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Neurological cases

Seng Wee Cheo, Qin Jian Low, Wei Chin Mow, Chia Yuen Kang
Myasthenia gravis is a common autoimmune neurological disorder that is frequently encountered in our daily practice. Its presentation can vary from ocular myasthenia, generalized myasthenia to myasthenia crisis. Diagnosing a myasthenia crisis is especially challenging in an intubated patient. Investigations that can be used to diagnose myasthenia gravis include serum acetylcholine receptor antibodies and repetitive nerve stimulation, however, these tests are not widely available. Here, we reported a case of myasthenia crisis which was diagnosed early by ice pack test and it resulted in full recovery of the patient...
December 4, 2018: QJM: Monthly Journal of the Association of Physicians
Nikolaos Settas, Rebecca Persky, Fabio R Faucz, Nicole Sheanon, Antonis Voutetakis, Maya Lodish, Louise A Metherell, Constantine A Stratakis
Context: Multiple autosomal recessive genes have been etiologically linked to Primary Adrenal Insufficiency (PAI). Recently, SGPL1 gene mutations were recognized as causes of steroid-resistant nephrotic syndrome type 14 (NPHS14), a sphingolipidosis with multisystemic manifestations including PAI. Interestingly, this is the only monogenetic form of nephrotic syndrome (NS) and the sole sphingolipidosis causing adrenal disease. Objective: To understand if SGPL1 mutations are involved in the pathogenesis of PAI in patients who do not exhibit NS...
December 3, 2018: Journal of Clinical Endocrinology and Metabolism
Renato D'Alonzo, Elisabetta Mencaroni, Lorenza Di Genova, Daniela Laino, Nicola Principi, Susanna Esposito
Mycoplasma pneumoniae is mainly recognized as a respiratory pathogen, although it is associated with the development of several extra-respiratory conditions in up to 25% of the cases. Diseases affecting the nervous system, both the peripheral (PNS) and the central nervous system (CNS), are the most severe. In some cases, particularly those that involve the CNS, M. pneumoniae -related neuropathies can lead to death or to persistent neurologic problems with a significant impact on health and a non-marginal reduction in the quality of life of the patients...
2018: Frontiers in Microbiology
Vasiliki Kalogera, Dimitrios Galopoulos, Gerasimos Eleftheriotis, Evangelia Meimeti, Ioannis Malios, Georgios Marathonitis, Chariclia Loupa
Introduction: Oxcarbazepine is a carbamazepine pre-drug with less drug interactions. Its adverse effects, including hyponatremia, somnolence and ataxia, are dose dependent. Olanzapine is an atypical antipsychotic drug most commonly used to manage psychoses and symptoms of irritability and aggressive behavior. Main side effects include extrapyramidal and anticholinergic symptoms, weight gain, and hyperglycemia. Case Report: In this manuscript a case of oxcarbazepine and olanzapine intoxication is discussed...
October 2018: Medical Archives
Sai Pooja Mahajan, Bunyarit Meksiriporn, Dujduan Waraho-Zhmayev, Kevin B Weyant, Ilkay Kocer, David C Butler, Anne Messer, Fernando A Escobedo, Matthew P DeLisa
Improving the affinity of protein-protein interactions is a challenging problem that is particularly important in the development of antibodies for diagnostic and clinical use. Here, we used structure-based computational methods to optimize the binding affinity of VH NAC1, a single-domain intracellular antibody (intrabody) from the camelid family that was selected for its specific binding to the nonamyloid component (NAC) of human α-synuclein (α-syn), a natively disordered protein, implicated in the pathogenesis of Parkinson's disease (PD) and related neurological disorders...
December 4, 2018: Scientific Reports
Zacariah K Shannon, Stacie A Salsbury, Donna Gosselin, Robert D Vining
BACKGROUND: Few studies have investigated patient and provider expectations of chiropractic care, particularly in multidisciplinary settings. This qualitative study explored stakeholder expectations of adding a chiropractor to the healthcare team at a rehabilitation specialty hospital. METHODS: The research methodology was an organizational case study with an inpatient facility for persons recovering from complex neurological conditions serving as the setting. Sixty stakeholders, including patients, families, hospital staff, and administrators, were interviewed or participated in focus groups in June 2015...
December 4, 2018: BMC Complementary and Alternative Medicine
Amy Armstrong-Javors, Kalpathy Krishnamoorthy
Headache and Neurologic Deficits with cerebrospinal fluid Lymphocytosis (HaNDL) syndrome is a rare stroke mimicker characterized by moderate to severe headache temporally associated with transient neurologic deficits, typically hemiparesis, hemisensory disturbance, and/or aphasia. Cerebrospinal fluid studies reveal a lymphocytosis and elevated protein. Episodes recur over a period no longer than 3 months. Here we describe the case of a 16-year-old boy who presented with 3 episodes of self-resolving neurologic deficits, papilledema on fundoscopic examination, and leptomeningeal enhancement on magnetic resonance imaging (MRI)...
