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Case Reports in Neurological Medicine

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https://www.readbyqxmd.com/read/28074165/bamboo-leaf-sign-as-a-sensitive-magnetic-resonance-imaging-finding-in-spinal-subependymoma-case-report-and-literature-review
#1
Hiroyuki Toi, Yukari Ogawa, Keita Kinoshita, Satoshi Hirai, Hiroki Takai, Keijiro Hara, Nobuhisa Matsushita, Shunji Matsubara, Masaaki Uno
Background and Importance. Subependymoma occurs very rarely in the spinal cord. We report another case of spinal subependymoma along with a review of the literature and discussion of a radiological finding that is useful for preoperative diagnosis of this tumor. Clinical Presentation. A 51-year-old man presented with a 2-year history of progressive muscle weakness in the right lower extremity. Sagittal magnetic resonance imaging (MRI) showed spinal cord expansion at the Th7-12 vertebral level. Surgical resection was performed and the tumor was found to involve predominantly subpial growth...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28070432/reversible-vitamin-b12-deficiency-presenting-with-acute-dementia-paraparesis-and-normal-hemoglobin
#2
Hani Almoallim, Fahtima S Mehdawi, Mohammed M Cheikh, Fahmi Al-Dhaheri, Abdullah Mahir Aqeel
Vitamin B12 is essential for neurological function and its deficiency is associated with many neuropsychiatric disorders. We report the case of a previously healthy 53-year-old male patient presenting with delirium and multiple neurological findings. Complete blood analysis indicated megaloblastic anemia. All infectious causes were excluded owing to negative cultures (blood and urine). Tests for human immunodeficiency virus, syphilis, and toxoplasma were also negative. Metabolic workup showed severe vitamin B12 deficiency, decreased reticulocyte count, and increased direct bilirubin and lactate dehydrogenase...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28070431/small-cell-lung-cancer-with-positive-anti-nmdar-and-anti-ampar-antibodies-paraneoplastic-limbic-encephalitis
#3
Sabina Boangher, Pascal Mespouille, Corina-Mihaela Filip, Sophie Goffette
We report the case of a 66-year-old woman, with paraneoplastic limbic encephalitis, treated 6 months earlier for bladder neoplasia. The patient presented to the emergency room with rapidly increasing symptoms, noninfectious cerebral spinal fluid associated with positive anti-NMDAR (as well as in serum) and positive AMPAR antibodies in the serum. Four months later, the patient was diagnosed with a small-cell lung cancer for which chemotherapy and radiotherapy was commenced. Simultaneously, endoscopic surgical treatment was undertaken for an in situ relapse of the bladder neoplasm...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28058122/acute-stroke-due-to-electrocution-uncommon-or-unrecognized
#4
Laxmi Kokatnur, Mohan Rudrappa
The growing dependence on electricity in our daily lives has increased the incidence of electrocution injuries. Although several neurological injuries have been described previously, acute stroke due to electrocution is rare. Our patient, a previously healthy man, was electrocuted after he grabbed a "live" high-voltage wire. Although he was hemodynamically stable, he remained confused with language defects. MRI of the brain showed acute stroke in the bilateral anterior cerebral artery territory and watershed regions of the left middle cerebral artery territory...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28050293/secondary-myelitis-in-dermal-sinus-causing-paraplegia-in-a-child-with-previously-normal-neurological-function
#5
Sakina Rashid, Grace Kinabo, Marissa Kellogg, William P Howlett, Marieke C J Dekker
Neural tube defects result from failure of neural tube fusion during early embryogenesis, the fourth week after conception. The spectrum of severity is not uniform across the various forms of this congenital anomaly as certain presentations are not compatible with extrauterine life (anencephaly) while, on the other hand, other defects may remain undiagnosed as they are entirely asymptomatic (occult spina bifida). We report a child with previously normal neurological development, a devastating clinical course following superinfection of a subtle spina bifida defect which resulted in a flaccid paralysis below the level of the lesion and permanent neurological deficits following resolution of the acute infection and a back closure surgery...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28044116/simultaneous-combined-myositis-inflammatory-polyneuropathy-and-overlap-myasthenic-syndrome
#6
Stéphane Mathis, Laurent Magy, Philippe Corcia, Karima Ghorab, Laurence Richard, Jonathan Ciron, Mathilde Duchesne, Jean-Michel Vallat
Immune-mediated neuromuscular disorders include pathologies of the peripheral nervous system, neuromuscular junction, and muscles. If overlap syndromes (or the association of almost two autoimmune disorders) are recognized, the simultaneous occurrence of several autoimmune neuromuscular disorders is rare. We describe two patients presenting the simultaneous occurrence of inflammatory neuropathy, myositis, and myasthenia gravis (with positive acetylcholine receptor antibodies). For each patient, we carried out a pathological analysis (nerve and muscle) and an electrophysiological study (and follow-up)...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28042487/pediatric-absence-status-epilepticus-prolonged-altered-mental-status-in-an-8-year-old-boy
#7
Scott J Adams, Melody Wong, Tahereh Haji, Shahmir Sohail, Salah Almubarak
