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https://www.readbyqxmd.com/read/30483455/extrapyramidal-symptoms-with-administration-of-lenalidomide-maintenance-therapy-for-multiple-myeloma
#1
Fnu Sagar, Saad Ullah Malik, Supranee Soontornprueksa, Awais Ijaz, Muhammad Usman, Ali Younas Khan, Pavan Tenneti, Mohammad A Fraz, Faiz Anwer
Lenalidomide is commonly used as induction or maintenance therapy in multiple myeloma. We report a case of 71-year-old female presenting with tardive dyskinesia-like symptoms one month after starting her lenalidomide maintenance therapy after high-dose chemotherapy and autologous hematopoietic stem cell rescue. Her symptoms evolved over days to pronounced uncontrollable limb movements, tongue smacking, lip-smacking, abnormal sounds, and tongue biting. The patient categorically denied any exposure to other drugs which are known to cause symptoms of tardive dyskinesia...
September 24, 2018: Curēus
https://www.readbyqxmd.com/read/30482825/diagnosis-and-management-of-immune-checkpoint-inhibitor-associated-neurologic-toxicity-illustrative-case-and-review-of-the-literature
#2
Kerry L Reynolds, Amanda C Guidon
Immune checkpoint inhibitors (ICIs) initiate antitumor immunity by blocking the action of immune inhibitor-signaled cytotoxic proteins, such as cytotoxic T-lymphocyte-associated protein 4, programmed cell death protein 1, and programmed cell death ligand 1. However, in rare cases (∼1%-12% of patients), ICI treatment causes neurologic immune-related adverse events (irAEs). These include, but are not limited to, headache, encephalitis, neuropathies, myasthenia gravis, and myositis. The symptoms associated with irAEs can range from mild (grade 1-2) to severe (grade 3-4); however, they are often challenging to diagnose because they may present as generalized symptoms, such as fatigue and weakness, that can also be caused by the cancer itself...
November 27, 2018: Oncologist
https://www.readbyqxmd.com/read/30478703/autonomic-dysfunction-and-hpv-immunization-an-overview
#3
Svetlana Blitshetyn, Louise Brinth, Jeanne E Hendrickson, Manuel Martinez-Lavin
This article reviews the case series reported from several countries describing patients with suspected severe side effects to the HPV vaccines. The described symptom clusters are remarkably similar and include disabling fatigue, headache, widespread pain, fainting, gastrointestinal dysmotility, limb weakness, memory impairment episodes of altered awareness, and abnormal movements. This constellation of symptoms and signs has been labeled with different diagnoses such as complex regional pain syndrome (CRPS), postural orthostatic tachycardia syndrome (POTS), small fiber neuropathy (SFN), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), or fibromyalgia...
November 27, 2018: Immunologic Research
https://www.readbyqxmd.com/read/30473736/successful-rituximab-treatment-of-granulomatosis-with-polyangiitis-with-cranial-neuropathies
#4
Maho Nakazawa, Katsuya Suzuki, Hidekata Yasuoka, Kunihiro Yamaoka, Tsutomu Takeuchi
Background: In granulomatosis with polyangiitis (GPA), peripheral nerve involvement is common but central nervous system (CNS) involvement is extremely rare and treatment strategy has not been established. We report a case of intravenous cyclophosphamide (IVCY)-resistant GPA with associated cranial neuropathies that was successfully treated with rituximab (RTX). Case presentation: A 37-year-old man with intractable sinusitis had several months of headache, hoarseness, and dysphagia; a month of right-sided deafness and nasal bleeding; and a week of dysarthria, steppage gait, and numbness in the right L5 distribution...
2018: Inflammation and Regeneration
https://www.readbyqxmd.com/read/30459136/a-case-of-entecavir-associated-bullous-fixed-drug-eruption-and-a-review-of-literature
#5
Selami Aykut Temiz, İlkay Özer, Arzu Ataseven, Sıddıka Fındık
Fixed drug eruption (FDE) is a type of drug reaction characterized by localized erythema, hyperpigmentation, and bullous at the same site(s), generally observed following every intake of a causative drug. Delayed-type cellular hypersensitivity (Type IVC) is considered to play a role in FDE etiology. Several antibiotics, barbiturates, oral contraceptives, nonsteroidal anti-inflammatory drugs, laxative-containing phenolphthalein, metronidazole, and quinine are known to be the primary drugs responsible for FDE...
