Navigating the complexity of Guillain-Barré syndrome and Miller-Fisher syndrome overlap syndrome: a pediatric case report.

Guillain-Barré syndrome/Miller-Fisher syndrome (GBS/MFS) overlap syndrome is an extremely rare variant of Guillain-Barré syndrome (GBS) in which Miller-Fisher syndrome (MFS) coexists with other characteristics of GBS, such as limb weakness, paresthesia, and facial paralysis. We report the clinical case of a 12-year-old patient, with no pathological history, who acutely presents with ophthalmoplegia, areflexia, facial diplegia, and swallowing and phonation disorders, followed by progressive, descending, and symmetrical paresis affecting first the upper limbs and then the lower limbs. An albuminocytological dissociation was found in the cerebrospinal fluid study. Magnetic resonance imaging of the spinal cord showed enhancement and thickening of the cauda equina roots. The patient was treated with immunoglobulins with a favorable clinical outcome.

Management of Ptosis in Kearns-Sayre Syndrome: A Case Report and Literature Review.

Kearns-Sayre syndrome (KSS) is a rare mitochondrial disease that affects young adults, due to a deletion of mitochondrial DNA and characterized by the triad: age of onset lower than 20 years, chronic progressive external ophthalmoplegia, and an atypical pigmentary retinopathy. It is also characterized by other endocrine, neurological, and especially cardiac impairment with a very high risk of cardiac complications during surgical procedures under all types of anesthesia. We report a case of KSS revealed by severe bilateral ptosis and confirmed by a muscle biopsy with "ragged red fibers." The ptosis was surgically managed by cautious Frontal suspension under local anesthesia "Frontal nerve block." Through this case, we discuss challenges in the management of KSS patients.

Immune thrombocytopenia and cerebral thrombophlebitis in a patient on eltrombopag: A rare complication.

Thrombopoietin receptor analogs (TPO-RAs) are indicated for splenectomized immune thrombocytopenia refractory to corticosteroids or immunoglobulins, intravenous, or as second-line therapy when splenectomy is contraindicated. Herein, we report a case of left transverse and superior sagittal sinus thrombophlebitis in a 49-year-old woman with chronic immune thrombocytopenia who received 10 days of eltrombopag treatment. Etiologic assessment ruled out acquired thrombophilia and antiphospholipid syndrome. Pharmacovigilance investigation confirmed causality between eltrombopag and the cerebral events, necessitating the definitive discontinuation of the drug. The patient was treated with anticoagulants and anticonvulsants. This evolution was marked by clinical recovery and significant radiological improvement of the thrombotic event. Cerebral venous thrombophlebitis within TPO-RA treatment remains rare, and without codified recommendations, a strict assessment of patients at risk of thrombotic events remains necessary prior to TPO-RA initiation.

Free floating aorto-iliac thrombosis: A rare complication of COVID-19 pneumonia.

Arterial thrombosis encountered during sars-cov2 infections is a rare complication with a poor prognosis compared to venous ones. They generally occur in severe and critical clinical forms of covid19 [1,2]. The physiopathology of arterial thrombosis, even if not completely understood highlights hypercoagulability and excessive inflammation as risk factors with a major role of the endothelial lesions in their occurrence. The presence of cardiovascular risk factors in patients infected with covid19 is also discussed as a predisposing factor for arterial thrombosis [2,3]. We report the case of a North African male patient hospitalized for acute respiratory distress syndrome (ARDS) secondary to covid19 pneumonia, complicated by the occurrence of multiple arterial thrombosis of the aorto-iliac axis with the rare finding of two free floating thrombus in the aorta and the right common iliac artery. Clinically, the patient had developed acute bilateral lower limb ischemia and multi-organ failure and the evolution was dramatic with rapid worsening of the patient...s health and eventually his death. Thromboembolic complications are frequent during covid19 infection but the aortic localization is very rare. Its diagnosis is difficult and it has a poor prognosis. Our objective through this case report is to increase knowledge about arterial thromboembolic events while discussing their link to the sars-cov2 viral infection.

Brain MR imaging in acute hyperammonemic: Case report.

Acute hyperammonemic encephalopathy is rare and generally is not widely known; only a few pediatric cases were found in the literature. These lesions' clinical presentation differs significantly so they can mimic other lesions. In this case report, we discuss a 5-year-old boy who presented with generalized seizures and was unconscious in an apyretic context, for which she had a cranial computed tomographic and magnetic resonance imaging, both objectified an acute hyperammonemic encephalopathy resulting from an enzyme deficiency. Magnetic resonance imaging revealed lesions throughout the cortex, with the perirolandic and occipital cortices spared. This distribution of cerebral signal abnormalities on magnetic resonance imaging with an abrupt and profound neurological disorder is secondary to hyperammonemic. The knowledge of the magnetic resonance imaging results of this entity is essential to accelerate the diagnosis, and treatment, also to prevent sequelae.

Periventricular nodular heterotopy of the gray matter: A case report.

Periventricular focal nodular heterotopia is a rare secondary cerebral distortion caused by the interruption of neuronal migration from the periventricular germinal zone to the cortex during the fetal period. Clinically, it may manifest as epilepsy resistant to pharmacological treatments or rarely as mental retardation. We report a case of a six years-old male child who was subject to the intensive care unit for the management of refractory epilepsy. The diagnosis was done by magnetic resonance imaging of the brain, which revealed a nodular periventricular heterotopia of the gray matter. After the management of the status of epilepticus, the child remained spastic, aphasic with no contact with his environment.