December 5, 2018: Journal of Child Neurology
Joseph F N Siewe, Leonard Ngarka, Godwin Tatah, Michel K Mengnjo, Leonard N Nfor, Eric S Chokote, Charlotte Boullé, Cyrille Nkouonlack, Fidèle Dema, Grace A Nkoro, Wepnyu Y Njamnshi, Earnest N Tabah, Anne-Cécile Zoung-Kanyi Bissek, Robert Colebunders, Alfred K Njamnshi
BACKGROUND: A high prevalence of epilepsy has been observed in several onchocerciasis-endemic countries, including Cameroon. However, little is known on the clinical presentations of the affected persons with epilepsy (PWE). A community-based study was conducted with the aim of describing the spectrum of seizures in selected onchocerciasis-endemic villages in Cameroon and documenting relevant medical history in patients with onchocerciasis-associated epilepsy (OAE). METHODS: We carried out door-to-door surveys in 5 onchocerciasis-endemic villages in Cameroon and recruited all consenting PWE...
December 1, 2018: Epilepsy & Behavior: E&B
Norullah Ramroodi, Hadi Saboori, Nima Sanadgol
Migraine is a chronic neurological disease described by recurrent moderate to severe headaches often in association with neuro-inflammation. As cytokines are affect the immune response and migraine exacerbation, the current study aimed to investigate the possible associations between CD40 polymorphisms and level of soluble CD154 protein with migraine. In a prospective case-control study, we studied blood samples of 190 patients with migraine (migraineurs) and 200 healthy controls (HCs) from southeast Iran. Genotyping for the CD40 (rs4810485-intron, rs1883832-5´-UTR, and rs3765459-intron) gene variants were executed using PCR-RFLP and soluble CD154 protein levels were measured via ELISA method...
November 30, 2018: Cellular and Molecular Biology
S Leopardi, P Priori, B Zecchin, G Poglayen, K Trevisiol, D Lelli, S Zoppi, M T Scicluna, N D'Avino, E Schiavon, H Bourhy, J Serra-Cobo, F Mutinelli, D Scaravelli, P De Benedictis
The wide geographical distribution and genetic diversity of bat-associated lyssaviruses (LYSVs) across Europe suggest that similar viruses may also be harboured in Italian insectivorous bats. Indeed, bats were first included within the passive national surveillance programme for rabies in wildlife in the 1980s, while active surveillance has been performed since 2008. The active surveillance strategies implemented allowed us to detect neutralizing antibodies directed towards European bat 1 lyssavirus in six out of the nine maternity colonies object of the study across the whole country...
December 4, 2018: Epidemiology and Infection
Rupesh Manam, Jasmine L Martin, Joshua A Gross, Dhishna Chaudhary, Sajeel Chowdhary, Patricio S Espinosa, Edgardo S Santos
Pembrolizumab is a humanized monoclonal antibody that blocks the programmed cell death 1 (PD-1) pathway, thereby enhancing antitumor immunity. As the use of immune checkpoint inhibitors becomes more prevalent, so do immune-related adverse events associated with their use. The immune-related adverse events linked with this class of drugs are commonly seen and most of the time are classified as mild adverse events. These are easily treated with steroids if recognition of symptomatology and treatment are promptly established...
September 27, 2018: Curēus
Megumi Yamamoto, Tatsuya Mimura, Koichi Matsumoto, Shigeki Hamano, Hisataka Nanba, Shoko Ubukata, Emiko Watanabe, Atsushi Mizota
Purpose: Iris mammillations are related to oculodermal melanosis and iris nevi. We report a rare case of bilateral simple iris mammillations without ocular melanosis or systemic neuronal disorders. Case Report: A healthy 10-year-old Japanese girl was found incidentally to have bilateral iris mammillations while being treated for amblyopia. The best-corrected visual acuity was 20/40 in both eyes. Ocular examination showed evenly spaced, uniform-size, iris protrusions completely covering the iris surface bilaterally...
2018: Case Reports in Ophthalmological Medicine
Stephanie S L Cheung, Gary K K Lau, Koon-Ho Chan, Ian Y H Wong, Jimmy S M Lai, Wai Kiu Tang, Kendrick C Shih
BACKGROUND: Limbic encephalitis is characterized by rapid onset of working memory deficit, mood changes, and often seizures. The condition has a strong paraneoplastic association, but not all cases are invariably due to tumors. CASE PRESENTATION: We present a case of limbic encephalitis in a Chinese patient who initially presented to our hospital with optic neuritis and no other neurological symptoms. The diagnosis was made radiologically, and cognitive and neurological symptoms did not occur until 5 months later...
