ASIA Impairment Scale C with Functional Independence Measure Score of 40/126. His Magnetic Resonance Imaging showed posterior displacement of CV3 resulting in cord compression and swelling at CV3 and CV4 levels. He was managed conservatively by comprehensive rehabilitation and improved to spinal cord injury C5 ASIA Impairment Scale D with Functional Independence Measure Score of 76/126. CONCLUSION This case report describes spinal cord injury secondary to front-rolls. As front-rolls are part and parcel of military training, awareness and coaching to ensure safety must be exercised from the beginning of any training program.