November 19, 2018: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/30456045/retrosigmoid-craniotomy-for-resection-of-an-epidermoid-cyst-of-the-posterior-fossa
#6
M Yashar S Kalani, William T Couldwell
This video illustrates the case of a 51-year-old woman who presented with sudden-onset headache, vertigo, and nausea. Imaging revealed an epidermoid cyst of the posterior fossa with mass effect upon the brainstem and displacement of the basilar artery. This lesion was approached using a left-sided keyhole retrosigmoid craniotomy with monitoring of the cranial nerves. This video illustrates the technique of internal debulking of the cyst contents with minimal manipulation of the cyst capsule, which is often densely adherent to the brainstem, cranial nerves, and vessels in the posterior fossa...
December 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/30390733/a-case-of-generalized-superinfected-dermatitis-and-inguinal-mycobacterium-lymphadenitis-tb-or-not-tb
#7
Maria Rotaru, Sanda Marchian, Gyula Laszlo Fekete, Gabriela Mariana Mariana Iancu
Dear Editor, Eczema is an inflammatory dermatitis mediated by cellular immunity, with an etiology in which environmental, immunological, and genetic factors are involved. Skin inflammation through proinflammatory cytokines creates a favorable environment for microbial antigens and optimal conditions for infection (1). In case of underlying immunosuppression, inflammatory features of dermatitis and superimposed infections are more severe. The presence of minor trauma of the skin in the form of fissures can favor both easier inoculation of some bacterial germs, leading to a dermatitis superinfection, and/or the transcutaneous inoculation of atypical mycobacteria, with a possibility of developing localized types of tuberculous lymphadenitis (TLA)...
October 2018: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/30344840/contraceptive-implant-related-acute-ulnar-neuropathy-prompt-diagnosis-early-referral-and-management-are-key
#8
Ayman Saeed, Nitisha Narayan, Ankur Pandya
Objective: Subdermal contraceptive implants are a well-established method of contraception. Aside from common side effects such as irregular menstrual periods, headaches, and weight gain, rarer complications related to their insertion and removal have been reported. These include traumatic peripheral neuropathy after procedures to remove nonpalpable implants. Only 2 cases of ulnar neuropathy after insertion of a contraceptive implant have been described in the literature, one which resolved spontaneously and another in which postoperative recovery was not described...
2018: Eplasty
https://www.readbyqxmd.com/read/30332974/complications-of-immunoglobulin-therapy-and-implications-for-treatment-of-inflammatory-neuropathy-a-review
#9
Ahmed Abbas, Yusuf A Rajabally
Intravenous immunoglobulin (IVIg) forms a cornerstone of effective treatment for acute and chronic inflammatory neuropathies, with a class I evidence base in Guillain-Barré syndrome (GBS), chronic inflammatory demyelinating polyneuropathy (CIDP) and multifocal motor neuropathy (MMN). It is generally considered to be a safe therapy however there are several recognised complications which are reviewed in this article. Most adverse events are immediate and mild such as headache, fever and nausea although more serious immediate reactions such as anaphylaxis may rarely occur...
October 17, 2018: Current Drug Safety
https://www.readbyqxmd.com/read/30302419/trigeminal-hypertrophic-interstitial-neuropathy-presenting-as-unilateral-proptosis-ptosis-tearing-and-facial-neuralgia
#10
Elizabeth R Duvall, Jennifer Pan, Kim Tien T Dinh, Majd Al Shaarani, Golden Pan, Marlyn P Langford, William A Byrd
Purpose: To show the utility of MRI and histology in diagnosing rare cases of trigeminal hypertrophic interstitial neuropathy (HIN). Observations: A 57-year-old African-American woman presented with a 4-year history of right eye proptosis with tearing, headaches, and worsening right-sided trigeminal neuralgia symptoms and jaw pain. HIV and diabetes tests were negative and thyroid function was normal. MRI identified abnormal thickening of all trigeminal nerve divisions and proptosis secondary to right trigeminal nerve V1 division enlargement...
