The neurologist and the hydrops

2021 ◽  
pp. 1-7
Author(s):  
Sylvain Redon ◽  
Maya Elzière ◽  
Anne Donnet
Keyword(s):  
Neurological Disorders ◽  
Endolymphatic Hydrops ◽  
Etiological Diagnosis ◽  
Pathophysiological Mechanisms ◽  
Csf Pressure ◽  
Vestibular Symptoms ◽  
Neurological Conditions ◽  
Noninvasive Tests

The presence of endolymphatic hydrops has been studied in many neurological disorders. The pathophysiological mechanisms may involve CSF pressure variations, transmitted to the innear ear. This hydrops could play a role in vestibular or cochlear symptoms. For the ENT specialist, the etiological diagnosis of endolymphatic hydrops is a challenge, and neurological etiologies must be known. The treatment of these neurological causes could be effective on cochleo-vestibular symptoms. The knowledge of endolymphatic hydrops could also be a target for noninvasive tests, able to estimate CSF pressure variations. For the neurologist, this could represent a useful tool for the diagnosis and follow-up, in some of these neurological disorders, related to a CSF pressure imbalance. The purpose of this paper is to summarize literature data on endolymphatic hydrops in neurological disorders. We define some neurological conditions, for which there is a particular interest in noninvasive investigations of endolymphatic hydrops.

scholarly journals NEUROLOGICAL COMPLICATIONS OF HIV INFECTION, EPILEPTIC SEIZURES AND RISK OF DEATH

2021 ◽  
Vol 80 (1) ◽  
pp. 7-13
Author(s):  
Corina Pascu ◽  
Any Docu Axelerad ◽  
Irina Magdalena Dumitru
Keyword(s):  
Neurological Disorders ◽  
Opportunistic Infections ◽  
Epileptic Seizures ◽  
Neurological Complications ◽  
Hiv Positive ◽  
Seizure Onset ◽  
Etiological Diagnosis ◽  
Risk Of Death ◽  
Neurological Conditions

Objectives: The study highlights the importance of epileptic seizures in HIV-positive patients with neurological complications, as well as the main neurological disorders that the seizures occurred in. The risk of death associated with seizure onset and the risk of death of the neurological conditions that the seizures arose from was calculated. Methods: 166 HIV-positive patients with neurological disorders admitted to the Clinical Infectious Diseases Hospital of Constanta between June 2012 and June 2020, were enrolled in an analytical, observational, and retrospective study. The data were extracted from the observation and follow-up sheets of these patients, which presented with neurological manifestations such as epileptic seizures. The data were processed using the IBM SPSS statistics 23 software. Results: Epileptic seizures were described in 47 patients (28,3%) and have been associated more with Progressive Multifocal Leukoencephalopathy (PML) and CNS Toxoplasmosis (CT) and less with HIV associated dementia (HAD) (p < 0,05). Extrapolating, the association of seizures with opportunistic infections versus other neurological complications was statistically significant (p < 0.05). The risk of death was 6 times higher for the patients diagnosed with opportunistic infections than for those suffering from other neurological conditions. In general, the risk of death associated with epileptic seizures in HIV positive patients was 3 times higher, compared to the risk of death in patients without epileptic seizures. Conclusions: The presence of epileptic seizures should accelerate the rhythm of the investigations being conducted; in order to establish the etiological diagnosis and decrease the morbidity and mortality of HIV-infected patients with neurological complications.

Brain FDG PET for the Etiological Diagnosis of Clinically Uncertain Cognitive Impairment During Delirium in Remission

2020 ◽  
Vol 77 (4) ◽  
pp. 1609-1622
Author(s):  
Franziska Mathies ◽  
Catharina Lange ◽  
Anja Mäurer ◽  
Ivayla Apostolova ◽  
Susanne Klutmann ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Fdg Pet ◽  
False Negative ◽  
Ground Truth ◽  
Etiological Diagnosis ◽  
Geriatric Unit ◽  
Positron Emission ◽  
The Brain ◽  
Hospitalized Geriatric Patients

