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neurologic disturbances in pregnancy

Lauren E Mak, B Anne Croy, Vanessa Kay, James N Reynolds, Matthew T Rätsep, Nils D Forkert, Graeme N Smith, Angelina Paolozza, Patrick W Stroman, Ernesto A Figueiró-Filho
BACKGROUND: Individuals (PE-F1s) born from preeclampsia (PE)-complicated pregnancies have elevated risks for cognitive impairment. Intervals of disturbed maternal plasma angiokines precede clinical signs of PE. We hypothesized pan-blastocyst dysregulation of angiokines underlies altered PE-F1 brain vascular and neurological development. This could alter brain functional connectivity (FC) patterns at rest. MATERIALS AND METHODS: Resting-state functional MRI datasets of ten, matched child pairs (5 boys and 5 girls aged 7-10 years of age) from PE or control pregnancies were available for study...
February 7, 2018: Pregnancy Hypertension
Kyoko Fujii, Makoto Orisaka, Makoto Yamamoto, Koji Nishijima, Yoshio Yoshida
Introduction: Primary spinal cord tumours can lead to severe neurological complications and even death. Pregnant women often complain of discomfort of the lower limbs, which is usually caused by sciatica. Here we present the case of a pregnant woman, who was initially considered to have sciatica, but was finally diagnosed with a primary intramedullary spinal cord tumour. Case presentation: A 28-year-old pregnant woman presented to our hospital with inexplicable numbness in her lower limbs...
2018: Spinal Cord Series and Cases
Michael Tchirikov, Erich Saling, Gauri Bapayeva, Michael Bucher, Oliver Thews, Gregor Seliger
In the first case, the AA and glucose were infused through a perinatal port system into the umbilical vein at 30 weeks' gestation due to severe IUGR. The patient received daily hyperbaric oxygenation (HBO, 100% O2 ) with 1.4 atmospheres absolute for 50 min for 7 days. At 31+4  weeks' gestation, the patient gave birth spontaneously to a newborn weighing 1378 g, pH 7.33, APGAR score 4/6/intubation. In follow-up examinations at 5 years of age, the boy was doing well without any neurological disturbance or developmental delay...
March 2018: Physiological Reports
Mohammad Ahmad
Mercury and its derivatives even in small concentration may cause a major human health problem. Though not reported in detail, there are various aquatic bacterial species that produce small quantities of methyl mercury (MM) growing under aerobic conditions. Consumption of food derived from sources contaminated with such bacteria within therapeutic doses and exposure to different forms of MM compounds through such sources may induce substantial toxic effects. In the present study, the perinatal oral exposure of pregnant mice to two strains of mercury resistant bacteria (MRB), Aeromonas KSU5 MRB and KSU6 MRB resulted in a significant reduction in postnatal body weight gain, delays in the opening of the eyes and appearance in the body hair fuzz, and deficits in the developing sensory motor reflexes in the mice pups during their weaning period on post-natal day (PD)7, PD14 and PD21...
January 2018: Microbial Pathogenesis
Ahmed Mustafa Ibrahim, Tarek Talaat ElSefi, Maha Ghanem, Akram Muhammad Fayed, Nesreen Adel Shaban
Neurological complications of snake bites have been well documented in the literature as neuromuscular paralysis and cerebrovascular complications; posterior reversible encephalopathy syndrome was rarely described. A 23-year-old lady presented near full term of her pregnancy with a horned snake Cerastes cerastes bite; after successful delivery she started complaining of altered mental status and visual disturbance with ulceration over the site of the snake bite. On admission, the patient had Glasgow Coma Score of 12, blood pressure 130/80 mmHg, temperature 38°C, sinus tachycardia at 120 beats per minute, severe dehydration, and reduction in visual acuity to "hand motion" in both eyes with poor light projection and sluggish pupillary reactions...
2017: Case Reports in Neurological Medicine
Maria Nelander, Jan Weis, Lina Bergman, Anders Larsson, Anna-Karin Wikström, Johan Wikström
BACKGROUND: Magnesium sulfate (MgSO4) is used as a prophylaxis for eclamptic seizures. The exact mechanism of action is not fully established. We used phosphorus magnetic resonance spectroscopy (31P-MRS) to investigate if cerebral magnesium (Mg2+) levels differ between women with preeclampsia, normal pregnant, and nonpregnant women. METHODS: This cross-sectional study comprised 28 women with preeclampsia, 30 women with normal pregnancies in corresponding gestational week (range: 23-41 weeks) and 11 nonpregnant healthy controls...
