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https://www.readbyqxmd.com/read/28194064/therapeutic-plasma-exchange-in-patients-with-neurologic-disorders-review-of-63-cases
#1
Anil Tombak, Mehmet Ali Uçar, Aydan Akdeniz, Arda Yilmaz, Hakan Kaleagası, Mehmet Ali Sungur, Eyup Naci Tiftik
Therapeutic plasma exchange (TPE) is a procedure that reduces circulating autoantibodies of the patients. TPE is commonly used in neurological disorders where autoimmunity plays a major role. We report our experience with regard to the indications, adverse events and outcomes of plasma exchange in neurological disorders. Sixty-three patients were included to this retrospective study. Median age was 48 years (range 1-85), there was a predominance of males. Neurological indications included Guillain-Barrè syndrome (n = 22), myasthenia gravis (n = 21), chronic inflammatory demyelinating polyneuropathy (n = 7), polymyositis (n = 3), multifocal motor neuropathy (n = 2), acute disseminated encephalomyelitis (n = 2), neuromyelitis optica (n = 2), multiple sclerosis (n = 2), limbic encephalitis (n = 1) and transverse myelitis (n = 1)...
March 2017: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/28174188/cervical-spine-arteriovenous-fistula-associated-with-hereditary-haemorrhagic-telangiectasia
#2
Iain John McGurgan, Roisin Lonergan, Ronan Killeen, Christopher McGuigan
Reported is a case of a man aged 55 years who presented with progressive spastic paraparesis. Examination demonstrated multiple cutaneous telangiectases. Subsequent development of upper limb weakness, acute urinary retention and eventual respiratory compromise resulted in the requirement for intensive care unit admission and mechanical ventilation. MRI spine revealed diffuse T2 hyperintensity in the cervical cord with enhancement and cord expansion. Immunomodulatory therapy for a presumed diagnosis of transverse myelitis yielded no response, so a vascular aetiology was suspected...
February 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28174033/acute-hypotonia-in-an-infant
#3
Jimme Sierakowski, Jason Arthur, Todd Wylie
BACKGROUND: Acute flaccid myelitis (AFM) is increasing in incidence in the United States and presenting to emergency departments (EDs) across the country. This clinical entity presents as acute paralysis, with magnetic resonance imaging changes in the gray matter only in children younger than 21 years of age. The etiology is unknown, although preceding viral illnesses are common. There are no consensus guidelines regarding treatment. CASE REPORT: A 4-month-old girl presented with decreased bilateral arm movement...
February 4, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28149080/urodynamic-profile-in-acute-transverse-myelitis-patients-its-correlation-with-neurological-outcome
#4
Anupam Gupta, Sushruth Nagesh Kumar, Arun B Taly
OBJECTIVE: The objective of this study was to observe urodynamic profile of acute transverse myelitis (ATM) patients and its correlation with neurological outcome. PATIENTS AND METHODS: This prospective study was conducted in the neurorehabilitation unit of a tertiary university research hospital from July 2012 to June 2014. Forty-three patients (19 men) with ATM with bladder dysfunction, admitted in the rehabilitation unit, were included in this study. Urodynamic study (UDS) was performed in all the patients...
January 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28115665/successfully-managed-acute-transverse-myelitis-related-to-scrub-typhus-and-serial-image-findings
#5
Jae Sung Yun, Ji Soo Song, Eun Jung Choi, Jeong-Hwan Hwang, Chang-Seop Lee, Eun Hae Park
Central nervous system involvement manifesting as meningitis or meningoencephalitis is a known complication of scrub typhus, but very few spinal cord lesions such as acute transverse myelitis (ATM) have been reported in association with this disease. Scrub typhus patients with a spinal lesion present with neurologic symptoms including dysuria, motor, and sensory weakness. Herein, we describe a rare case of ATM associated with scrub typhus. Clinical characteristics, cerebrospinal fluid cytology, Orientia tsutsugamushi serum antibody titer, and serial magnetic resonance imaging scans resulted in a diagnosis of ATM associated with scrub typhus...
