scholarly journals Tacrolimus induced diffuse pontine hyperintensity in status epilepticus: a rare entity

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Madhuri Khilari ◽  
◽  
Niranjan Panigrahi ◽  
Keyword(s):  
Status Epilepticus ◽  
Imaging Finding ◽  
Autoimmune Encephalitis ◽  
Complete Recovery ◽  
Vasogenic Oedema ◽  
Symptomatic Management ◽  
History Of ◽  
Neuro Imaging ◽  
Reversible Encephalopathy ◽  
And Control

Posterior Reversible Encephalopathy Syndrome resulting from the hypertension-induced Failure of cerebral autoregulation, is a well-described neuro-imaging finding resulting from vasogenic oedema. Pontine Hyperintensities resulting from this condition need recognition to prognosticate and avoid unnecessary investigations.  We report a 48 year old male with chronic diabetes mellitus, Hypertension, and chronic kidney disease, and history of liver transplantation who presented with established status epilepticus. He was on Tacrolimus for prophylaxis for graft rejection. His MRI brain showed diffuse pontine and predominantly left thalamic hyperintensity, which suggested the diagnosis of central PRES. His evaluation for CNS infections and autoimmune encephalitis was negative.  On stopping Tacrolimus, the imputed drug, and control of hypertension, along with dialysis, and symptomatic management for seizures, a complete recovery was observed over one week. Repeat MRI also showed partial regression of the pontine hyperintensity. This report documents the importance of this less described neuroradiological finding that can change the management significantly and have a bearing on the prognosis.

Posterior reversible encephalopathy syndrome (PRES) presenting as Status Epilepticus in a case of Autoimmune Hemolytic Anemia (AIHA): A Case report

2021 ◽  
Vol 12 (6) ◽  
pp. 102-106
Author(s):  
Sameera Dronamraju ◽  
Shilpa Gaidhane ◽  
Aayush Somani ◽  
Sourya Acharya
Keyword(s):  
Status Epilepticus ◽  
Hemolytic Anemia ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Autoimmune Hemolytic Anemia ◽  
Vasogenic Edema ◽  
Complete Recovery ◽  
Young Female ◽  
Posterior Reversible Encephalopathy ◽  
Oral Steroids ◽  
Reversible Encephalopathy

Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic state, caused by imbalance in autoregulation of posterior cerebral circulation. We report a case of young female, presented at emergency department with complains of nausea, vomiting and generalized tonic clonic seizures prior to admission. During the course of hospital stay patient landed in status epilepticus which was treated appropriately. Patient’s magnetic resonance imaging (MRI) was done which had classical features of vasogenic edema in occipital and parietal region, suggestive of PRES. She was a known case of autoimmune hemolytic anemia thatwas treated with multiple blood transfusions and low dose oral steroids. She was discharged after complete resolution of symptoms with the advice to follow up in medicine outpatient department. Our case describes about autoimmune hemolytic anemia in which occurrence of PRES is uncommon. Early diagnosis and robust treatment can prevent permanent damage to the brain, and is often associated with complete recovery.

scholarly journals Posterior Reversible Encephalopathy Syndrome in a Postpartum Preeclamptic Woman without Seizure

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Ülkü Mete Ural ◽  
Gülsah Balik ◽  
Şenol Şentürk ◽  
Işık Üstüner ◽  
Uğur Çobanoğlu ◽  
...  
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Complete Resolution ◽  
Term Pregnancy ◽  
Vasogenic Oedema ◽  
White Matter Changes ◽  
Posterior Reversible Encephalopathy ◽  
Appropriate Treatment ◽  
History Of ◽  
Reversible Encephalopathy ◽  
Visual Disturbances

Posterior reversible encephalopathy syndrome (PRES) is a cliniconeuroradiological entity presenting with headache, confusion, visual disturbances or blindness, and seizures. Parieto-occipital white matter changes due to vasogenic oedema can be observed on imaging modalities. It rarely occurs without seizures and after delivery. We report a 33-year-old multigravida with a history of preeclampsia in term pregnancy complicated by PRES without seizures at the postpartum period. Clinical improvement with complete resolution without any complications was observed on the 6th day after delivery. Posterior reversible encephalopathy syndrome is reversible when early diagnosis is established and appropriate treatment is started without delay.

scholarly journals Headache and Status Epilepticus in the Postpartum Period; Posterior Reversible Encephalopathy Syndrome or Cerebral Venous Thrombosis?