December 2018: American Journal of Ophthalmology Case Reports
https://www.readbyqxmd.com/read/30290905/thalidomide-before-and-after-autologous-stem-cell-transplantation-in-recently-diagnosed-multiple-myeloma-hovon-50-long-term-results-from-the-phase-3-randomised-controlled-trial
#11
RANDOMIZED CONTROLLED TRIAL
Niels Wcj van de Donk, Bronno van der Holt, Monique C Minnema, Edo Vellenga, Sandra Croockewit, Marie José Kersten, Peter A von dem Borne, Paula Ypma, Ron Schaafsma, Okke de Weerdt, Saskia K Klein, Michel Delforge, Mark-David Levin, Gerard M Bos, Kon-Siong G Jie, Harm Sinnige, Jules Llm Coenen, Esther G de Waal, Sonja Zweegman, Pieter Sonneveld, Henk M Lokhorst
BACKGROUND: In patients with recently diagnosed multiple myeloma, the HOVON-50 phase 3 trial showed improved event-free survival for thalidomide-containing induction and maintenance regimens (in conjunction with high-dose melphalan and autologous stem cell transplantation [auto-SCT]) after a median of 52 months of follow-up, by comparison with regimens containing classical cytotoxic drugs. In this follow-up analysis, we aimed to determine the long-term effects of thalidomide in induction and maintenance therapy in multiple myeloma...
October 2018: Lancet Haematology
https://www.readbyqxmd.com/read/30271035/profile-of-patients-from-a-neurology-registry-in-resource-poor-rural-northwest-india
#12
Amit Bhardwaj, Ashish Sharma, Girish Kumar, Monika Angra, Sapna S Bhardwaj, Sunil Kumar Raina, Sushant Sharma, Piyush Sharma
Background: The neurology register is based in a tertiary care center in a rural north-west India. The center caters to a predominantly rural population. The present study is based on the data retrieved from this registry over a period of 1 year. Materials and Methods: Details of the patients reporting to the Department of Neurology are entered in a registry. For the purpose of this study, 1-year data (from August 1, 2013, to July 31, 2014) of patients (with complete information and final diagnosis) were analyzed...
October 2018: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/30268100/cases-of-visual-impairment-caused-by-cerebral-venous-sinus-occlusion-induced-intracranial-hypertension-in-the-absence-of-headache
#13
Tongtao Zhao, Gang Wang, Jiaman Dai, Yong Liu, Yi Wang, Shiying Li
BACKGROUND: Cerebral venous sinus thrombosis or stenosis (here collectively referred to as cerebral venous sinus occlusion, CVSO) can cause chronically-elevated intracranial pressure (ICP). Patients may have no neurological symptoms other than visual impairment, secondary to bilateral papilledema. Correctly recognizing these conditions, through proper ophthalmological examination and brain imaging, is very important to avoid delayed diagnosis and treatment. CASE PRESENTATION: We report a case series of 3 patients with chronic CVSO, who were admitted to an ophthalmological department in Chongqing, China, from 2015 March to 2017 February...
September 29, 2018: BMC Neurology
https://www.readbyqxmd.com/read/30237691/sleep-disturbances-in-diabetic-peripheral-neuropathy-patients-a-clinical-and-polysomnographic-study
#14
Wafik Said Bahnasy, Yasser Abo Elfotoh El-Heneedy, Ehab Ahmed Shawky El-Seidy, Nema Ata Allah Labib, Ibrahim Salah Eldeen Ibrahim
Background: Disordered sleep breathing is a common complication of diabetic peripheral neuropathy (DPN) manifested by excessive daytime sleepiness, morning headache, morning dizziness, cognitive decline, and mood changes. Methods: This study was performed on 30 non-obese type 2 diabetic patients; 20 with clinically evident DPN and 10 without. Ten age-, sex-, and body mass index-matched healthy control subjects were also included. Patients and control were subjected to history taking, neurological examination, glycated hemoglobin, and clinical assessment of the sensori-motor manifestations by the neuropathy symptom score and neuropathy disability score...
2018: The Egyptian journal of neurology, psychiatry and neurosurgery
https://www.readbyqxmd.com/read/30232672/atypical-clinical-manifestations-of-miller-fisher-syndrome
#15
Jae Ho Jung, Eun Hye Oh, Jin-Hong Shin, Dae-Seong Kim, Seo-Young Choi, Kwang-Dong Choi, Jae-Hwan Choi
Miller Fisher syndrome (MFS) is characterized by a clinical triad of ophthalmoplegia, ataxia, and areflexia, and is closely associated with serum anti-GQ1b antibody. Although the clinical triad is the cardinal diagnostic clue, a variety of other symptoms and signs beyond the triad have been reported. To elucidate the frequency and characteristics of atypical clinical manifestations of MFS, we recruited 38 patients with MFS and evaluated the symptoms or signs beyond the classic triad. Eleven (29%) of 38 patients had atypical clinical manifestations of MFS such as headache (n = 6), delayed facial palsy (n = 3), divergence insufficiency (n = 2), and taste impairment (n = 2)...