January 23, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28109263/common-and-uncommon-neurological-manifestations-of-neuroborreliosis-leading-to-hospitalization
#6
Philipp Schwenkenbecher, Refik Pul, Ulrich Wurster, Josef Conzen, Kaweh Pars, Hans Hartmann, Kurt-Wolfram Sühs, Ludwig Sedlacek, Martin Stangel, Corinna Trebst, Thomas Skripuletz
BACKGROUND: Neuroborreliosis represents a relevant infectious disease and can cause a variety of neurological manifestations. Different stages and syndromes are described and atypical symptoms can result in diagnostic delay or misdiagnosis. The aim of this retrospective study was to define the pivotal neurological deficits in patients with neuroborreliosis that were the reason for admission in a hospital. METHODS: We retrospectively evaluated data of patients with neuroborreliosis...
January 21, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28095134/physical-and-occupational-therapy-for-a-teenager-with-acute-flaccid-myelitis-a-case-report
#7
Tracy Kornafel, Elaine Y Tsao, Emily Sabelhaus, Lori Surges, Susan D Apkon
AIMS: The purpose of this case report is to describe the inpatient rehabilitation program of a 13-year-old boy with acute flaccid myelitis (AFM), specific to physical and occupational therapy examination, treatment, and outcomes. CASE DESCRIPTION: AFM is a rare, acute neurologic illness in children and young adults who present with weakness and/or paralysis of unknown etiology. The teenager was admitted to the program, dependent for all mobility and self-care. Interventions focused on range of motion, transfer training, self-care, power wheelchair mobility, and environmental adaptations...
January 17, 2017: Physical & Occupational Therapy in Pediatrics
https://www.readbyqxmd.com/read/28074391/etiologic-spectrum-and-functional-outcome-of-the-acute-inflammatory-myelitis
#8
Edgar Carnero Contentti, Javier Pablo Hryb, Ana Diego, José Luis Di Pace, Mónica Perassolo
Clinical, neuroimaging, and laboratory features are not specific enough to establish the etiological diagnosis of the acute inflammatory myelitis (AIM). Longitudinally extensive transverse myelitis (LETM) seen on magnetic resonance imaging (MRI) has been associated with a poor functional prognosis. The aim of this study was to assess the functional outcomes of a first AIM event comparing patients with LETM vs. no LETM on MRI and to report the differential diagnosis. Clinical, radiological, biochemical aspects were collected, and Winner-Hughes Functional Disability Scale (WHFDS) was performed after 3 and 6 months...
January 10, 2017: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/28071799/seroepidemiological-and-phylogenetic-characterisation-of-neurotropic-enteroviruses-in-ireland-2005-2014
#9
Jorge Abboud Guerra, Allison Waters, Alison Kelly, Ursula Morley, Paul O'Reilly, Edwin O'Kelly, Jonathan Dean, Robert Cunney, Piaras O'Lorcain, Suzanne Cotter, Jeff Connell, Joanne O'Gorman, William W Hall, Michael Carr, Cillian F De Gascun
Enteroviruses (EVs) are associated with a broad spectrum of clinical presentation, including aseptic meningitis (AM), encephalitis, hand, foot and mouth disease, acute flaccid paralysis and acute flaccid myelitis. Epidemics occur sporadically and are associated with increased cases of AM in children. The present study describes the seroepidemiological analysis of circulating EVs in Ireland from 2005-2014 and phylogenetic characterisation of echovirus 30 (E-30), enterovirus A71 (EV-A71) and enterovirus D68 (EV-D68)...
January 10, 2017: Journal of Medical Virology
https://www.readbyqxmd.com/read/28068933/screening-for-onconeural-antibodies-in-neuromyelitis-optica-spectrum-disorders
#10
Benjamin Berger, Tilman Hottenrott, Sebastian Rauer, Oliver Stich
BACKGROUND: Some so-called "non-classical" paraneoplastic neurological syndromes (PNS), namely optic neuritis and myelitis, clinically overlap with neuromyelitis optica spectrum disorders (NMOSD), and conversely, in cancer-associated NMOSD, a paraneoplastic etiology has been suggested in rare cases. Therefore, we retrospectively investigated the prevalence of onconeural antibodies, which are highly predictive for a paraneoplastic etiology, and the prevalence of malignancies in NMOSD patients...