July 1, 2017: American Journal of Hypertension
Renata H Bahous, Nafisa M Jadavji, Liyuan Deng, Marta Cosín-Tomás, Jessica Lu, Olga Malysheva, Kit-Yi Leung, Ming-Kai Ho, Mercè Pallàs, Perla Kaliman, Nicholas D E Greene, Barry J Bedell, Marie A Caudill, Rima Rozen
Methylenetetrahydrofolate reductase (MTHFR) generates methyltetrahydrofolate for methylation reactions. Severe MTHFR deficiency results in homocystinuria and neurologic impairment. Mild MTHFR deficiency (677C > T polymorphism) increases risk for complex traits, including neuropsychiatric disorders. Although low dietary folate impacts brain development, recent concerns have focused on high folate intake following food fortification and increased vitamin use. Our goal was to determine whether high dietary folate during pregnancy affects brain development in murine offspring...
March 1, 2017: Human Molecular Genetics
Mohamed Adnane Berdai, Smael Labib, Mustapha Harandou
Wernicke's encephalopathy is caused by severe thiamine deficiency; it is mostly observed in alcoholic patients. We report the case of a 28-year-old woman, at 17 weeks of gestational age, with severe hyperemesis gravidarum. She presented with disturbance of consciousness, nystagmus, ophthalmoplegia, and ataxia. The resonance magnetic imagery showed bilaterally symmetrical hyperintensities of thalamus and periaqueductal area. The case was managed with very large doses of thiamine. The diagnosis of Wernicke's encephalopathy was confirmed later by a low thiamine serum level...
2016: Case Reports in Critical Care
P Berlit
Neurological disorders caused by pregnancy and puerperium include the posterior reversible encephalopathy syndrome, the amniotic fluid embolism syndrome (AFES), the postpartum angiopathy due to reversible vasoconstriction syndrome, and the Sheehan syndrome. Hypertension and proteinuria are the hallmarks of preeclampsia, seizures define eclampsia. Hemolysis, elevated liver enzymes and low platelets constitute the HELLP syndrome. Vision disturbances including cortical blindness occur in the posterior reversible encephalopathy syndrome (PRES)...
February 2016: Fortschritte der Neurologie-Psychiatrie
Ankuri Desai, Jeffrey M Sequeira, Edward V Quadros
Folates are essential in the intermediary metabolism of amino acids, synthesis of nucleotides and for maintaining methylation reactions. They are also linked to the production of neurotransmitters through GTP needed for the synthesis of tetrahydrobiopterin. During pregnancy, folate is needed for fetal development. Folate deficiency during this period has been linked to increased risk of neural tube defects. Disturbances of folate metabolism due to genetic abnormalities or the presence of autoantibodies to folate receptor alpha (FRα) can impair physiologic processes dependent on folate, resulting in a variety of developmental disorders including cerebral folate deficiency syndrome and autism spectrum disorders...
July 2016: Biochimie
Mirta Starčević, Maja Predojević, Dražan Butorac, Jasna Tumbri, Paško Konjevoda, Aida Salihagić Kadić
AIMS: To determine whether the brain disturbances develop in late-onset intrauterine growth restriction (IUGR) before blood flow redistribution towards the fetal brain (detected by Doppler measurements in the middle cerebral artery and umbilical artery). Further, to evaluate predictive values of Doppler arterial indices and umbilical cord blood gases and pH for early functional and/or morphological brain disturbances in late-onset IUGR. STUDY DESIGN: This cohort study included 60 singleton term pregnancies with placental insufficiency caused late-onset IUGR (IUGR occurring after 34 gestational weeks)...
February 2016: Early Human Development
Lingyun Yang, Pang Xu, Mingrong Xi, Hongjing Wang
Choriocarcinoma is a rare, highly malignant neoplasm, which may occur during or following any type of pregnancy. This tumor often demonstrates rapid hematogenous spread to multiple organs, and is associated with high human chorionic gonadotropin (HCG) levels and a good response to chemotherapy. In the present study, the case of a 29-year-old female with distant metastatic choriocarcinoma [International Federation of Gynecology and Obstetrics (FIGO) stage IV; World Health Organization score, 15], who was misdiagnosed with pulmonary tuberculosis at a local hospital is presented...
September 2015: Oncology Letters
F Begum, K Nahar, M U Ahmed, R A Ferdousi, F A Akter, M M Rahman
This cross sectional study was carried out in the Department of Obstetrics & Gynaecology in Mymensingh Medical College Hospital during the period of January 2011 to December 2012 to evaluate neurological manifestations in eclampsia by CT scan of brain. A total 35 patients with eclampsia were studied, who underwent CT scan of brain in Radiology & Imaging Department of Mymensingh Medical College Hospital. The study patients were divided into two groups, those who had changes in brain on CT scan (Group A) & those who had no changes in brain on CT scan (Group B)...
