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1.
Cureus ; 13(8): e16857, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34367838

RESUMO

Several neurological manifestations can occur in the acute phase or in post-infection severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In certain cases, they can even reveal the disease. Although some may be consequences of direct cellular viral invasion, many represent post-infectious inflammation mediated by autoimmune mechanisms. We report the case of a 60-year-old woman who was initially consulted for acute blindness without optic neuritis. Brain MRI revealed nonspecific demyelinating lesions without any radiological signs of optic neuritis. The patient underwent an exhaustive assessment and then the diagnosis of optic neuritis with a normal orbital MRI following a SARS-CoV-2 infection was reached.

2.
Cureus ; 13(8): e16951, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34405075

RESUMO

Neurosyphilis (NS) remains a public health problem. Several recent reports suggest a worldwide increase in the incidence of this condition. Various syndromes can occur in NS, such as syphilitic meningitis, meningovascular syphilis, parenchymatous and gummatous neurosyphilis. Syphilis meningovascular will be the focus of this study. We report 14 new observations of meningovascular syphilis. A review of demographic and clinical features, neuroimaging findings, cerebrospinal fluid changes, treatment and outcome, pathophysiology mechanism of meningovascular syphilis are presented.

3.
Radiol Case Rep ; 16(11): 3602-3609, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34422148

RESUMO

Since the introduction of tyrosine kinase inhibitors as primary therapy for patients with chronic myeloid leukemia (CML), the prognosis of these patients has improved significantly, and the number of patients who progress to the blast phase has decreased considerably. We report the case of a 35 year-old CML patient in accelerated phase treated with nilotinib, who presents a severe COVID-19 infection requiring non-invasive ventilation, and who subsequently presents a multiple cranial nerve palsy revealing a blast crisis of his CML. Multiple cranial nerve palsy is a sign of neurological involvement of CML in its blast phase. The blast crisis represents a real challenge for the clinician, especially during COVID-19 infection. The treatment remains the association of a tyrosine kinase inhibitors with a chemotherapy protocol, as well as the administration of methotrexate and cytarabine by intrathecal and intravenous infusion in high doses. Despite the importance of the association of CML with COVID-19 infection, there is not yet enough data to know the true impact of this infection on the evolution of this hemopathy.

4.
Epilepsia Open ; 6(1): 13-21, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33681643

RESUMO

The World Health Organization (WHO) estimates that about 50 million people of all ages have epilepsy and nearly 85% of whom live in low- and middle-income (LMICs) countries. In Morocco, epilepsy is one of the major neurological health conditions, with an estimated prevalence of 1.1%. The management of patients is difficult due to multiple factors. The lack of neurologists whose number is currently 180, the uneven distribution of neurologists who are concentrated in large cities, 43% of whom are in Rabat and Casablanca alone; the low involvement of general practitioners in the management of epilepsy; the frequent consultation of traditional healers; and the low coverage of social security all contribute to the treatment gap. The management of epilepsy has advanced considerably since the early nineties. Several factors contributed to this progress: the increasing number of neurologists compared to previous years, the creation of well-equipped new academic centers, and small units of general neurology, in addition to the disuse of several antiepileptic drugs. However, much work remains to be done against the use of many forms of traditional practices and the low involvement of general practitioners in the management of epilepsy. This is the first study on epilepsy conducted in Morocco.


Assuntos
Anticonvulsivantes/uso terapêutico , Carbamazepina/uso terapêutico , Epilepsia/tratamento farmacológico , Acessibilidade aos Serviços de Saúde/economia , Neurologistas/provisão & distribuição , Centros Médicos Acadêmicos , Humanos , Medicinas Tradicionais Africanas/psicologia , Marrocos , População Rural
5.
Pan Afr Med J ; 36: 267, 2020.
Artigo em Francês | MEDLINE | ID: mdl-33088396

RESUMO

Wernicke's encephalopathy is a deficiency disease resulting from severe thiamine deficiency (vitamin B1). It mainly occurs in alcoholic subjects, but sometimes it is difficult to diagnose. The absence of treatment leads to severe cognitive sequelae. Magnetic resonance imaging is the gold standard imaging modality to confirm the diagnosis. The diagnostic sign is T2-weighted hyperintensity in the periaqueducal, thalami and mammillary bodies. We report the case of a 30-year-old woman with abundant vomiting during the first trimester of pregnancy (hyperemesis gravidarum), causing symptomatic Wernicke's encephalopathy.


Assuntos
Hiperêmese Gravídica/complicações , Deficiência de Tiamina/complicações , Encefalopatia de Wernicke/etiologia , Adulto , Feminino , Humanos , Imageamento por Ressonância Magnética , Gravidez , Primeiro Trimestre da Gravidez , Deficiência de Tiamina/etiologia , Encefalopatia de Wernicke/diagnóstico por imagem
6.
Spinal Cord Ser Cases ; 6(1): 56, 2020 06 30.
Artigo em Inglês | MEDLINE | ID: mdl-32606288

RESUMO

INTRODUCTION: Neurosyphilis is a sexually transmitted disease secondary to the invasion of the central nervous system by the Treponema pallidum. The spinal syphilitic gumma is rare. CASE PRESENTATION: We report a case of extradural cervical spinal syphilitic gumma revealed by spinal cord compression in a 58-year-old male. The epidural lesion was removed via a posterior approach. Histological examination revealed syphilis. Syphilis serologies were positive. Brain MRI showed an associated cerebro-meningeal syphilitic gumma. Antibiotic regime based on aqueous penicillin G was introduced for 14 days. DISCUSSION: Currently, there is an increase in the frequency of syphilis and changes in its clinical manifestations. Neurosyphilis can take atypical forms. Spinal syphilitic gumma is a rare manifestation and its association with cerebral involvement is exceptional. Diagnosis is based on serologies in the blood and cerebrospinal fluid. The place of imagery, especially magnetic resonance imaging, is essential. Neurosyphilis should be discussed as a possible differential diagnosis in evaluation of spinal and cerebral lesions.


Assuntos
Neurossífilis/complicações , Compressão da Medula Espinal/complicações , Compressão da Medula Espinal/patologia , Sífilis/patologia , Antibacterianos/uso terapêutico , Vértebras Cervicais/patologia , Vértebras Cervicais/fisiopatologia , Diagnóstico Diferencial , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Neurossífilis/diagnóstico , Neurossífilis/terapia , Compressão da Medula Espinal/diagnóstico , Sífilis/diagnóstico
7.
Clin Park Relat Disord ; 3: 100057, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-34316640

RESUMO

Parkinsonism related to chronic Manganese exposure is notably due to focal lesions of the basal ganglia. Our study focused on epidemiological, clinical, toxicological and experimental aspects of Manganese-induced Parkinsonism in south of Morocco. It is a prospective study concerning the workers and the residents bordering on the 2 mines in the south of Morocco. The results of the study concerned 120 cases divided into 4 groups of patients: G1: 30 cases exposed to different incriminated toxic products, which present Parkinsonian signs, G2: 30 cases healthy and exposed, G3: 30 cases affected with Idiopathic Parkinson's disease, and G4: 30 cases healthy and unexposed (controls). The results from the first mine show that 5.7% of the sample developed Manganese-Induced Parkinsonism and this percentage is slightly higher (4.5%) than the second mine site. Chemical and biological analysis revealed high levels of Manganese. The majority of patients did not improve the clinical signs under L-dopa treatment. The authors underline the gravity of Manganese-induced Parkinsonism and propose a listing of the various exposures as well as a cartography of the regions of risk in Morocco.

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