Background: Positron emission tomography (PET) of the brain with 2-[F-18]-fluoro-2-deoxy-D-glucose (FDG) is widely used for the etiological diagnosis of clinically uncertain cognitive impairment (CUCI). Acute full-blown delirium can cause reversible alterations of FDG uptake that mimic neurodegenerative disease. Objective: This study tested whether delirium in remission affects the performance of FDG PET for differentiation between neurodegenerative and non-neurodegenerative etiology of CUCI. Methods: The study included 88 patients (82.0±5.7 y) with newly detected CUCI during hospitalization in a geriatric unit. Twenty-seven (31%) of the patients were diagnosed with delirium during their current hospital stay, which, however, at time of enrollment was in remission so that delirium was not considered the primary cause of the CUCI. Cases were categorized as neurodegenerative or non-neurodegenerative etiology based on visual inspection of FDG PET. The diagnosis at clinical follow-up after ≥12 months served as ground truth to evaluate the diagnostic performance of FDG PET. Results: FDG PET was categorized as neurodegenerative in 51 (58%) of the patients. Follow-up after 16±3 months was obtained in 68 (77%) of the patients. The clinical follow-up diagnosis confirmed the FDG PET-based categorization in 60 patients (88%, 4 false negative and 4 false positive cases with respect to detection of neurodegeneration). The fraction of correct PET-based categorization did not differ between patients with delirium in remission and patients without delirium (86% versus 89%, p = 0.666). Conclusion: Brain FDG PET is useful for the etiological diagnosis of CUCI in hospitalized geriatric patients, as well as in patients with delirium in remission.

scholarly journals Encephalopathy with progression to posterior reversible encephalopathy pattern in a patient with COVID-19: clinical, imaging findings and follow-up

2021 ◽  
Vol 14 (2) ◽  
pp. e241240
Author(s):  
Ali Kerro
Keyword(s):  
Blood Pressure ◽  
Inflammatory Markers ◽  
Elevated Blood ◽  
Imaging Findings ◽  
Clinical Imaging ◽  
Respiratory Dysfunction ◽  
Posterior Reversible Encephalopathy ◽  
Neurological Conditions ◽  
Reversible Encephalopathy

Neurological conditions are being more recognised in patients with COVID-19, with encephalopathy being the most prevalent problem. Posterior reversible encephalopathy is suspected to occur due to elevated blood pressure and overproduction of inflammatory markers, both of which have been reported in the setting of COVID-19 infection. Encephalopathy was the main presentation in this case, without respiratory dysfunction initially, and with imaging findings indicative of posterior reversible encephalopathy syndrome as an aetiology. Follow-up imaging showed resolution of the abnormal results with mental status returning to baseline upon discharge.

The Korsakov Syndrome in Spontaneous Subarachnoid Haemorrhage

1953 ◽  
Vol 99 (416) ◽  
pp. 521-530 ◽  
Author(s):  
John N. Walton
Keyword(s):  
Subarachnoid Haemorrhage ◽  
Neurological Disorders ◽  
Review Of The Literature ◽  
Case Histories ◽  
Actual Case ◽  
Mental Symptoms ◽  
Symptom Complex ◽  
Excellent Description ◽  
The Subject ◽  
Neurological Conditions

The amnestic-confabulatory symptom-complex to which the eponymous title of Korsakov's syndrome is usually given was probably first described by the Swedish physician Magnus Huss (1807–90), who spent the greater part of his lifetime in the study of alcoholism. There is, however, no doubt that Korsakov's (1890) paper on the subject gave an excellent description of the syndrome, and stressed the fact that whereas it often developed in patients with alcoholism and polyneuritis, numerous other metabolic and neurological disorders could be complicated by the characteristic mental changes. Indeed, in Korsakov's (1890) own series of cases alcoholics were in the minority. One of the neurological conditions in which the syndrome has been described significantly often is spontaneous subarachnoid haemorrhage. The first reports of the association were probably those of Flatau (1918 and 1921), and it was discussed in some detail by Goldflam (1923) and Herman (1925 and 1926). Each of these authors described the mental symptoms exhaustively but gave no actual case-histories; the first fully documented cases in the literature were the two reported by Hall (1929). Single cases have since been described by Cubitt (1930), Popow (1930) and Kulkow (1935), and in 1939 Tarachow gave an extensive review of the literature and reported an additional 3 cases. It is remarkable that since 1939 the association has received little attention, although it has been mentioned by Sands (1941) and Meadows (1951).

