RESUMO
No disponible
Assuntos
Humanos , Feminino , Idoso , Abscesso Hepático , Colecistite , Klebsiella pneumoniae , Diabetes MellitusRESUMO
BACKGROUND: Disproportionate fear of contracting COVID-19 (coronaphobia) may result in inappropriate use of preventive measures that could, in turn, result in severe harm to the patient. OBJECTIVE: To describe a patient with subacute parkinsonism and cognitive dysfunction and magnetic resonance imaging (MRI) evidence of bilateral deep white matter and basal ganglia damage. CASE PRESENTATION: A 56-year-old female presented with a 4-week history of insomnia, cognitive decline, and parkinsonism. Brain MRI revealed a bilateral lesion of both globus pallidus, deep white matter, and cerebellar hemispheres. Her son reported that, for the previous month, she had been cleaning her facial mask three times a day with a pure methanol solution as a disinfectant due to an intense fear of acquiring COVID-19. Previously, she had used 97% isopropyl alcohol and had inadvertently switched to methanol. After the exposure ended, she slowly improved but 4 months later she remains severely disabled. CONCLUSIONS: The repeated exposure to methanol vapor, the MRI findings, and the absence of other etiologies for her cognitive and parkinsonian features led to the diagnosis of chronic methanol intoxication with severe central nervous system damage. Misinformation is a likely contributory factor to such scenario. Efforts should be made by the scientific community to educate the general public on avoiding self-damaging behaviors as a result of coronaphobia.
Assuntos
COVID-19 , Metanol , Medo , Feminino , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , SARS-CoV-2Assuntos
Encéfalo/fisiopatologia , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , Estado Epiléptico/diagnóstico , Encéfalo/diagnóstico por imagem , COVID-19 , Infecções por Coronavirus/complicações , Infecções por Coronavirus/terapia , Eletroencefalografia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/terapia , Estado Epiléptico/etiologiaRESUMO
Neurological complications of Epstein Barr virus (EBV) infection are infrequent and may include occasionally encephalitis, usually with a benign evolution. We here report on an aggressive case of EBV encephalitis in a 14-year-old boy with extensive basal ganglia involvement, and to a lesser degree of brain cortex who presented atypically with akinetic mutism and non-convulsive status epilepticus, requiring intensive care but showed a favorable outcome. EBV encephalitis is uncommon and its best management is unclear. Its pathophysiology is not well understood but could include autoimmunity. Onconeuronal and synaptic antibodies were negative in serum and cerebrospinal fluid, including the dopamine D2 receptor. To the best of our knowledge, this is the first report to evaluate antibodies to D2 receptors in EBV encephalitis. Corticosteroid therapy is usually recommended but the use of acyclovir is controversial. Intensive care is required in severe cases to assure a favorable outcome.
