Quadriparesis in Tophaceous Gout

✍ Scribed by Winston Sequeira; Alan Bouffard; Karanmal Salgia; John Skosey

• Publisher: John Wiley and Sons
• Year: 1981
• Tongue: English
• Weight: 257 KB
• Volume: 24
• Category: Article
• ISSN: 0004-3591
• DOI: 10.1002/art.1780241116

✦ Synopsis

Cord compression secondary to tophaceous deposits of sodium urate is rare. Quadriparesis has never been described. There is only one other case of true cord compression in the literature (I); two other patients with paraplegia had cauda equina syndromes W ) .

Case Report. JR, a 61-year-old black man, came to the hospital in July 1979 with a 5-week history of progressive weakness. The weakness was greater in the lower extremities and initially resulted in difficulty climbing stairs. By the time he was seen, weakness had progressed to the point that sitting up and walking could be accomplished only with difficulty, and he developed urinary incontinence. There was no fecal incontinence, sensory symptoms, or pain. His medical history included a long period of alcohol abuse, hypertension, chronic renal failure, gouty arthritis, mitral insufficiency, chronic pancreatitis, and hemolytic anemia of uncertain etiology.

The examination disclosed a spastic quadriparesis, with legs weaker than arms. The arms were equal to each other in weakness, but the right leg was weaker than the left. Hyperactive muscle stretch re-~~