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Panagiotis Zis ◽  
Antonios Tavernarakis
Keyword(s):  
Status Epilepticus ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Treatment Initiation ◽  
Sinus Thrombosis ◽  
Correct Diagnosis ◽  
Posterior Reversible Encephalopathy ◽  
Appropriate Treatment ◽  
History Of ◽  
Medical Emergencies ◽  
Reversible Encephalopathy

We report a case of a young woman, with a history of a miscarriage and a molar pregnancy, who developed headache and status epilepticus in postpartum day three. Posterior reversible encephalopathy syndrome (PRES) and cerebral venous and sinus thrombosis (CVST) can present with identical clinical picture; however, the imaging findings can help the clinician to make the correct diagnosis and initiate the appropriate treatment. Both PRES and CVST are medical emergencies and fully reversible entities especially when treatment initiation is immediate.

Het posterieur reversibel encefalopathiesyndroom

2021 ◽  
Author(s):  
J. Moonen ◽  
J. Poelaert ◽  
M. Matic
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Complete Recovery ◽  
Underlying Disease ◽  
Vasogenic Oedema ◽  
Posterior Reversible Encephalopathy ◽  
Immunosuppressive Medication ◽  
Failure Treatment ◽  
Wide Range ◽  
Reversible Encephalopathy ◽  
The Brain

Posterior reversible encephalopathy syndrome Being confronted with postoperative complications can be challenging. When a patient shows signs of postoperative neurological deficit, a wide range of possible explanations has to be considered. In this specific case, the diagnosis of posterior reversible encephalopathy syndrome (PRES) was made. PRES is characterised by neurological symptoms (headache, confusion, visual changes, paresis and/or convulsions) and certain findings on cerebral imaging (vasogenic oedema, predominantly in the posterior areas of the brain). It is linked to hypertensive disorders, (pre-)eclampsia, certain auto-immune diseases, the use of immunosuppressive medication and kidney failure. Treatment of the hypertension is crucial, but antiseizure drugs and treatment of the underlying disease may also be necessary. Most patients have a complete recovery within 2 weeks. A small minority, however, experiences residual neurologic deficits resulting from secondary cerebral infarction or haemorrhage.

scholarly journals Autoimmune Encephalitis: An Unusual Presentation as Nonconvulsive Status Epilepticus

2019 ◽  
Vol 7 (01) ◽  
pp. 41-43
Author(s):  
Deepak Solanki ◽  
Saurabh Anand
Keyword(s):  
Status Epilepticus ◽  
Autoimmune Encephalitis ◽  
Refractory Status Epilepticus ◽  
Clinical Findings ◽  
Acute Onset ◽  
Prior History ◽  
Laboratory Findings ◽  
Epileptiform Discharges ◽  
Refractory Status ◽  
History Of

AbstractWhen refractory status epilepticus (RSE) occurs in an individual without any history of epilepsy and no immediate underlying etiology is found, it is referred to as new-onset refractory status epilepticus (NORSE). This clinical scenario may be notoriously difficult to treat and does not respond to initial medications. In cases of NORSE in which an etiology is found, antibody-mediated disorders are the most common cause. Autoimmune encephalitis refers to a diverse group of neuropsychiatric disorders and can present with an array of symptoms many of which make diagnosis difficult due to similarities in clinical, imaging, and laboratory findings with respect to other forms of autoimmune or infectious encephalitis. This case report highlights how a patient with acute-onset history, showing generalized periodic epileptiform discharges on electroencephalogram (EEG) but with no prior history of seizures, was eventually diagnosed as autoimmune encephalitis based on clinical findings, cerebrospinal fluid (CSF) reports, and EEG analysis.

THE RISK FACTORS OF MOLAR PREGNANCY

2017 ◽  
pp. 53-58
Author(s):  
Lam Huong Le
Keyword(s):  
High Risk ◽  
Gestational Trophoblastic Disease ◽  
Living Standard ◽  
Control Group ◽  
Uterine Perforation ◽  
Molar Pregnancy ◽  
Health It ◽  
Pregnancy Risk ◽  
History Of ◽  
And Control

