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Byline: Ahmet N. Kok (1), Omer S. Yildirim (2), Mehmet Kizilkaya (3), Ali F. Isik (4), Nasuhi E. Aydin (5), Talat Yurtman (6) Keywords: Solitary plasmacytoma; Neck pain; Trivial injury; Quadriplegia Abstract: Abstract After complaining of neck pain for 3 weeks, a 36-year-old man suddenly become quadriplegic during a massage session in a traditional Turkish bath. He was immediately transferred to hospital, where the initial examination consisting in plain radiography and magnetic resonance imaging revealed a compression fracture of the fourth cervical vertebra. The patient was immediately treated by anterior vertebral decompression and bone grafting from the iliac crest. Unfortunately, the patient did not respond to surgical intervention and died. Solitary plasmacytoma of the fourth cervical vertebrae was detected at autopsy during forensic examination. Pain and spinal cord compression resulted from solitary plasmacytoma of the vertebral column. However, paralysis, especially quadriplegia, occurs seldom. In this case report, solitary plasmacytoma of the vertebral column associated with neck pain is presented with the relevant pathological and clinical aspects. Author Affiliation: (1) Department of Forensic Medicine, Faculty of Medicine, Ataturk University, Erzurum, Turkey (2) Surgery Orthopaedic, Faculty of Medicine, Ataturk University, Erzurum, Turkey (3) Department of Anesthesia and Reanimation, Faculty of Medicine, Ataturk University, Erzurum, Turkey (4) Department of Forensic Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey (5) Department of Pathology, Faculty of Medicine, Inonu University, Malatya, Turkey (6) Council of Forensic Medicine, Ankara, Turkey Article History: Registration Date: 01/01/2004 Received Date: 08/10/2003 Accepted Date: 01/03/2004

Byline: D. D. Kennedy (1), S. N. Fletcher (1), I. R. Ghosh (2), J. H. Coakley (1), J. P. Monson (3), C. J. Hinds (1) Keywords: Key words Critical illness; Diabetes; Sepsis; Neuromuscular disease; Neuropathies; Motor and sensory; Electromyography Abstract: Critical illness polyneuromypathy has not previously been reported as a complication of diabetic coma. We describe a patient with hyperosmolar non-ketotic coma (HONK) complicating gram-negative sepsis in whom persistent coma and profound tetraplegia caused considerable concern. Although, initially, it was feared that the patient had suffered a central neurological complication such as stroke or cerebral oedema, a diagnosis of critical illness motor syndrome (CIMS) was subsequently confirmed neurophysiologically. Profound limb weakness associated with HONK is not necessarily due to a catastrophic cerebral event, rather it may be a result of CIMS, which has an excellent prognosis for full neurological recovery. Author Affiliation: (1) Department of Intensive Care, St. Bartholomew's Hospital, Smithfield, London EC1A 7BE, UK Tel.: + 44-1 71-6 01 75 26 Fax: + 44-1 71-6 01 75 26, GB (2) Department of Neurophysiology, St. Bartholomew's Hospital, Smithfield, London EC1A 7BE, UK, GB (3) Division of Metabolism, St. Bartholomew's Hospital, Smithfield, London EC1A 7BE, UK, GB Article note: Received: 4 June 1999 Accepted: 22 September 1999