scholarly journals An unusual neurological complication from a garden‐variety organism: post‐melioidosis parkinsonism

2015 ◽  
Vol 202 (6) ◽  
pp. 333-334 ◽  
Author(s):  
Choon Seong Ng ◽  
Shahrul Azmin ◽  
Zhe Kang Law ◽  
Ramesh Sahathevan ◽  
Wan Nur Nafisah Wan Yahya ◽  
...  
2020 ◽  
Vol 17 ◽  
Author(s):  
Shiling Chen ◽  
Chao Pan ◽  
Ping Zhang ◽  
Yingxin Tang ◽  
Zhouping Tang

Abstract:: Acute Ischemic Stroke (AIS) is currently the most frequently reported neurological complication of Coronavirus disease 2019 (COVID-19). This article will elaborate on the clinical features of inpatients with COVID-19 and AIS and the pathophysiological mechanism of AIS under the background of COVID-19. Through a detailed search of relevant studies, we found that the incidence of AIS among COVID-19 patients varied from 0.9% to 4.6%, and AIS has been observed in many people without underlying diseases and cardiovascular risk factors as well as young people. The National Institute of Health Stroke Scale (NIHSS) score of COVID-19 patients with AIS was higher than historical AIS patients, and the proportion of large vessel occlusion (LVO) was about 64.2%. COVID-19 patients with AIS have commonly high levels of D-D dimer, fibrinogen, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR), suggesting systemic hyperinflammatory and hypercoagulable state. The pooled mortality of COVID-19 patients with AIS was 38% and the mortality of LVO patients is higher (45.9%). Compared with COVID-19-negative AIS patients in the same period in 2020 and 2019, COVID- 19 patients with AIS had a worse prognosis.


2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Mohamed Hadbi ◽  
Dalila Benalakma ◽  
Nadia Fellah

Abstract Background The dramatic evolution of incoercible vomiting in pregnancy is at the origin of a rare and serious neurological complication known as EGW; its symptomatology is polymorphic posing a diagnostic problem. MRI is the test of choice for screening. Early vitamin supplementation is essential to improve the maternal-fetal prognosis. Case presentation A 35-year-old parturient, G5P1, without particular pathological history presented incoercible vomiting at 8 weeks, which led to dehydration, undernutrition, and impairment of general condition. Neurological signs: headaches, confused scored at 14 on the Glasgow scale, amnesia, a cerebellar syndrome, sensory-motor deficit. Ophthalmological examination revealed: edema in the eye fundus, a decrease in visual acuity, nystagmus, and ophthalmoplegia. The biological analysis showed moderate hepatic cytolysis. Given the polymorphic neurological symptomatology presented by our parturient, several differential diagnoses were evoked: intracranial hypertension (headache - vomiting - decrease in visual acuity - papillary edema), brain stroke (sensory-motor deficit, ground “pregnancy”), deficit in vitamin B12 (sensory-motor deficit, confusion, memory impairment), and GWE (nystagmus-confusion-ataxia). Cerebral MRI has allowed us to establish the diagnosis of GWE. Conclusion All pregnant with severe hyperemesis gravidarum should be supplemented with thiamine prior to glucose administration to prevent and improve the prognosis of GWE.


2021 ◽  
Vol 38 (5) ◽  
Author(s):  
Tenzin Tender ◽  
Rakesh Ravishankar Rahangdale ◽  
Sridevi Balireddy ◽  
Madhavan Nampoothiri ◽  
K. Krishna Sharma ◽  
...  

Abstract Chemotherapy-induced peripheral neuropathy (CIPN) is the most prevalent neurological complication of cancer treatment which involves sensory and motor nerve dysfunction. Severe CIPN has been reported in around 5% of patients treated with single and up to 38% of patients treated with multiple chemotherapeutic agents. Present medications available for CIPN are the use of opioids, nonsteroidal anti-inflammatory agents, and tricyclic antidepressants, which are only marginally effective in treating neuropathic symptoms. In reality, symptom reappears after these drugs are discontinued. The pathogenesis of CIPN has not been sufficiently recognized and methods for the prevention and treatment of CIPN remain vulnerable to therapeutic problems. It has witnessed that the present medicines available for the disease offer only symptomatic relief for the short term and have severe adverse side effects. There is no standard treatment protocol for preventing, reducing, and treating CIPN. Therefore, there is a need to develop curative therapy that can be used to treat this complication. Melittin is the main pharmacological active constituent of honeybee venom and has therapeutic values including in chemotherapeutic-induced peripheral neuropathy. It has been shown that melittin and whole honey bee venom are effective in treating paclitaxel and oxaliplatin-induced peripheral neuropathy. The use of melittin against peripheral neuropathy caused by chemotherapy has been limited despite having strong therapeutic efficacy against the disease. Melittin mediated haemolysis is the key reason to restrict its use. In our study, it is found that α-Crystallin (an eye lens protein) is capable of inhibiting melittin-induced haemolysis which gives hope of using an appropriate combination of melittin and α-Crystallin in the treatment of CIPN. The review summarizes the efforts made by different research groups to address the concern with melittin in the treatment of chemotherapeutic-induced neuropathy. It also focuses on the possible approaches to overcome melittin-induced haemolysis. Graphic Abstract