The probiotic Lactobacillus casei Shirota attenuates symptoms of vestibular migraine: a randomised placebo-controlled double-blind clinical trial

2020 ◽  
Vol 11 (5) ◽  
pp. 469-476
Author(s):  
X. Qi ◽  
G. Fan ◽  
H. Jia
Keyword(s):  
Depressive Symptoms ◽  
Lactobacillus Casei ◽  
Daily Basis ◽  
Vestibular Migraine ◽  
Double Blind ◽  
Beneficial Effects ◽  
Lactobacillus Casei Shirota ◽  
Probiotic Lactobacillus ◽  
Vestibular Symptoms

Vestibular migraine (VM) has emerged as one of the major vestibular syndromes. Although probiotics have exhibited beneficial effects on migraine headache, its effect on VM is not clear. This trial aimed to investigate the treatment efficacy of the probiotic Lactobacillus casei Shirota (LcS) on symptoms of VM. 247 VM patients were enrolled, of which 204 eligible patients receiving either LcS or placebo on a daily basis completed the 4 month study. They were re-visited at 2 and 4 months after study initiation to assess treatment outcomes. The primary endpoints were vestibular symptoms, evaluated by the number of vertiginous attacks during the past week, the Vertigo Severity Score (VSS), and Dizziness Handicap Inventory (DHI) scores. The secondary endpoints were anxiety and depressive symptoms, evaluated using Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) scores. Efficacy of LcS over placebo was not obvious at 2 month follow-up. At 4 month follow-up, while both LcS and placebo groups of VM patients displayed alleviated symptoms, the extents of the improvements were significantly better in LcS group than those of placebo group, with regard to vestibular symptoms using DHI and VSS, as well as anxiety and depressive symptoms using BAI and BDI. Although placebo effect cannot be ignored in intervention for VM patients, the probiotic LcS still exhibits considerable efficacy against VM symptoms over a 4 month study period, supporting further clinical study of a larger and more diverse cohort.

Clinical Features and Endolymphatic Hydrops in Patients With MRI Evidence of Hydrops

2018 ◽  
Vol 128 (4) ◽  
pp. 286-292 ◽  
Author(s):  
Suming Shi ◽  
Ping Guo ◽  
Wenquan Li ◽  
Wuqing Wang
Keyword(s):  
Diagnostic Criteria ◽  
Clinical Features ◽  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Endolymphatic Hydrops ◽  
Low Frequency ◽  
Clinical Severity ◽  
Mri Findings ◽  
Vestibular Symptoms ◽  
Magnetic Resonance Imaging Mri

Objectives: The purpose of this study was to investigate the correlation between grades of endolymphatic hydrops (ELH) and clinical characteristics and determine the detailed clinical characteristics of Ménière’s disease (MD) patients with evidence of hydrops based on magnetic resonance imaging (MRI). Methods: One hundred ninety-eight MD patients (396 ears) with MRI evidence of hydrops were included. ELH grades were evaluated using the Nakashima grading standard. Correlations between the extent of ELH and clinical features were evaluated. Detailed clinical characteristics were analyzed to assess the clinical diagnostic criteria. Results: Of 198 patients, ELH was observed in 100% of cases on the clinically affected side and 8.6% of cases on the asymptomatic side. In addition, 98.5% of ELH was classified as moderate or significant grade. Low-frequency hearing loss was significantly correlated with the extent of both vestibular and cochlear hydrops, whereas the vertigo attack frequency showed no significant correlation with ELH grades. The disease duration of MD with bilateral ELH was longer than that with unilateral ELH. The clinical characteristics were variant and did not completely fit the proposed diagnostic criteria. Conclusions: MRI findings have relevance to the clinical severity, to a certain extent, but not vestibular symptoms. The proposed diagnostic criteria based on clinical characteristics may be partially effective; analysis of the detailed clinical characteristics of MD was meaningful. Diagnosis of MD based on both MRI and clinical symptoms could facilitate an early diagnosis.

