lumbar punction

BACKGROUND: Production of kappa free light chains (KFLC) represents a part of humoral immune response, along with the synthesis of intrathecal immunoglobulins. Increased concentrations of immunoglobulin G light chains, kappa and lambda chains, were identified through research of numerous diseases of central nervous system. The qualitative method of isoelectric focusing (IEF) followed by immunofixation currently represents the accepted standard in identifying oligoclonal bands (OCB), but establishing a sensitive immunonephelometric method for quantification of kappa free light chains (KFLC) in cerebrospinal fluid (CSF) has paved a way for new diagnostic possibilities...

PURPOSE: To describe the dynamic changes of the intraocular pressure (IOP) and intracranial pressure (ICP) with normal or pathological values (intracranial hypertension) in nonglaucomatous neurological patients during lumbar punction (LP). METHODS: Case-control study, prospective measurement of tonometry in both groups referred for LP. Intraocular pressure, ICP and translaminar pressure difference (TPD) were compared pre- and post-LP. RESULTS: Thirty-six patients (72 eyes) with mean age of 38...

Premature neonates are customarily submitted to invasive painful procedures during their stay in NICUs that are necessary to maintain their clinically stability. Topical anesthesia is a good option to be considered in the treatment of interventions that lead to mild to moderate pain and has the advantage of no systemic effects. In Brazil the most known topical anesthetic available for use is the eutectic mixture of local anesthetics (EMLA® cream). Its efficacy in the treatment of cutaneous painful procedures is well established for children and adults...

Spontaneous intracranial hypotension was first described by Schalternbarn. Severe complications like cerebral venous thrombosis and subdural hemorrhage are seldomly seen. A 40-year-old man was examined for weakness of right arm started 9 months earlier and aggravated in last 3 months. He was undergo a lumbar punction because of a demyelinating plaque at C2 level in MRI. After 10 days of lumbar punction he experienced a generalised tonic clonic seizure. At cranial MRI and venography thrombosed superior sagittal and right transverse sinus and image of pachymeningitis, caused by intracranial hypotension were observed...

Sepsis-associated encephalopathy (SAE) is a diffuse brain dysfunction due to a systemic response to infection. We report the case of a 4-year-old girl with fever and vomiting for 48h, brought to the university hospital of Grenoble because of vigilance disorders, loss of verbal fluency, and a cerebellar syndrome. She had a biological infectious syndrome. Infectious encephalitis was suggested first, but the cerebral scan and the lumbar punction were normal. Magnetic resonance imaging (MRI) showed a diffuse brain edema with extended involvement of cortical and basal ganglia...

The aim of this paper is to demonstrate that differential diagnostics of intra-medullary spinal lesions can sometimes be very difficult, even when the latest complement examinations are used, including magnetic resonance imaging. The particular case dealt with here was complicated by the presence of two different pathological processes. We present the case report, where the case history, clinical course and results of the paraclinical examinations, including the magnetic resonance imaging, suggested an intra-medullary inflammatory/demyelinating process...

The aim of this paper is to demonstrate that differential diagnostics of intra-medullary spinal lesions can sometimes be very difficult, even when the latest complement examinations are used, including magnetic resonance imaging. The particular case dealt with here was complicated by the presence of two different pathological processes. We present the case report, where the case history, clinical course and results of the paraclinical examinations, including the magnetic resonance imaging, suggested an intra-medullary inflammatory/demyelinating process...

OBJECTIVE: To present a new case of an infected simple renal cyst, its diagnosis and the treatment carried out. METHODS: 30 year-old female patient admitted to the Internal Medicine ward suffering a prolonged fever syndrome. On physical examination she presented tachycardia and pain in the left hypochondrium on deep palpation. Abdominal ultrasound revealed the existence of a great size left renal cyst with a highly echogenic content; this liquid hyperdensity was confirmed by simple and i...

INTRODUCTION: Idiopathic intracranial hypertension (IH) occurs most commonly in women and overweight subjects. It must be reported associated to general diseases, like systemic lupus erythematosus (SLE). METHODS: We report an observation of a patient with lupus complicated by glomerulonephritis and IH. OBSERVATION: A 29 years old woman, without overweight, was followed for a SLE with skin and arthritic involvement . Four years after onset, a renal complication appeared with severe nephrotic syndrome...

Noradrenergic and HPA axis dysregulation may play a role in suicide risk. Studies of suicide risk have not found consistent relationship to the noradrenaline metabolite 3-methoxy-4-hydroxphenylglycol (MHPG) in the cerebrospinal fluid (CSF). Non-suppression in the dexamethasone test (DST) has been associated with increased risk of suicide in depressed patients. The study sample consisted of 51 mood disorder inpatients admitted to the Department of Psychiatry at the Karolinska University Hospital between 1980 and 2000...