October 2015: Mymensingh Medical Journal: MMJ
Johannes Kerschbaumer, Christian F Freyschlag, Günter Stockhammer, Susanne Taucher, Hans Maier, Claudius Thomé, Marcel Seiz-Rosenhagen
Meningiomas are known to be associated with female sex hormones. Worsening neurological symptoms or newly diagnosed meningiomas have been described in the context of elevated levels of sex hormones, for example, in pregnancy. To the authors' knowledge, tumor shrinkage after the normalization of hormones has not been described, even if it is known that neurological deficits due to meningioma compression may improve after giving birth. A 32-year-old female patient presented with severe headache and vision disturbances at the end of her second pregnancy...
January 2016: Journal of Neurosurgery
Pranita, Ajit Kumar, Seema Shahi, Debasish Choudhary
Pregnancy Induced Hypertension (PIH) is a condition characterised by raised blood pressure in pregnancy. It affects approximately one out of every 14 pregnant women. Although PIH more commonly occurs during first pregnancy, it can also occur in subsequent pregnancies. It can present with variable complications related to vasospasm. But focal neurologic deficits are extremely rare in patients with PIH. We report a case of quadriparesis due to posterior reversible encephalopathy syndrome (PRES). A 36 year old full term pregnant female was admitted for emergency lower segment caesarean section (LSCS) as a result of uncontrolled PIH with early clinical signs of left ventricular failure...
April 2015: Journal of Clinical and Diagnostic Research: JCDR
E Nash, P Ranka, G Tarigopula, T Rashid
Primary hyperparathyroidism is rare during pregnancy. Recognition may be challenging as symptoms overlap with those of other common disorders of pregnancy. Furthermore, physiological changes of pregnancy affecting calcium homoeostasis mean awareness of the condition and careful interpretation of results in the light of pregnancy are essential for diagnosis. Maternal complications of primary hyperparathyroidism include nephrolithiasis, pancreatitis, cardiac arrhythmias, hypertension and peptic ulcers. At its most severe, hypercalcaemic crisis may occur, presenting with acute neurological disturbance...
March 27, 2015: BMJ Case Reports
G Lambert, J F Brichant, G Hartstein, V Bonhomme, P Y Dewandre
Preeclampsia was formerly defined as a multisystemic disorder characterized by new onset of hypertension (i.e. systolic blood pressure (SBP) ≥ 140 mmHg and/or diastolic blood pressure (DBP) ≥ 90 mmHg) and proteinuria (> 300 mg/24 h) arising after 20 weeks of gestation in a previously normotensive woman. Recently, the American College of Obstetricians and Gynecologists has stated that proteinuria is no longer required for the diagnosis of preeclampsia. This complication of pregnancy remains a leading cause of maternal morbidity and mortality...
2014: Acta Anaesthesiologica Belgica
B De Keersmaecker, P Ramaekers, F Claus, I Witters, E Ortibus, G Naulaers, F Van Calenbergh, L De Catte
OBJECTIVES: To investigate the natural history, associated abnormalities and outcome of 12 fetuses with arachnoid cyst diagnosed antenatally by ultrasound and magnetic resonance imaging and to compare the outcome with cases in the literature. METHODS: A retrospective study of all cases of antenatally detected fetal arachnoid cysts was performed in patients referred to a tertiary unit between 2007 and 2013. Associated abnormalities, pregnancy outcome and postnatal follow-up were analyzed...
March 2015: European Journal of Paediatric Neurology: EJPN
Gillian Douglas, Ashley B Hale, Mark J Crabtree, Brent J Ryan, Alex Hansler, Katrin Watschinger, Steven S Gross, Craig A Lygate, Nicholas J Alp, Keith M Channon
INTRODUCTION: GTP cyclohydrolase I (GTPCH) catalyses the first and rate-limiting reaction in the synthesis of the enzymatic cofactor, tetrahydrobiopterin (BH4). Loss of function mutations in the GCH1 gene lead to congenital neurological diseases such as DOPA-responsive dystonia and hyperphenylalaninemia. However, little is known about how GTPCH and BH4 affects embryonic development in utero, and in particular whether metabolic replacement or supplementation in pregnancy is sufficient to rescue genetic GTPCH deficiency in the developing embryo...
March 1, 2015: Developmental Biology
Akihiro Inoue, Shohei Kohno, Yoshiaki Kumon, Hideaki Watanabe, Takanori Ohnishi, Hisashi Hashimoto, Keiichi Matsubara
We report herein a case of cerebellar hemangioblastoma complicated by pregnancy and concerns about the period in which surgery could be performed successfully. A 19-year-old woman, who was also 35 weeks pregnant, was admitted to our hospital with headache, nausea, and general fatigue. Neurological examination on admission revealed disturbed consciousness, and the patient's general condition was poor. Computed tomography and magnetic resonance imaging showed a large tumor in the cerebellar vermis along with an obstructive hydrocephalus...
January 2015: No Shinkei Geka. Neurological Surgery
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