Absence status epilepticus is characterized by a prolonged state of impaired consciousness or altered sensorium with generalized electroencephalographic abnormalities. It is most commonly diagnosed in patients with known idiopathic generalized epilepsy; however, it may also be the first presentation of epilepsy. Due to the subtle and variable manifestations of the condition, absence status epilepticus may be underrecognized, particularly in children. We present the case of an 8-year-old boy who experienced two episodes of prolonged altered mental status, subsequently determined to be absence status epilepticus with idiopathic generalized epilepsy with phantom absences...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28003922/motor-speech-apraxia-in-a-70-year-old-man-with-left-dorsolateral-frontal-arachnoid-cyst-a-18-f-fdg-pet-ct-study
#8
Nicolaas I Bohnen, Jacob Haugen, Karen Kluin, Vikas Kotagal
Motor speech apraxia is a speech disorder of impaired syllable sequencing which, when seen with advancing age, is suggestive of a neurodegenerative process affecting cortical structures in the left frontal lobe. Arachnoid cysts can be associated with neurologic symptoms due to compression of underlying brain structures though indications for surgical intervention are unclear. We present the case of a 70-year-old man who presented with a two-year history of speech changes along with decreased initiation and talkativeness, shorter utterances, and dysnomia...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27994897/progressive-multifocal-leukoencephalopathy-in-a-multiple-sclerosis-patient-diagnosed-after-switching-from-natalizumab-to-fingolimod
#9
Tim Sinnecker, Jalal Othman, Marc Kühl, Imke Metz, Thoralf Niendorf, Annett Kunkel, Friedemann Paul, Jens Wuerfel, Juergen Faiss
Background. Natalizumab- (NTZ-) associated progressive multifocal leukoencephalopathy (PML) is a severe and often disabling infectious central nervous system disease that can become evident in multiple sclerosis (MS) patients after NTZ discontinuation. Recently, novel diagnostic biomarkers for the assessment of PML risk in NTZ treated MS patients such as the anti-JC virus antibody index have been reported, and the clinical relevance of milky-way lesions detectable by MRI has been discussed. Case Presentation and Conclusion...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27994896/proximal-limb-weakness-in-a-patient-with-celiac-disease-copper-deficiency-gluten-sensitivity-or-both-as-the-underlying-cause
#10
J David Avila, David Lacomis
Celiac disease has been associated with several neurologic disorders which may result from micronutrient deficiencies, coexisting autoimmune conditions, or gluten sensitivity. Copper deficiency can produce multiple neurologic manifestations. Myeloneuropathy is the most common neurologic syndrome and it is often irreversible, despite copper replacement. We report the case of a 55-year-old man who presented with progressive proximal limb weakness and weight loss in the setting of untreated celiac disease without gastrointestinal symptoms...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27990305/a-66-year-old-woman-with-a-progressive-longitudinally-extensive-tract-specific-myelopathy
#11
Elizabeth O'Keefe, Katherine E Schwetye, John Nazarian, Richard Perrin, Robert E Schmidt, Robert Bucelli
A 66-year-old woman presented with progressive lancinating pain and sensory deficits attributable to a myelopathy of unclear etiology. Spinal cord magnetic resonance imaging showed a longitudinally extensive T2-hyperintense lesion of the dorsal columns. Comprehensive serum, urine, and cerebrospinal fluid analyses failed to identify an etiology. Empiric intravenous methylprednisolone and intravenous immunoglobulin were of no benefit and serial screens for an occult malignancy were negative. She developed dysesthesias and allodynia affecting her entire body and lost the use of her arms and legs due to severe sensory ataxia that was steadily progressive from onset...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27974981/an-overlapping-case-of-miller-fisher-syndrome-bickerstaff-s-encephalitis-and-the-asman-variant-of-guillain-barre-syndrome
#12
E J Pegg, S K Chhetri, U G Lekwuwa, T Majeed
A 56-year-old man presented with a 3-day history of progressive tingling of the hands, unsteadiness, and diplopia. He was initially diagnosed clinically with Miller Fisher Syndrome (MFS) but later developed limb weakness consistent with Guillain-Barre Syndrome (GBS) and subsequently reduced consciousness consistent with Bickerstaff's brainstem encephalitis (BBE). Neurophysiology revealed an axonal motor and sensory neuropathy, in keeping with the Acute Motor and Sensory Axonal Neuropathy (AMSAN) variant of GBS...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27965905/stroke-as-the-sole-manifestation-of-takayasu-arteritis-in-a-15-year-old-boy-with-latent-tuberculosis
#13
Espen Benjaminsen, Anne Reigstad, Vanja Cengija, Vibke Lilleby, Maria Carlsson
Introduction. Takayasu arteritis is a rare disease affecting the aorta and its main branches, causing arterial claudication and end-organ ischemia, including stroke. The etiology is unknown but is believed to be autoimmune. An association between Takayasu arteritis and tuberculosis has been suggested, but the possible relation is unclear. Case Presentation. A 15-year-old Somali boy was diagnosed with latent tuberculosis. He had a lesion in the right lung, and both the tuberculin skin test by the Mantoux method and Quantiferon GOLD test turned out positive...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27957363/aseptic-meningitis-caused-by-lassa-virus-case-series-report
