A girl with acute encephalitis followed by acute cerebellitis/cerebellopathy.

OBJECTIVE: The purpose of this study is to bring attention to a case of acute encephalitis not concurrent with acute cerebellitis. CASE PRESENTATION: Five days after onset of common cold symptoms, a 17-months-old girl suffered convulsions, vomiting and respiratory arrest. On exam, she had pharyngeal inflammation, brisk deep tendon reflexes, respiratory acidosis, leukocytosis, negative rapid antigen tests, and segmental pneumonia. Brain CT and MRI/MRA were negative, and EEG was consistent with acute encephalitis. Following hypothermic therapy, methylprednisolone pulse therapy and cefotaxime, she recovered. Four days after discharge, she sustained limb and truncal ataxia associated with normal EEG, followed by bilateral intention tremor. Blood and CSF chemistry and cell counts were normal. Brain MRI revealed high intensity signals in the dentate nuclei and enhancement in the cerebellar white matter, suggestive of acute cerebellitis/cerebellopathy. SPECT imaging showed reduced blood flow in the cerebellum, right thalamus and brain stem. Following short-term administration of g-globulin and prednisolone, she regained her ability to sit and, eventually, to walk. Four months after initial presentation, her brain MRI was normal. No relapse has occurred in 5 years. CONCLUSIONS: The uncommon sequential development of acute encephalitis followed by acute cerebellitis suggests an immune-mediated cerebellar ataxia.

The attempted assassination of President Reagan. Medical implications and historical perspective.

In 1981, President Ronald Reagan became the first incumbent president of the United States to survive being struck by a would-be assassin's bullet. Had President Reagan not survived, the history of this country and the world most certainly would have been changed. This report is the only first-hand account of the details of his medical care and complications following the assassination attempt, an event that emphasizes the vulnerability of presidents to would-be assassins and the importance of readily available expert medical care and facilities to their survival.

[Changes in the severity of burn shock in irradiated animals under the influence of blood serum alpha- and beta-globulins]. / Izmenenie tiazhesti ozhogovogo shoka u obluchennykh zhivotnykh pod vliianiem al'fa- i beta-globulinov syvorotki krovi.

Injection of blood serum alpha-beta-globulins during burn shock normalizes the amount of middle mass molecular peptides, acid proteinase activity, acid-base balance, and hemodynamics in irradiated rats. The survival of animals in this period increases from 23% to 52%.