September 19, 2018: Neurological Sciences
https://www.readbyqxmd.com/read/30215116/neurological-symptoms-in-hypophosphatasia
#16
J M Colazo, J R Hu, K M Dahir, J H Simmons
Hypophosphatasia (HPP) typically manifests with fractures, tooth loss, and muscle pain. Although mental health diagnoses and neurological symptoms have not been previously well documented in HPP, they occur commonly. The recognition of non-traditional symptoms may improve patient satisfaction, preempt costly evaluation and misdiagnosis, and lead to further treatment options. INTRODUCTION: Hypophosphatasia (HPP) is an inborn error of metabolism due to deficiency of tissue non-specific alkaline phosphatase (TNSALP)...
September 13, 2018: Osteoporosis International
https://www.readbyqxmd.com/read/30190242/first-presentation-with-psychotic-behavior-to-the-emergency-department-meningitis-or-not-that-is-the-question
#17
Abdullah E Laher, Yousef Etlouba, Muhammed Moolla, Feroza Motara, Nazeema Ariefdien
INTRODUCTION: Meningitis is a potentially life threatening medical emergency. Psychotic behavior may be a presenting feature in patients with meningitis. We aimed to determine the value of various clinical and laboratory features at ruling-out meningitis in the patient presenting with a first-episode of psychotic behavior. METHODS: Medical records of 159 subjects presenting to a tertiary academic hospital over a 6-month period with one or more psychotic features for the first time were prospectively gathered...
November 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30174689/evaluation-of-adverse-drug-reaction-profile-of-drugs-used-as-first-line-antiretroviral-therapy
#18
Mukta N Chowta, Priyanka Kamath, John T Ramapuram, K Ashok Shenoy, Sanjay Hadigal
Background and Objectives: The objective was to study the adverse drug reaction (ADR) profile in HIV patients receiving first-line antiretroviral therapy. Methods: This was a prospective, observational study that included 171 HIV patients with a follow-up at six months. Demographic details, medical history, details of HIV infection including most recent CD4 count, details of antiretroviral therapy, and other concomitant medication were recorded. Adverse drug reactions were elicited by reviewing patient records and also by interviewing the patient/attendants directly...
2018: Interdisciplinary Perspectives on Infectious Diseases
https://www.readbyqxmd.com/read/30123591/a-case-report-on-chikungunya-virus-associated-encephalomyelitis
#19
Harsh Khatri, Heli Shah, Dhara Roy, Kaushalendra Mani Tripathi
Chikungunya is a rerising alphavirus infection that has resulted from enhanced vector competence. Alphaviruses are divided into arthritogenic viruses (old world) and encephalitogenic viruses (new world) including equine encephalitis viruses. Chikungunya is a dengue-like illness characterized by acute febrile polyarthralgia, arthritis, malaise, body ache, rash, headache, and nausea. The illness is self-limiting. The neurological manifestations are uncommon and incorporate meningoencephalitis, myelitis, Guillain-Barre syndrome, cranial nerve palsies, myelopathy, and neuropathy; MRI abnormalities in patients with encephalopathy from India have been reported in the form of multiple punctuate white matter lesions that are more prominent on diffusion-weighted MRI than on T2 or T1...
2018: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/30098921/sleep-quality-and-psychosocial-characteristics-of-patients-with-painful-post-traumatic-trigeminal-neuropathies
#20
Eduardo Vazquez-Delgado, Marta Viaplana-Gutierrez, Charles Carlson, Rui Figueiredo, Eduard Valmaseda-Castellon
OBJECTIVES: The aim of this study was to explore how pain and psychological distress influence the sleep quality of patients with painful post-traumatic trigeminal neuropathy (PPTN). STUDY DESIGN: Thirty-two patients with a diagnosis of PPTN according to the International Classification for Headache Disorders of the International Headache Society were enrolled. All patients completed a number of questionnaires that examined sleep quality, psychological distress, and quality of life...
October 2018: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
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