BACKGROUND: Streptococcus pneumoniae is a rare cause of sepsis in the newborn. CASE: The term baby was admitted on complaint of dyspnea, and antibiotherapy was begun after samples for hemocultures were obtained with the suspicion of sepsis according to the clinical and laboratory data. S. pneumoniae was demonstrated in the vaginal culture of the mother of the patient whose lumbar punction and chest roentgenogram were normal but hemoculture revealed the propagation of S...

BACKGROUND: Febrile seizure is a frequent cause of hospitalization. Its management remains problematic. According to the American Academy of Pediatrics, lumbar puncture, which is not devoid of risk, is strongly recommended in infants under 1 year. AIM: to define the utility of lumbar puncture in the management of febrile seizures in infants under 12 months and to identify risk factors of meningitis and to respond to this question: "lumbar punction should be done in which infant with febrile seizure?" PATIENTS AND METHODS: This retrospective study was conducted in the department of pediatrics B in the Children Hospital of Tunis on eight-year period (2000-2008)...

We here report a 13-year-old Marfan patient who suffered from severe, medication-resistant, intermittent headache, which was provoked when getting into an upright position and immediately relieved by lying down or after intravenous rehydration. The postural benefit and the sudden relief after intravenous hydration suggested (intermittent) intracranial hypotension, although a normal opening pressure on lumbar punction was observed and no cerebrospinal fluid (CSF) leakage was identified. Imaging studies revealed severe dural ectasia at lumbosacral level, and two intradural cysts and two extradural presacral cysts were detected...

STUDY DESIGN: A case report of spontaneous pyogenic spondylodiscitis and epidural abscess in vertebral fracture by an uncommon pathogen is described. OBJECTIVE: The uncommon presentation of spondylodiscitis with epidural abscess due to Gemella morbillorum after an acute lumbar vertebral fracture treated conservatively is discussed. SUMMARY OF BACKGROUND DATA: Spontaneous spondylodiscitis and epidural abscess in nonsurgical fractures is exceptionally rare...

INTRODUCTION: Benign convulsions with mild gastroenteritis (CwG) are a rare diagnosis in Western countries, and it is characterized by afebrile seizures, almost times more than once, during a gastroenteritis without severe hydroelectrolitic affection. The most frequent implied virus is rotavirus. This is a benign disease, in spite of cluster seizures, and neither complementary explorations nor antiepileptic treatment is required. PATIENTS AND METHODS: Seven cases between 6 and 27 months aged of CwG due to rotavirus are reported...

INTRODUCTION: Eosinophilic meningoencephalitis due to Angiostrongylus cantonensis is an emergent infectious disease in our area. The objective of the present paper is to determine if the activation of the complement system was taken placed with the C3c production in cerebrospinal fluid. PATIENTS AND METHODS: 14 patients with an average age 4.5 years were studied. In such patients a lumbar punction was performed. C3c was quantified in serum and cerebrospinal fluid by radial immunodiffusion...

UNLABELLED: The goals of this paper were to study the various types of digestive disease in acute lymphoblastic leukemia (ALL), to characterize the children in the study group by age, sex and environment, by presence of liver and spleen enlargement, levels of GOT, GPT, vomiting, to evaluate methotrexate (MTX) serum levels al 24 hours and 48 hours after administration, and to analyze the correlation between MTX levels and MTX liver and blood toxicity. MATERIAL AND METHOD: We studied 39 immunocompromised children hospitalized in the IV-th Pediatric Clinic-Oncology Ward, between 1983-2005, with acute lymphoblastic leukemia (ALL); most of them exhibited defects of humoral immunity such as transitory hypogammaglobulinemia, and defects of the cellular immunity that accompanied hepatomegaly, hepatic cytolysis and biliary obstruction...

We report the story of a 81 year old man referred for confusion and unexplained hyperthermia. He had no meningeal sign. Routine emergency examinations (CT scanner and lumbar punction) were not contributory, but, later, PCR for herpes virus was highly positive and cerebral CT scan showed the temporal lobe necrosis typical of an herpes virus meningoencephalitis. This severe neurologic emergency is then shortly discussed.

Facial palsy is a uncommon clinical manifestation that it can be caused by different etiologies. We show a patient with a chronic periodontal disease who presented a sudden facial palsy, initially in left-face but it becomes bilateral quickly. In few days he associated paresthesias in his right arm and hyporreflexia. These clinical findings with albumin-cytological dissociation, they had allowed to establish the diagnosis of regional variant of Guillain-Barré Syndrome (SGB). Facial diplejia is an idiopathic manifestation in 25% of patients, and this is the most common cause...

The major causes of central diabetes insipidus are neoplastic or infiltrative lesions of the hypothalamus or pituitary, severe head injuries and pituitary or hypothalamic surgery. Central diabetes insipidus caused by viral infections has been rarely reported in immunosuppressed patients, such as those with acquired immunodeficiency syndrome or Cushing's syndrome. We report the case of a 48-year-old woman suffering from diffuse large cell lymphoma, who developed hypotonic polyuria, hypernatriaemia and somnolence after the first course of chemotherapy with CHOEP and rituximab...