scholarly journals Uncommon Cause of Psychotic Behavior in a 9-Year-Old Girl: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Willemina K. Van Putten ◽  
Said Hachimi-Idrissi ◽  
Anna Jansen ◽  
Viola Van Gorp ◽  
Luc Huyghens
Keyword(s):  
Cerebrospinal Fluid ◽  
Case Report ◽  
Nmda Receptor ◽  
Intravenous Immunoglobulin ◽  
Adult Women ◽  
Mycoplasma Infection ◽  
Autonomic Instability ◽  
Life Threatening ◽  
Full Neurological Recovery ◽  
Psychotic Behavior

Anti-N-methyl-D-aspartate receptors encephalitis (ANMDARE) is a well-defined, life threatening, but treatable disorder that often occurs as a paraneoplastic manifestation of ovarian teratomas in adult women. We report a child with this disorder who displayed a subacute onset of delirium, seizures, and autonomic instability. Antibodies against NMDA receptor were detectable in the serum and in the cerebrospinal fluid. No teratoma or other tumour was detected. We speculate that the previous viral/mycoplasma infection may be the trigger of this encephalitis. This patient showed a reversal of the neurological symptoms after intravenous immunoglobulin. Prompt recognition of this disorder followed by immunotherapy results in full neurological recovery.

Acute Disseminated Encephalomyelitis (ADEM) in Adult Women, Is it Unpreceded by Infection History?: A Case Report

2021 ◽  
Vol 8 (10) ◽  
pp. 21-27
Author(s):  
Kenia` Izzawa ◽  
Putri Irsalina ◽  
Yudha Haryono
Keyword(s):  
Case Report ◽  
Intravenous Immunoglobulin ◽  
Acute Disseminated Encephalomyelitis ◽  
Initial Therapy ◽  
Adult Women ◽  
Previous Infection ◽  
History Of ◽  
The Central Nervous System ◽  
Children And Young Adults ◽  
Whole Spine

Background: Acute disseminated encephalomyelitis (ADEM) is a demielination disease of the central nervous system (CNS) in response to previous infection or immunizations that occur acute, monofasic. ADEM generally occurs in children and young adults, rarely in middle-aged or elderly. Case report: We present a woman 46 years old with chief complaint of headache since 7 months ago, weakness of both legs, sudden loss of vision in both eyes since 3 days after weakness of both legs. There was no history of infection or previous vaccination. Brain and whole spine MRI were performed. Initial therapy methylprednisolone does not show improvement, then continued with administration of intravenous immunoglobulin. After 6 months, clinical improvements were obtained and no new lesions of the imaging. Conclusion: In this case report it is presented a case of ADEM in adult without a history of infection who recovered after intravenous immunoglobulin. Then that is still the current question, whether ADEM in the adult can be occur without preceded infection history? Keywords: ADEM, adult woman, history of infection.

scholarly journals Autonomic instability in severe tetanus: a case report

2021 ◽  
Vol 23 (2) ◽  
pp. 117-120
Author(s):  
Seung Won Seo ◽  
Jaewon Lee ◽  
Bong-Goo Yoo ◽  
Jehun Kim ◽  
So-Young Huh
Keyword(s):  
Infectious Disease ◽  
Nervous System ◽  
Case Report ◽  
Autonomic Dysfunction ◽  
Ankle Fracture ◽  
Clostridium Tetani ◽  
Cardiovascular Instability ◽  
Autonomic Instability ◽  
Life Threatening ◽  
Severe Tetanus

Tetanus is an infectious disease of the nervous system caused by Clostridium tetani, and is characterized by tonic muscle contractions, painful spasms, and autonomic dysfunction. Severe autonomic dysfunction associated with tetanus can be life-threatening. We present a 62-year-old female who experienced lockjaw after an ankle fracture. The patient was diagnosed with tetanus and received tetanus immunoglobulin and a vaccination. The patient subsequently experienced labile hypertension. This case highlights the challenge and importance of managing cardiovascular instability.

scholarly journals Case report: meningitis as a presenting feature of anti-NMDA receptor encephalitis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Maria Stavrou ◽  
Jing Ming Yeo ◽  
Alexander David Slater ◽  
Oliver Koch ◽  
Sarosh Irani ◽  
...  
Keyword(s):  
Case Report ◽  
Nmda Receptor ◽  
Rapid Development ◽  
Clonic Seizure ◽  
Ovarian Teratoma ◽  
Caucasian Woman ◽  
Case Presentation ◽  
Nmda Receptor Encephalitis ◽  
Autonomic Instability ◽  
Lymphocytic Meningitis

Abstract Background Meningitis is a very rare atypical presenting feature of anti-NMDA receptor encephalitis. In our case report, we describe an unusual clinical presentation of anti-NMDA receptor encephalitis with a biphasic pattern of meningitis followed by encephalitis and discuss potential mechanisms underlying this presentation. We aim to widen the differential diagnosis to be considered in a patient presenting with clinical meningitis and pyrexia. Case presentation This is a case of a 33-year old Caucasian woman who initially presented with a lymphocytic meningitis attributed to a viral infection. She subsequently developed fluctuating consciousness, agitation, visual hallucinations, dyskinetic movements, a generalized tonic-clonic seizure, and autonomic instability. Investigations revealed a diagnosis of anti-NMDA receptor encephalitis secondary to a previously unidentified ovarian teratoma. She made an excellent recovery with immunotherapy and removal of the teratoma. Conclusion Clinicians should consider autoimmune encephalitides in individuals with meningitis, particularly where extensive investigations fail to identify a causative pathogen and there is rapid development of an encephalitic phenotype.

