Subject(s)
Diphtheria/etiology , Miller Fisher Syndrome/complications , Pertussis Vaccine , Tetanus/etiology , Diphtheria/diagnosis , Female , Humans , Middle Aged , Miller Fisher Syndrome/diagnosis , Pertussis Vaccine/blood , Pertussis Vaccine/cerebrospinal fluid , Tetanus/diagnosis , Whooping Cough/diagnosisABSTRACT
Medial temporal lobe epilepsy is commonly associated with hippocampal atrophy on MRI and hippocampal sclerosis on histopathological examination of surgically-resected specimens. Likewise, it is well-established that prolonged seizures and status epilepticus can lead to hippocampal edema as noted on MRI. In this paper, the authors present an unusual patient with prolonged refractory status epilepticus, due to limbic encephalitis associated with anti-GAD antibody, who underwent palliative epilepsy surgery. Bilateral hippocampal edema was noted on preoperative MRI. Histologic evaluation confirmed presence of acute necrosis and neuronal loss in the left hippocampal formation. Follow-up MRI several months after surgery demonstrated severe atrophy of the contralateral right hippocampus. This is the first clear histopathological evidence that hippocampal atrophy following status epilepticus is the result of acute neuronal necrosis and cell loss.
Subject(s)
Atrophy , Hippocampus/pathology , Necrosis , Nerve Degeneration/pathology , Status Epilepticus/pathology , Adult , Edema , Female , Humans , Nerve Degeneration/complications , NeuroimagingSubject(s)
Herpes Zoster/complications , Myelitis , Adult , Female , Herpes Zoster/cerebrospinal fluid , Herpes Zoster/immunology , Herpesvirus 3, Human/genetics , Herpesvirus 3, Human/immunology , Humans , Immunoglobulin G/cerebrospinal fluid , Magnetic Resonance Imaging/methods , Myelitis/etiology , Myelitis/pathology , Myelitis/virologySubject(s)
Brain/diagnostic imaging , Brain/pathology , Carbon Monoxide Poisoning/complications , Hearing Loss, Sudden/etiology , Audiometry, Pure-Tone , Hearing Loss, Sudden/diagnosis , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Severity of Illness Index , Tomography, X-Ray ComputedSubject(s)
Brain Ischemia/therapy , Stroke/therapy , Thrombolytic Therapy/methods , Vitreous Hemorrhage/chemically induced , Vitreous Hemorrhage/prevention & control , Acute Disease/therapy , Aged , Blindness/chemically induced , Blindness/prevention & control , Brain Ischemia/complications , Clinical Protocols , Contraindications , Emergency Medical Services/methods , Emergency Medical Services/standards , Fibrinolytic Agents/adverse effects , Fibrinolytic Agents/standards , Humans , Iatrogenic Disease/prevention & control , Injections, Intravenous/adverse effects , Injections, Intravenous/standards , Male , Risk Assessment , Stroke/complications , Thrombectomy/methods , Thrombectomy/standards , Thrombolytic Therapy/standards , Tissue Plasminogen Activator/administration & dosage , Vascular Surgical Procedures/methods , Vascular Surgical Procedures/standards , Vitreous Hemorrhage/physiopathologyABSTRACT
Peduncular hallucinosis (PH) is a rare form of visual hallucination characterized by vivid, nonstereotypical visual images of people, animals, and plants of brief duration that are nonthreatening to the patient. The clinical syndrome of PH consists of formed visual hallucinations, localizing signs of the offending lesion, and sleep disturbances. In the absence of localizing focal neurologic deficits, it is easily confused with a delirium or psychosis. It is seen with lesions involving the upper brainstem and diencephalon. The authors report a case of PH due to ischemic infarction of the midbrain after cardiac catheterization. Although PH has been reported after vertebral angiography, it has never been reported as a complication of cardiac catheterization.