Objectives: Molar pregnancy is the gestational trophoblastic disease and impact on the women’s health. It has several complications such as toxicity, infection, bleeding. Molar pregnancy also has high risk of choriocarcinoma which can be dead. Aim: To assess the risks of molar pregnancy. Materials and Methods: The case control study included 76 molar pregnancies and 228 pregnancies in control group at Hue Central Hospital. Results: The average age was 32.7 ± 6.7, the miximum age was 17 years old and the maximum was 46 years old. The history of abortion, miscarriage in molar group and control group acounted for 10.5% and 3.9% respectively, with the risk was higher 2.8 times; 95% CI = 1.1-7.7 (p<0.05). The history of molar pregnancy in molar pregnancy group was 9.2% and the molar pregnancy risk was 11.4 times higher than control group (95% CI = 2.3-56.4). The women having ≥ 4 times births accounted for 7.9% in molar group and 2.2% in control group, with the risk was higher 3.8 times, 95% CI= 1.1-12.9 (p<0.05). The molar risk of women < 20 and >40 years old in molar groups had 2.4 times higher than (95% CI = 1.1 to 5.2)h than control group. Low living standard was 7.9% in molar group and 1.3% in the control group with OR= 6.2; 95% CI= 1.5-25.6. Curettage twice accounted for 87.5%, there were 16 case need to curettage three times. There was no case of uterine perforation and infection after curettage. Conclusion: The high risk molar pregnancy women need a better management. Pregnant women should be antenatal cared regularly to dectect early molar pregnancy. It is nessecery to monitor and avoid the dangerous complications occuring during the pregnancy. Key words: Molar pregnancy, pregnancy women

Work and Technological Change

2020 ◽  
Author(s):  
Stephen R. Barley
Keyword(s):  
Artificial Intelligence ◽  
Historical Context ◽  
Energy Transformation ◽  
History Of ◽  
Work And Organizations ◽  
Role Based ◽  
Control Technologies ◽  
And Control ◽  
Work And Employment

The four chapters of this book summarize the results of thirty-five years dedicated to studying how technologies change work and organizations. The first chapter places current developments in artificial intelligence into the historical context of previous technological revolutions by drawing on William Faunce’s argument that the history of technology is one of progressive automation of the four components of any production system: energy, transformation, and transfer and control technologies. The second chapter lays out a role-based theory of how technologies occasion changes in organizations. The third chapter tackles the issue of how to conceptualize a more thorough approach to assessing how intelligent technologies, such as artificial intelligence, can shape work and employment. The fourth chapter discusses what has been learned over the years about the fears that arise when one sets out to study technical work and technical workers and methods for controlling those fears.

Galileo Unbound

2018 ◽  
Author(s):  
David D. Nolte
Keyword(s):  
Free Fall ◽  
The Sun ◽  
Quantum Field ◽  
Many Worlds ◽  
Quantum Particles ◽  
Light Rays ◽  
History Of ◽  
And Control ◽  
The Universe ◽  
Insight Into

Galileo Unbound: A Path Across Life, The Universe and Everything traces the journey that brought us from Galileo’s law of free fall to today’s geneticists measuring evolutionary drift, entangled quantum particles moving among many worlds, and our lives as trajectories traversing a health space with thousands of dimensions. Remarkably, common themes persist that predict the evolution of species as readily as the orbits of planets or the collapse of stars into black holes. This book tells the history of spaces of expanding dimension and increasing abstraction and how they continue today to give new insight into the physics of complex systems. Galileo published the first modern law of motion, the Law of Fall, that was ideal and simple, laying the foundation upon which Newton built the first theory of dynamics. Early in the twentieth century, geometry became the cause of motion rather than the result when Einstein envisioned the fabric of space-time warped by mass and energy, forcing light rays to bend past the Sun. Possibly more radical was Feynman’s dilemma of quantum particles taking all paths at once—setting the stage for the modern fields of quantum field theory and quantum computing. Yet as concepts of motion have evolved, one thing has remained constant, the need to track ever more complex changes and to capture their essence, to find patterns in the chaos as we try to predict and control our world.

Animal Pain Scales in Public Policy

1990 ◽  
Vol 18 (1_part_1) ◽  
pp. 41-50
Author(s):  
F. Barbara Orlans
Keyword(s):  
Public Policy ◽  
Animal Welfare ◽  
The United States ◽  
Pain Scale ◽  
Laboratory Animals ◽  
Practical Applications ◽  
Animal Pain ◽  
Pain Scales ◽  
History Of ◽  
And Control

Pain scales classify the severity of pain inflicted on laboratory animals from little or none up to severe. A pain scale as part of public policy serves beneficial purposes that promote animal welfare. It can be used to educate people about the two alternatives of refinement and replacement, and the need to reduce animal pain. Furthermore, a pain scale has practical applications: 1) in review procedures for animal welfare concerns; 2) in developing policies on the use of animals in education; and 3) as a basis for collecting national data on animal experimentation, so that meaningful data can be collected on trends in reduction and control in animal pain. So far, only a few countries (including Sweden, the Netherlands, Canada and New Zealand) have adopted pain scales as part of their public policy. Most countries, including the United States, have not yet done so. The history of the development and adoption of pain scales by various countries is described and the case is presented for wider adoption of a pain scale in countries not currently using one.

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