scholarly journals Electrophysiologic studies in leprosy

1992 ◽  
Vol 50 (3) ◽  
pp. 313-318 ◽  
Author(s):  
Joaquim P. Brasil-Neto
Keyword(s):  
Surgical Treatment ◽  
Early Diagnosis ◽  
Conduction Velocity ◽  
Nerve Conduction ◽  
Nerve Conduction Velocity ◽  
Pathophysiological Mechanisms ◽  
Electrophysiologic Studies

The author reviews the literature on electromyography and nerve conduction velocity studies in leprosy. It is concluded that these studies can be helpful in the early diagnosis of neural involvement, in the elucidation of pathophysiological mechanisms, and in the follow-up of patients under medical and/or surgical treatment.

Intracanalicular Acoustic Neurinomas

Neurosurgery ◽  
1991 ◽  
Vol 29 (2) ◽  
pp. 189-199 ◽  
Author(s):  
Madjid Samii ◽  
Cordula Matthies ◽  
Marcos Tatagiba
Keyword(s):  
Resonance Imaging ◽  
Tumor Removal ◽  
Diagnostic Reliability ◽  
Computed Tomographic ◽  
Acoustic Neurinomas ◽  
Vestibular Symptoms ◽  
Symptoms And Signs ◽  
Facial Function ◽  
Complete Tumor

Abstract The cases of 16 patients with acoustic neurinomas confined to the intracanalicular area are presented. These represent 2.7% of the 600 patients with acoustic neurinomas consecutively operated upon at the Neurosurgical Clinic at Nordstadt Hospital during the last 8 years. The comparatively earlier onset of vestibular symptoms and signs was characteristic of this group and precipitated diagnosis. The diagnostic reliability of magnetic resonance imaging was at least equivalent to that of air computed tomographic cisternography. Complete tumor removal was accomplished via the suboccipital approach in all patients, with 100% preservation of facial nerve and facial function; the cochlear nerve was preserved anatomically in 100% of the patients and functionally in 57%. No recurrence has occurred during follow-up periods of up to 8 years in all 16 patients. A broad spectrum of the current literature is considered, and purely intracanalicular acoustic neurinomas are discussed with regard to clinical characteristics, diagnostic steps—including neuroradiological and neurophysiological approaches—and surgical treatment and results.

scholarly journals IncobotulinumtoxinA (Xeomin)

2021 ◽  
Vol 1 (9) ◽  
Author(s):  
Reimbursement Team
Keyword(s):  
Neurological Disorders ◽  
Adult Patients ◽  
Swallowing Difficulties ◽  
Neurological Conditions ◽  
The Cost ◽  
Public Drug

CADTH recommends that Xeomin should be reimbursed by public drug plans for the treatment of chronic sialorrhea associated with neurological disorders if certain conditions are met. Xeomin should only be covered to treat adult patients with moderate to severe chronic troublesome sialorrhea who do not have swallowing difficulties. Xeomin should only be reimbursed if prescribed by a specialist with experience in managing neurological conditions, and the cost of Xeomin is reduced.

Acute neurological disorders in women during pregnancy and peurperium

2021 ◽  
Vol 12 (2) ◽  
pp. 58-64
Author(s):  
Akhil Kulkarni M ◽  
Keyword(s):  
Neurological Disorders ◽  
Physiological Mechanism ◽  
Postpartum Women ◽  
Physiological Changes ◽  
Imaging Findings ◽  
Posterior Reversible Encephalopathy ◽  
Increased Risk ◽  
Neurological Conditions ◽  
Reversible Encephalopathy ◽  
In Pregnancy

Neurological disorders in women during pregnancy and puerperium are a significant cause of morbidity and mortality in pregnancy. There are certain neurological conditions which are specifically related to physiological changes during this period (eg: eclampsia, Sheehan’s syndrome, posterior reversible encephalopathy syndrome) and some disorders which have increased risk but not specific to women in pregnancy and puerperium (eg: cerebral venous thrombosis, infarction). As radiologists, an understanding of the patho physiological mechanism and imaging findings associated with these various conditions is necessary in timely diagnosis and initiating therapy which in turn helps prevent complications to both them other and the fetus. Any prophylaxis against these events should be particularly targeted to postpartum women, indicating the need to better identify pregnant women at increased risk.

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