scholarly journals Acute Psychosis Due to Anti-N-Methyl D-Aspartate Receptor Encephalitis Following COVID-19 Vaccination: A Case Report

2021 ◽  
Vol 12 ◽  
Author(s):  
Patrick Flannery ◽  
Ingrid Yang ◽  
Madjid Keyvani ◽  
George Sakoulas
Keyword(s):  
Cerebrospinal Fluid ◽  
Case Report ◽  
Nmda Receptor ◽  
Young Female ◽  
High Dose ◽  
Acute Psychosis ◽  
Neurological Assessment ◽  
Aspartate Receptor ◽  
Nmdar Encephalitis ◽  
History Of

Anti-N-methyl D-aspartate (NMDA) receptor (anti-NMDAR) encephalitis has been reported after SARS-CoV-2 infection, but not after SARS-CoV-2 vaccination. We report the first known case of anti-NMDAR encephalitis after SARS-CoV-2 immunization in a young female presenting with acute psychosis, highlighting a rare potential immunological complication of vaccination against SARS-CoV-2 that is currently being distributed worldwide. The patient presented initially with anxiety and hypochondriacal delusions which progressed to psychosis and catatonia but returned to baseline with aggressive immunomodulatory therapy consisting of intravenous immunoglobulin, high-dose glucocorticoids, and rituximab. This study highlights that the workup of acute psychosis should include establishing a history of recent vaccination followed by a thorough neurological assessment, including for anti-NMDAR antibodies in blood and cerebrospinal fluid.

scholarly journals The Ultimate Poker Face: A Case Report of Facial Diplegia, a Guillain-Barré Variant

2020 ◽  
Vol 4 (2) ◽  
pp. 150-1523
Author(s):  
Joshua Lowe ◽  
James Pfaff
Keyword(s):  
Emergency Department ◽  
Cerebrospinal Fluid ◽  
Case Report ◽  
Lyme Disease ◽  
Intravenous Immunoglobulin ◽  
Facial Palsy ◽  
Facial Diplegia ◽  
Disease Case ◽  
Standard Of Practice ◽  
Guillain Barré

Introduction: Facial diplegia, a rare variant of Guillain-Barré syndrome (GBS), is a challenging diagnosis to make in the emergency department due to its resemblance to neurologic Lyme disease. Case report: We present a case of a 27-year-old previously healthy man who presented with bilateral facial paralysis. Discussion: Despite the variance in presentation, the recommended standard of practice for diagnostics (cerebrospinal fluid albumin-cytological dissociation) and disposition (admission for observation, intravenous immunoglobulin, and serial negative inspiratory force) of facial diplegia are the same as for other presentations of GBS. Conclusion: When presented with bilateral facial palsy emergency providers should consider autoimmune, infectious, idiopathic, metabolic, neoplastic, neurologic, and traumatic etiologies in addition to the much more common neurologic Lyme disease.

scholarly journals Are Repeated Cycles of Intravenous Immunoglobulin Justified in Patients With Poorly Responsive Guillain-Barré Syndrome?

2019 ◽  
Vol 10 (3) ◽  
pp. 224-228
Author(s):  
Hussein Algahtani ◽  
Bader Shirah ◽  
Khalid Alrefaei ◽  
Mohammed Albassam ◽  
Nawal Abdelghaffar
Keyword(s):  
Case Report ◽  
Intravenous Immunoglobulin ◽  
Guillain Barre Syndrome ◽  
Gadolinium Enhancement ◽  
Multicenter Trials ◽  
Guillain Barré Syndrome ◽  
Reasonable Approach ◽  
Life Threatening ◽  
Guillain Barré ◽  
The Cost

Guillain-Barré syndrome (GBS) is a life-threatening form of inflammatory polyneuropathy. Immunotherapy with intravenous immunoglobulin (IVIG) has been used successfully in the treatment of GBS. In this case report, we present a severe axonal form of GBS that showed improvement after 3 cycles of IVIG. Repeated cycles of IVIG may be an option for treating severe forms of GBS not responding to the first course of such treatment. The recent work suggests that patients who are severely affected and have severe gadolinium enhancement on the magnetic resonance imaging of the spine should be considered for retreatment with IVIG. Although the cost of management was high, the outcome was excellent, which is definitely considered a reasonable approach. This case report is an urgent call for performing large multicenter trials on the use of repeated cycles of IVIG in the management of severe cases of GBS.

Presentation of Gall Stone Ileus as Gut Obstruction

JMS SKIMS ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. 117-119
Author(s):  
Munir Ahmad Wani ◽  
Mubarak Ahmad Shan ◽  
Syed Muzamil Andrabi ◽  
Ajaz Ahmad Malik
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Ct Scan ◽  
Bowel Obstruction ◽  
Emergency Surgery ◽  
Gallstone Ileus ◽  
Gall Stone ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Gall Stone Ileus

Gallstone ileus is an uncommon and often life-threatening complication of cholelithiasis. In this case report, we discuss a difficult diagnostic case of gallstone ileus presenting as small gut obstruction with ischemia. A 56-year-old female presented with abdominal pain and vomiting. A CT scan was performed and showed an evolving bowel obstruction with features of gut ischemia with pneumobilia although no frank hyper density suggestive of a gallstone was noted. The patient underwent emergency surgery and a 60 mm obstructing calculus was removed from the patient's jejunum, with a formal tube cholecystostomy. JMS 2018: 21 (2):117-119

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