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 Acute Disseminated Encephalomyelitis Following Typhoid Fever: A Case Report

2014 ◽  
Vol 9 (4) ◽  
pp. 55-58
Author(s):  
R Adhikari ◽  
A Tayal ◽  
PK Chhetri ◽  
B Pokhrel
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Case Report ◽  
Typhoid Fever ◽  
Demyelinating Disease ◽  
Acute Disseminated Encephalomyelitis ◽  
Medical Sciences ◽  
Cerebellar Syndrome ◽  
Immune Mediated ◽  
The Central Nervous System

The involvement of central nervous system in children with typhoid fever is common. Acute disseminated encephalomyelitis is a rare immune mediated and demyelinating disease of the central nervous system that usually affects children. We report a 7-year-old child with typhoid fever who developed acute cerebellar syndrome due to acute disseminated encephalomyelitis.Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-4, 55-58 DOI: http://dx.doi.org/10.3126/jcmsn.v9i4.10237

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.

scholarly journals Metronidazole, an Uncommon Cause of Dizziness and Ataxia in the Emergency Department: A Case Report

2021 ◽  
Vol 2 (5) ◽  
pp. 239-241
Author(s):  
Mary Starrs ◽  
Onur Yenigun
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Adverse Reactions ◽  
Clinical Presentation ◽  
Use Case ◽  
Resonance Imaging ◽  
Cerebellar Dysfunction ◽  
History Of ◽  
The Central Nervous System ◽  
Local Emergency Department

Introduction: Metronidazole, a nitroimidazole antibiotic, is a well-known antibacterial and antiprotozoal agent that is generally well tolerated without many serious side effects. Most adverse reactions affect the gastrointestinal or genitourinary system, but the central nervous system may also be afflicted. In addition to headache and dizziness, cerebellar dysfunction can occur with metronidazole use. Case Report: We discuss the clinical presentation and imaging findings of metronidazole-induced encephalopathy in a 12-year-old male. The patient had a history of Crohn’s disease and chronic Clostridium difficile infection for which he had received metronidazole for approximately 75 days prior to arrival to a local emergency department (ED). He presented with five days of progressive vertigo, nausea, vomiting, and ataxia. Subsequent magnetic resonance imaging showed symmetric hyperintense dentate nuclei lesions, characteristic of metronidazole-induced encephalopathy. The patient’s symptoms improved rapidly after cessation of metronidazole, and his symptoms had completely resolved by discharge on hospital day two. Conclusion: Metronidazole-induced encephalopathy is a rare cause of vertigo and ataxia that can lead to permanent sequela if not identified and treated promptly. Thus, it is important for physicians to keep this diagnosis in mind when evaluating patients on metronidazole who present to the ED with new neurologic complaints.

scholarly journals Acute Demyelinating Encephalomyelitis Following Measles Infection Due to Vaccine Failure: A Case Report

2021 ◽  
Vol 2 (5) ◽  
pp. 171-173
Author(s):  
Robert McMickle ◽  
Lauren Fryling ◽  
Ross Fleischman
Keyword(s):  
Case Report ◽  
Altered Mental Status ◽  
Acute Disseminated Encephalomyelitis ◽  
International Travel ◽  
Vaccine Failure ◽  
Lower Extremity Weakness ◽  
Vaccination Rates ◽  
Acute Encephalitis ◽  
History Of ◽  
New Onset

Introduction: Local outbreaks of measles infection are primarily mediated by international travel of persons from endemic areas, with subsequent spread of the virus via undervaccinated populations. Recent resurgences of measles in communities where vaccination rates are non-ideal secondary to philosophical objections require the emergency physician to more routinely consider the diagnosis. In cases of measles complicated by acute encephalitis or encephalopathy, the diagnosis can be especially difficult to make due to lack of a reliable primary historian. Case report: Here we present a case of altered mental status and new-onset bilateral lower extremity weakness in a fully vaccinated young woman diagnosed with measles infection caused by acute disseminated encephalomyelitis in the setting of vaccine failure. Conclusion: Despite a documented history of immunization, acute measles infection and its uncommon sequelae are possible. Recognizing vaccine failure and appropriately isolating patients are of paramount importance.

scholarly journals Brief psychotic disorder occurring after Covid-19 in a patient with no history of psychiatric diseases - a case report

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Julita Poleszak-Szabat ◽  
Małgorzata Romaniuk-Suswał ◽  
Paweł Krukow
Keyword(s):  
Case Report ◽  
Psychotic Disorder ◽  
Psychiatric Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Psychiatric Diseases ◽  
Brief Psychotic Disorder ◽  
History Of ◽  
The Central Nervous System ◽  
Isolation Ward