January 10, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28025408/a-case-of-anti-aquapolin-4-antibody-positive-myelitis-with-hyperhidrosis-following-herpes-zoster
#11
Machiko Suda, Michiko Tsutsumiuchi, Yoshikazu Uesaka, Nobukazu Hayashi
We report an acute myelitis in a 53-year-old woman that occurred in 7 days after the diagnosis of Th5-6 herpes zoster. Clinical examination revealed hyperhidrosis of left side of her face, neck, arm and upper chest. She also had muscle weakness of her left leg and sensory impairment for light touch and temperature in her chest and legs. Spinal cord MRI demonstrated a longitudinal T2-hyperintense lesion extending from Th1 to 7. In the axial imaging, the lesion dominantly located in the left side gray matter...
December 23, 2016: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/28018472/concurrency-of-guillain-barre-syndrome-and-acute-transverse-myelitis-a-case-report-and-review-of-literature
#12
Orkun Tolunay, Tamer Çelik, Ümit Çelik, Mustafa Kömür, Zeynep Tanyeli, Abdurrahman Sönmezler
Guillain-Barré syndrome and acute transverse myelitis manifest as demyelinating diseases of the peripheral and central nervous system. Concurrency of these two disorders is rarely documented in literature. A 4-year-old girl presenting with cough, fever, and an impaired walking ability was admitted to hospital. She had no previous complaints in her medical history. A physical examination revealed lack of muscle strength of the lower extremities and deep tendon reflexes. MRI could not be carried out due to technical problems; therefore, both Guillain-Barré syndrome and acute transverse myelitis were considered for the diagnosis...
November 2016: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/28000111/uncommon-disorders-masquerading-as-acute-flaccid-paralysis-in-children
#13
Meenal Garg, Shilpa D Kulkarni, Varsha Patil, Rafat Sayed, Anaita Udwadia Hegde
The syndrome of acute flaccid paralysis (AFP) is a common medical emergency in children. In the era of poliomyelitis eradication, the common causes of AFP include Guillain-Barré syndrome (GBS), transverse myelitis and traumatic neuritis. However, many common diseases can uncommonly present as AFP and some uncommon diseases may also masquerade like it. Uncommon causes of AFP seen at a tertiary care pediatric hospital are discussed along with relevant points in diagnosis and management. Also, common pitfalls in diagnosis of pediatric AFP and an approach to investigations are discussed...
December 21, 2016: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/27995511/zika-virus-disease-for-the-neurointensivist
#14
Daniel M Pastula, Julia C Durrant, Daniel E Smith, J David Beckham, Kenneth L Tyler
Zika virus (ZIKV) is a mosquito-borne and sexually transmitted flavivirus currently spreading throughout the Pacific and Western Hemisphere. ZIKV infection is often either asymptomatic or causes a self-limiting illness with symptoms such as rash, fever, myalgia, arthralgia, headache, or conjunctivitis. Rarely, ZIKV infection has been associated with conditions such as severe thrombocytopenia, microcephaly and other developmental abnormalities, acute polyneuropathy/Guillain-Barré syndrome, myelitis, meningoencephalitis, transient encephalopathy, provoked seizures, and various ophthalmologic conditions...
December 19, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27979798/mri-atlas-based-measurement-of-spinal-cord-injury-predicts-outcome-in-acute-flaccid-myelitis
#15
D B McCoy, J F Talbott, Michael Wilson, M D Mamlouk, J Cohen-Adad, Mark Wilson, J Narvid
BACKGROUND AND PURPOSE: Recent advances in spinal cord imaging analysis have led to the development of a robust anatomic template and atlas incorporated into an open-source platform referred to as the Spinal Cord Toolbox. Using the Spinal Cord Toolbox, we sought to correlate measures of GM, WM, and cross-sectional area pathology on T2 MR imaging with motor disability in patients with acute flaccid myelitis. MATERIALS AND METHODS: Spinal cord imaging for 9 patients with acute flaccid myelitis was analyzed by using the Spinal Cord Toolbox...
December 15, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/27956656/transverse-myelitis-as-an-unusual-complication-of-dengue-fever
#16
Mânlio Tasso de Oliveira Mota, Cássia Fernanda Estofolete, Nathalia Zini, Ana Carolina Bernardes Terzian, Delzi Vinha Nunes Gongora, Irineu Luiz Maia, Maurício Lacerda Nogueira
Dengue fever is the most common arbovirus disease, and presents with a large spectrum of clinical manifestations ranging from asymptomatic disease through to the development of dengue hemorrhagic fever. These extreme cases can lead to dengue shock syndrome, and sometimes death. Spinal cord involvement in dengue virus (DENV) infections is rare. Here, we report a case in which the patient developed acute transverse myelitis (TM) without paraparesis following a DENV infection. This case highlights the importance of physicians' awareness of the possible link between DENV and TM in endemic areas...