Author(s):  
Lívio Pereira de Macêdo ◽  
Arlindo Ugulino Netto ◽  
Kauê Franke ◽  
Pierre Vansant Oliveira Eugenio ◽  
John Anderson da Silva Rocha ◽  
...  

Abstract Introduction The increase in intracranial pressure (ICP) is a neurological complication resulting from numerous pathologies that affect the brain and its compartments. Therefore, decompressive craniectomy (DC) is an alternative adopted to reduce ICP in emergencies, especially in cases refractory to clinical therapies, in favor of patient survival. However, DC is associated with several complications, including hydrocephalus (HC). The present study presents the results of an unusual intervention to this complication: the implantation of an external ventricular drain (EVD) in the intraoperative period of cranioplasty (CP). Methods Patients of both genders who presented with HC and externalization of the brain through the cranial vault after decompressive hemicraniectomy and underwent EVD implantation, to allow the CP procedure, in the same surgical procedure, were included. Results Five patients underwent DC due to a refractory increase in ICP, due to automobile accidents, firearm projectiles, falls from stairs, and ischemic strokes. All evolved with HC. There was no uniform time interval between DC and CP. The cerebrospinal fluid (CSF) was drained according to the need for correction of cerebral herniation in each patient, before undergoing cranioplasty. All patients progressed well, without neurological deficits in the immediate postoperative period. Conclusion There are still several uncertainties about the management of HC resulting from DC. In this context, other CP strategies simultaneous to the drainage of CSF, not necessarily related to ventriculoperitoneal shunt (VPS), should be considered and evaluated more deeply, in view of the verification of efficacy in procedures of this scope, such as the EVD addressed in this study.


Burns ◽  
2001 ◽  
Vol 27 (6) ◽  
pp. 647-651 ◽  
Author(s):  
Mustafa Deveci ◽  
Mehmet Bozkurt ◽  
Mustafa Sengezer

2014 ◽  
Vol 2014 ◽  
pp. 1-16 ◽  
Author(s):  
Neera Chaudhry ◽  
Ashish Kumar Duggal

Sepsis associated encephalopathy (SAE) is a common but poorly understood neurological complication of sepsis. It is characterized by diffuse brain dysfunction secondary to infection elsewhere in the body without overt CNS infection. The pathophysiology of SAE is complex and multifactorial including a number of intertwined mechanisms such as vascular damage, endothelial activation, breakdown of the blood brain barrier, altered brain signaling, brain inflammation, and apoptosis. Clinical presentation of SAE may range from mild symptoms such as malaise and concentration deficits to deep coma. The evaluation of cognitive dysfunction is made difficult by the absence of any specific investigations or biomarkers and the common use of sedation in critically ill patients. SAE thus remains diagnosis of exclusion which can only be made after ruling out other causes of altered mentation in a febrile, critically ill patient by appropriate investigations. In spite of high mortality rate, management of SAE is limited to treatment of the underlying infection and symptomatic treatment for delirium and seizures. It is important to be aware of this condition because SAE may present in early stages of sepsis, even before the diagnostic criteria for sepsis can be met. This review discusses the diagnostic approach to patients with SAE along with its epidemiology, pathophysiology, clinical presentation, and differential diagnosis.


2021 ◽  
Vol 32 (2) ◽  
pp. 142-144
Author(s):  
Abdul Basit Ibne Momen ◽  
Furial Quraishi Twinkle ◽  
Aminur Rahman ◽  
Firoz Ahmed Quraishi

Guillain-Barre syndrome (GBS) following typhoid is extremely uncommon and only few case reports are available in literature. The importance of this case report is to highlight upon the fact that a diagnosis of GBS should always be kept in mind whenever a patient of typhoid fever develops weakness. We report a young girl with blood culture proven typhoid fever that developed this very rare neurological complication quite early in the course of the disease. Following treatment with intravenous antibiotics and intravenous immunoglobulin, she was improved. Bangladesh J Medicine July 2021; 32(2) : 142-144


2018 ◽  
Vol 33 (1) ◽  
pp. 96
Author(s):  
Joo-Yun Kim ◽  
Hyun-Su Ri ◽  
Ji-Uk Yoon ◽  
Eun-Ji Choi ◽  
Hye-Jin Kim ◽  
...  

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