Abstract Introduction: Although the typical symptoms of SARS-CoV-2 infection are respiratory symptoms, it has been shown that the virus can also attack the central nervous system (CNS) causing neurological and psychiatric symptoms. Aim: The aim of the study was to present a case of a 52-year-old woman, previously untreated for psychiatric diseases, who developed brief psychotic disorder occurring after Covid-19 infection. Case report: A patient in the biological treatment of asthma, came for a follow-up visit, during which the doctor diagnosed psychopathological symptoms in the form of delusions, never previously observed. The interview showed that the patient was discharged from the Isolation ward 10 days before, where she was hospitalized because of SARS-CoV-2 infection. Discussion: There are several theories regarding the mechanisms of pathogenesis of neuropsychiatric symptoms in the course of Covid-19 infection. Much space in the literature is devoted to pathological immune responses. One of the reasons for the development of delusions in the described patient could therefore be the acute phase of the inflammatory reaction in the course of SARS-CoV-2 infection.

scholarly journals Use of Cyclophosphamide in a Child With Fulminant Acute Disseminated Encephalomyelitis

2018 ◽  
Vol 5 ◽  
pp. 2329048X1875463
Author(s):  
Hana Ayed ◽  
Mohammed W. Chaudhary ◽  
Raidah AlBaradie ◽  
Ali Mir
Keyword(s):  
Intravenous Immunoglobulin ◽  
Immunosuppressive Agents ◽  
Acute Disseminated Encephalomyelitis ◽  
High Dose ◽  
Intravenous Methylprednisolone ◽  
First Line ◽  
Demyelinating Disorder ◽  
Immune Mediated ◽  
Minimal Improvement ◽  
The Central Nervous System

Acute disseminated encephalomyelitis is an immune-mediated inflammatory demyelinating disorder of the central nervous system. The first-line treatment is usually high-dose intravenous methylprednisolone. Intravenous immunoglobulin and plasmapheresis have also shown to be beneficial. Immunosuppressive agents like cyclophosphamide have been used in adults with fulminant acute disseminated encephalomyelitis. We report a case of a 3-year-old boy with fulminant acute disseminated encephalomyelitis. Minimal improvement was seen with high-dose intravenous methylprednisolone, intravenous immunoglobulin, and plasmapheresis. Based on the reports of cyclophosphamide being used successfully to treat adult patients with fulminant acute disseminated encephalomyelitis, we used it in our patient who then showed dramatic and quick improvement. We suggest that if conventional treatment fails, cyclophosphamide could be tried in pediatric patients with fulminant acute disseminated encephalomyelitis.

scholarly journals Delayed Relapse of Paracoccidioidomycosis in the Central Nervous System: A Case Report

2020 ◽  
Vol 7 (4) ◽  
Author(s):  
Rifat Rahman ◽  
Leela Davies ◽  
Amir M Mohareb ◽  
Paula M Peçanha-Pietrobom ◽  
Nirav J Patel ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Case Report ◽  
Treatment Strategies ◽  
Current Treatment ◽  
System A ◽  
History Of ◽  
The Central Nervous System ◽  
Relapsed Disease ◽  
Review Current

Abstract Paracoccidioidomycosis is a dimorphic fungal infection endemic in Latin America. We report a patient with a history of pulmonary paracoccidioidomycosis who presented with relapsed disease in the central nervous system 4 years after initial treatment. We review current treatment strategies for paracoccidioidomycosis and neuroparacoccidioidomycosis.

scholarly journals Role of Plasma Exchange in a Steroid- and IVIG-Refractory Patient with Acute Disseminated Encephalomyelitis: A Case Report

2020 ◽  
Vol 47 (5) ◽  
pp. 420-423 ◽  
Author(s):  
Parmatma Prasad Tripathi ◽  
Rekha Hans ◽  
Ratti Ram Sharma ◽  
Divjot Singh Lamba ◽  
Preeti Paul ◽  
...  
Keyword(s):  
Case Report ◽  
Plasma Exchange ◽  
Intravenous Immunoglobulin ◽  
Steroid Therapy ◽  
Neurological Deficit ◽  
Demyelinating Disease ◽  
Acute Disseminated Encephalomyelitis ◽  
Complete Loss ◽  
High Dose