December 3, 2018: Journal of Medical Case Reports
Anna Karolina Matczuk, Małgorzata Skarbek, Natalia Anna Jackulak, Barbara Anna Bażanów
BACKGROUND: Equid alphaherpesvirus 1 (EHV-1) is one of the main infectious causative agents of abortion in mares and can also be associated with stillbirth, neonatal foal death, rhinopneumonitis in young horses and a neurological disorder called equine herpesvirus myeloencephalopathy (EHM). The neuropathogenicity of the virus was shown to be significantly higher in EHV-1 strains that carry a single nucleotide point (SNP) mutation in the ORF30, which encodes a catalytic subunit of viral DNA polymerase (ORF30 D752 )...
December 3, 2018: Virology Journal
Hongxiang Wang, Liangzhe Wang, Yicheng Lu, Chengyin Lu, Tao Xu, Yong Yan, Juxiang Chen
Haemangiopericytomas (HPCs) in the spinal canal are extremely rare and have only been infrequently reported. Severe and sustained spinal cord compression resulting from these intraspinal tumours may cause potentially irreversible neurological impairment. We described a rare case of primary intradural extramedullary HPC recovered from serious compression of thoracic spinal cord in a 65-year-old man suffered from a rapidly progressive disease with complete paralysis of the lower limbs. Magnetic resonance imaging (MRI) and spinal angiography exhibited an unusual hypervascular mass, which was confirmed as HPC by pathological examination, in the dorsal aspects of T7 to T8 spine...
2018: Folia Neuropathologica
Sung Ho Jang, Seong Ho Kim, Young Hyeon Kwon
RATIONALE: Many studies using diffusion tensor imaging (DTI) have demonstrated traumatic axonal injury (TAI) in patients whose conventional brain magnetic resonance imaging (MRI) results are negative following head trauma. Injury mechanism for TAI in these patients has been mainly associated with motor vehicle accident, whereas very little is known about TAI by violence. PATIENT CONCERNS: A 42-year-old male patient presented after experiencing head trauma due to violence...
November 2018: Medicine (Baltimore)
Francesco Corallo, Viviana Lo Buono, Marcella Di Cara, Simona De Salvo, Caterina Formica, Rosa Morabito, Daniela Floridia, Concetta Pastura, Carmela Rifici, Giangaetano D'Aleo, Edoardo Sessa, Placido Bramanti, Silvia Marino
RATIONALE: Limbic encephalitis is a parenchymal inflammation caused by viral, bacterial, or other microbial and postinfectious agents, which is usually expressed by multifocal neurological signs and cognitive impairment. PATIENT CONCERNS: A 50-year-old female was admitted in postacute phase, at our rehabilitative Center, to undertake neuro-motor treatment for a period of 4 months. DIAGNOSES: The patient was affected by limbic encephalitis...
November 2018: Medicine (Baltimore)
Imke Kandzia, Michael Kowar, Monika Frackowiak, Andreas H Jacobs
HISTORY AND CLINICAL FINDINGS:  We present a 86-year-old patient who suffered from progressive weakness in his right leg. Due to a hypercholesterinemia he had received Simvastatin for a few years. Because of higher cholesterine levels the dosis had been increased from 40 to 80 mg 6 months ago. INVESTIGATIONS AND DIAGNOSIS:  We saw elevated levels of creatinine kinase and creatinine. In the EMG, a neuromuscular impairment was detected. In context with the medical history we could make the diagnosis of a statin-induced myopathy with rhabdomyolysis...
December 2018: Deutsche Medizinische Wochenschrift
Maximilian Luehr, Christian D Etz, Mikolaj Berezowski, Michael Nozdrzykowski, Thomas Jerkku, Sven Peterss, Michael A Borger, Martin Czerny, Ramin Banafsche, Maximilian A Pichlmaier, Friedhelm Beyersdorf, Christian Hagl, Andrej Schmidt, Bartosz Rylski
BACKGROUND: Our study aim was to evaluate the impact of left subclavian artery (LSA) flow preservation during thoracic endovascular aortic repair (TEVAR) on outcome. METHODS: Between 08/2001-10/2016, 176 patients (mean age 61.3±15.8yrs) underwent TEVAR with complete LSA coverage. Fifty-five of those patients (31.3%) also underwent LSA revascularization while 121 (68.7%) patients did not. Perioperative data was acquired retrospectively for statistical analysis at the three study institutions...
November 30, 2018: Annals of Thoracic Surgery
Suresh S Pillai, Moidu Shameer, Asif Hassan, Abdurehiman K Parambil, Sivasankar Reddy, Bala Vishnu R, Shameem G Mohammad
STUDY DESIGN: A retrospective case series. OBJECTIVE: The aim of this study was to report the immunosuppression and secondary bacterial infection after dengue viral infection and the predilection of these infections in the spine. This can trigger further research in to this fact. The possibility of change in the serotype of dengue virus, which are neurotropic, may be looked into. SUMMARY OF BACKGROUND DATA: This is the largest case series of epidural abscess with or without spondylodiscitis within 6 weeks following dengue virus infection...
December 15, 2018: Spine
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