#14
Peter O Okokhere, Idowu A Bankole, Christopher O Iruolagbe, Benard E Muoebonam, Martha O Okonofua, Simeon O Dawodu, George O Akpede
The Lassa virus is known to cause disease in different organ systems of the human body, with varying clinical manifestations. The features of severe clinical disease may include bleeding and/or central nervous system manifestations. Whereas Lassa fever encephalopathy and encephalitis are well described in the literature, there is paucity of data on Lassa virus meningitis. We present the clinical description, laboratory diagnosis, and management of 4 consecutive cases of aseptic meningitis associated with Lassa virus infection without bleeding seen in a region of Nigeria known to be endemic for both the reservoir rodent and Lassa fever...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27891270/primary-diffuse-leptomeningeal-gliomatosis-radiological-pathological-features
#15
Ehtasham Ahmad, Mohamed Mohamed, Apostolos Vrettos
We present the case of a 43-year-old lady who presented with headaches, visual impairment, and seizures, progressing rapidly over the course of a few weeks. Extensive workup excluded an inflammatory or infectious cause. Imaging studies revealed diffuse thickening of the leptomeninges and serial CSF analysis showed raised opening pressures and increased protein levels. A diagnostic biopsy of the lower thoracic dura confirmed the diagnosis of primary diffuse leptomeningeal gliomatosis (PDGL). She was managed supportively for her symptoms and unfortunately she passed away a few weeks later...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27891269/unruptured-basilar-tip-aneurysm-with-internal-septation-coiling-implications
#16
Ayman Khalil, Hong Kuan Kok, Mark Schembri, Paul Brennan, Mohsen Javadpour, John Thornton, Alan O'Hare, Hamed Asadi
An internal septum within a basilar artery aneurysm is an infrequent anomaly and is very rarely reported in the literature. We report a 62-year-old lady that was incidentally diagnosed with basilar tip aneurysm. Further imaging with magnetic resonance imaging (MRI) revealed internal septation within this aneurysm which was later confirmed with digital subtraction angiography (DSA). She underwent coil embolisation, which involved technical manipulation of the microcatheter and the balloon to enable coiling of each separate aneurysm compartment...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27882256/eeg-triggered-functional-electrical-stimulation-therapy-for-restoring-upper-limb-function-in-chronic-stroke-with-severe-hemiplegia
#17
Cesar Marquez-Chin, Aaron Marquis, Milos R Popovic
We report the therapeutic effects of integrating brain-computer interfacing technology and functional electrical stimulation therapy to restore upper limb reaching movements in a 64-year-old man with severe left hemiplegia following a hemorrhagic stroke he sustained six years prior to this study. He completed 40 90-minute sessions of functional electrical stimulation therapy using a custom-made neuroprosthesis that facilitated 5 different reaching movements. During each session, the participant attempted to reach with his paralyzed arm repeatedly...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27882255/tip-of-an-iceberg-skull-fracture-as-an-adult-presentation-of-encephalocraniocutaneous-lipomatosis
#18
Sinead Culleton, Christen D Barras, Hamed Asadi, Seamus Looby, Paul Brennan, Hong Kuan Kok
The severity of seizures presenting to the emergency department ranges from benign to life threatening. There are also a wide number of possible etiologies. Computed tomography (CT) emergency imaging may be required at presentation to elucidate a possible cause and assess signs of intracranial trauma. This case describes a serious seizure episode in a young man while on holiday. A CT brain showed a skull fracture as a consequence of seizure-related head trauma but unexpectedly there were image findings consistent with encephalocraniocutaneous lipomatosis...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27872776/cerebral-venous-sinus-thrombosis-during-everest-expedition-a-case-report-and-review-of-the-literature
#19
P Khanal, L Thapa, A M Shrestha, S Bhattarai, D Sapkota, N Sharma, U P Devkota
Cerebral venous sinus thrombosis (CVST) is a rare but serious disorder that is associated with a poor clinical outcome. We report a 35-year-old man who had a severe headache and diplopia while climbing Mount Everest. His MR venography showed right transverse and right sigmoid sinus thrombosis. He improved on anticoagulant and symptomatic measures. Cerebral venous sinus thrombosis at high altitude is discussed.
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27847661/thermoregulatory-instability-in-childhood-linking-the-normal-brain-to-hypothalamic-storm
#20
William Alves Martins, Rafael do Amaral Cristovam, Helena Fussiger, Viviane Maria Vedana, Marta Hemb
Central core temperature is tightly controlled by hypothalamic centers, a feature that makes sudden changes in body temperature very unusual. A dysfunction of these hypothalamic pathways leads to Shapiro's syndrome, comprising spontaneous hypothermia, hyperhidrosis, and corpus callosum dysgenesis. Although it may affect any age, usually it presents in childhood. Variants to this syndrome with completely normal brain anatomy have been consistently reported, expanding the clinical spectrum of the syndrome. Herein, we report the case of a 4-year-old girl with Shapiro's syndrome and unaffected corpus callosum...
2016: Case Reports in Neurological Medicine
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