February 8, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/27936193/occurrence-of-asymptomatic-acute-neuromyelitis-optica-spectrum-disorder-typical-brain-lesions-during-an-attack-of-optic-neuritis-or-myelitis
#17
Su-Hyun Kim, Jae-Won Hyun, AeRan Joung, Sang Hyun Lee, Ho Jin Kim
We aimed to investigate the frequency of asymptomatic acute brain MRI abnormalities accompanying optic neuritis (ON) or myelitis in neuromyelitis optica spectrum disorder (NMOSD) patients with aquaporin-4 antibodies (AQP4-Ab). We reviewed 324 brain MRI scans that were obtained during acute attacks of ON or myelitis, in 165 NMOSD patients with AQP4-Ab. We observed that acute asymptomatic NMOSD-typical brain lesions accompanied 27 (8%) acute attacks of ON or myelitis in 24 (15%) patients. The most common asymptomatic brain abnormalities included edematous corpus callosum lesions (n = 17), followed by lesions on the internal capsule and/or cerebral peduncle lesions (n = 9), periependymal surfaces of the fourth ventricle (n = 5), large deep white matter lesions (n = 4), periependymal cerebral lesions surrounding the lateral ventricles (n = 3), and hypothalamic lesions (n = 1)...
2016: PloS One
https://www.readbyqxmd.com/read/27928148/acute-transverse-myelitis-associated-with-salmonella-bacteremia-a-case-report
#18
Mary E Richert, Hillary Hosier, Adam S Weltz, Eric S Wise, Manjari Joshi, Jose J Diaz
BACKGROUND Acute transverse myelitis (ATM) is an uncommon and often overlooked complication of certain bacterial and viral infections that can have a rapid onset and result in severe neurological deficits.  CASE REPORT This case report describes a previously healthy 28-year-old woman who presented to the trauma center after developing acute paralysis and paresthesias of all four extremities within the span of hours. The initial presumptive diagnosis was spinal cord contusion due to a fall versus an unknown mechanism of trauma, but eventual laboratory studies revealed Salmonella bacteremia, indicating a probable diagnosis of parainfectious ATM...
December 8, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27923705/icam-5-telencephalin-is-a-functional-entry-receptor-for-enterovirus-d68
#19
Wei Wei, Haoran Guo, Junliang Chang, Yingzi Yu, Guanchen Liu, Nannan Zhang, Stephen H Willard, Shu Zheng, Xiao-Fang Yu
Enterovirus D68 (EV-D68) is a member of the Picornaviridae family. Although EV-D68-associated infection was once considered rare, it has been increasing in recent years. EV-D68 infection is most frequently associated with respiratory illness. However, it has also been implicated in a polio-like neurological disorder, acute flaccid myelitis. Although sialic acid has been implicated in EV-D68 entry, the existence of a protein receptor has yet to be clarified. Here we identify neuron-specific intercellular adhesion molecule 5 (ICAM-5/telencephalin) as a cellular receptor for sialic acid-dependent and -independent EV-D68 viruses...
November 9, 2016: Cell Host & Microbe
https://www.readbyqxmd.com/read/27920716/acute-clinical-worsening-after-steroid-administration-in-cervical-myelitis-may-reveal-a-subdural-arteriovenous-fistula
#20
Silvia Rain, Jan Udding, Daniel Broere
Subdural arteriovenous fistula (SDAVF) is a rare condition characterized by clinical manifestations ranging from mild bilateral sensory deficits to quadriplegia. The diagnosis is often delayed due to unspecific neurological symptoms, initially diagnosed as polyneuropathy or myelopathy. The diagnosis can be delayed for as long as 1-15 years. The following report describes a cervical SDAVF case initially misdiagnosed as myelitis transversa and treated with intravenous steroids. A 56-year-old male presented with sensory deficits and mild leg and right arm weakness...
September 2016: Case Reports in Neurology
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