Background: Acute disseminated encephalomyelitis (ADEM) is a demyelinating disease usually affecting children and is treated with high-dose steroid therapy. Case Report: An 8-year boy presented with limbs weakness and complete loss of vision and was resistant to steroid therapy. He was further treated with plasma exchange and showed full recovery from the neurological deficit. Conclusion: Therapeutic plasma exchange appears to be effective in ADEM patients in reversing the neuropathological process especially refractory to steroids and intravenous immunoglobulin.

scholarly journals A Case Report of Chondromyxoid Fibroma of the Neck of Femur, Intracapsular Location

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Siddharth Jain ◽  
Sitender Garg ◽  
Ravi Mittal
Keyword(s):  
Case Report ◽  
Benign Tumor ◽  
Histopathological Examination ◽  
Good Prognosis ◽  
Chondromyxoid Fibroma ◽  
Intralesional Curettage ◽  
Neck Of Femur ◽  
Left Femur ◽  
History Of ◽  
Children And Young Adults

Introduction: Chondromyxoid fibroma (CMF) is an uncommon benign tumor accounts for <2% of all benign and <1% all bone tumors. It is a cartilage tumor with myxoid and fibrous elements. Because of rarity and resemblance with other benign and malignant tumor, diagnosis of this tumor always remains challenging. Often, this lesion affects metaphysis of long growing bones of children and young adults. Common locations of this tumor are around the growth plate of proximal tibia and fibula and distal femur. Case Report: A 21-year-old male presented to orthopedic outpatient department with a history of the left hip pain for 1 year, following a trivial fall before 1 year. The patient was not able to do heavy strenuous activities such as running, jumping, and other sports activities. Terminal range of movements were painful. Magnetic resonance imaging suggested of cystic lesion involving synovial lining near head-and-neck junction of the left femur. Curettage of the lesion was done. The bone defect was not found to be large enough to be filled with bone graft. Histopathological examination showed lobular pattern with stellate to spindle-shaped cells on the myxoid background. Conclusion: CMF of subcapital region of femoral neck is an extremely unusual presentation. When occurring in middle-aged persons and in uncommon locations, this can raise suspicion of chondrosarcoma. Although intralesional curettage has the risk of recurrence in post-operative period, sufficient and careful curettage and excision of lesion will be enough to treat these benign lesions with good prognosis. Keywords: Chondromyxoid fibroma, intracapsular, benign tumor.

scholarly journals Evaluation of demographic, clinical and paraclinical characteristics of children with acute disseminated encephalomyelitis

2020 ◽  
Vol 7 (1) ◽  
pp. e08-e08
Author(s):  
Ahad Ghazavi ◽  
Ezatolah Abbasi ◽  
Hashem Mahmodzadeh ◽  
Tohid Nasiri
Keyword(s):  
Clinical Signs ◽  
Complete Recovery ◽  
Acute Disseminated Encephalomyelitis ◽  
Recent Infection ◽  
Demyelinating Disorder ◽  
Epidemiological Features ◽  
Previous Infection ◽  
History Of ◽  
And Gender ◽  
Common Clinical Finding

Introduction: Acute disseminated encephalomyelitis (ADEM) is an immunologically mediated inflammatory demyelinating disorder that commonly occurs following a viral infection or vaccination. Objectives: This study aimed to evaluate the demographic, clinical and paraclinical characteristics of children with ADEM. Patients and Methods: In a retrospective study, all children who had a definite diagnosis of ADEM were included in the study. Demographic information (including age and gender), epidemiological features (season of onset, history of previous vaccination and previous infection), clinical signs of ADEM, paraclinical features and also clinical outcomes were extracted from patients’ records and entered into a researcher-made checklist. All data were collected, classified and entered into SPSS version 21 for statistical analysis. Results: A total of 27 patients with ADEM were studied out of which, 16 (59.3%) were male and 11 (40.7%) were female. The mean age of patients was 5.21 ± 4.37 years, the youngest of which was three months and the oldest patient had 13 years old. The highest incidence (33.3%) was observed in autumn and 66.7% of patients had a history of recent infection. Electroencephalographic (EEG) findings were abnormal in 55.6% of patients. The most common clinical finding of abnormal EEG was motor disorders (51.8%). Among those who conducted MRI, 71.4% of them had cortical lesions in the brain. In the majority of cases (51.9%), the treatment achieved with intravenous immunoglobulin (IVIG) alone and complete recovery. Conclusion: The ADEM in this region has relatively similar epidemiological features to those studied worldwide and the favorable treatment of our cases has led to a satisfactory percentage of complete clinical recovery.

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