RESUMO
The spontaneous occurrence of blepharospasm and dystonic movements in face muscles, particularly those of the perioral and mandibular regions, has been named as Meige's disease which was first described by Henry Meige in 1910. We report the case of a woman with Meige's syndrome whose symptoms improved with the use of levetiracetam.
Assuntos
Anticonvulsivantes/administração & dosagem , Músculos Faciais/fisiopatologia , Síndrome de Meige/tratamento farmacológico , Piracetam/análogos & derivados , Toxinas Botulínicas Tipo A/efeitos adversos , Encéfalo/efeitos dos fármacos , Encéfalo/fisiopatologia , Distúrbios do Sono por Sonolência Excessiva/induzido quimicamente , Relação Dose-Resposta a Droga , Eletromiografia/efeitos dos fármacos , Músculos Faciais/inervação , Feminino , Humanos , Canais Iônicos/efeitos dos fármacos , Canais Iônicos/metabolismo , Levetiracetam , Síndrome de Meige/diagnóstico , Síndrome de Meige/fisiopatologia , Pessoa de Meia-Idade , Chaperonas Moleculares/genética , Piracetam/administração & dosagem , Resultado do TratamentoRESUMO
OBJECTIVE: To report a case of disc herniation at T1-2. CLINICAL PRESENTATION: A 57-year-old man presented with hand weakness, Horner's syndrome, and pain radiating along the medial aspect of one upper extremity. Magnetic resonance imaging demonstrated extruded T1-2 disc herniation with upward herniation of a sequestrated fragment. INTERVENTION: An anterior approach was used to excise the disc, that was compressing the spinal cord and the T1 nerve root. All the patient's symptoms resolved completely, including Horner's syndrome. CONCLUSION: Anterior discectomy may be the simplest and most effective method for disc excision and relief of spinal cord and T1 nerve root compression.
Assuntos
Discotomia/métodos , Deslocamento do Disco Intervertebral/patologia , Compressão da Medula Espinal/etiologia , Compressão da Medula Espinal/patologia , Raízes Nervosas Espinhais/lesões , Vértebras Torácicas/patologia , Síndrome de Horner/etiologia , Síndrome de Horner/patologia , Síndrome de Horner/fisiopatologia , Humanos , Deslocamento do Disco Intervertebral/fisiopatologia , Deslocamento do Disco Intervertebral/cirurgia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Debilidade Muscular/etiologia , Debilidade Muscular/patologia , Debilidade Muscular/fisiopatologia , Dor/etiologia , Dor/patologia , Dor/fisiopatologia , Compressão da Medula Espinal/fisiopatologia , Raízes Nervosas Espinhais/patologia , Raízes Nervosas Espinhais/cirurgia , Vértebras Torácicas/fisiopatologia , Vértebras Torácicas/cirurgia , Resultado do TratamentoAssuntos
Demência Vascular/induzido quimicamente , Imunossupressores/efeitos adversos , Falência Renal Crônica/cirurgia , Transplante de Rim/imunologia , Complicações Pós-Operatórias/diagnóstico , Tacrolimo/efeitos adversos , Adolescente , Encéfalo/patologia , Edema Encefálico/diagnóstico , Infarto Cerebral/diagnóstico , Demência Vascular/diagnóstico , Humanos , Imageamento por Ressonância Magnética , MasculinoRESUMO
End-stage renal disease patients who have been on long-term hemodialysis tend to develop central nervous system complications. The most common neurologic complications in this patient group include white matter changes, cerebral atrophy, osmotic demyelination syndrome, dialysis encephalopathy, hypertensive encephalopathy, intracranial hemorrhage, infarct, sinus thrombosis, and infection. Clinical evaluation of these patients is somehow complicated and MRI is important before establishment of the therapy. The purpose of this article is to illustrate the range of MRI findings of neurologic complications in end-stage renal failure patients on hemodialysis with etiologic factors.
Assuntos
Encefalopatias/diagnóstico , Falência Renal Crônica/diagnóstico , Imageamento por Ressonância Magnética , Diálise Renal , Atrofia , Encéfalo/patologia , Diagnóstico Diferencial , Humanos , Falência Renal Crônica/terapiaRESUMO
Pachymeningitis is a rare complication of rheumatoid arthritis. The case of a 52-year-old male rheumatoid arthritis patient with pachymeningitis and optic neuritis who was successfully treated with intravenous cyclophosphamide is described.
Assuntos
Artrite Reumatoide/complicações , Ciclofosfamida/uso terapêutico , Imunossupressores/uso terapêutico , Meningite/tratamento farmacológico , Neurite Óptica/tratamento farmacológico , Antirreumáticos/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Artrite Reumatoide/patologia , Cloroquina/uso terapêutico , Ciclofosfamida/administração & dosagem , Quimioterapia Combinada , Humanos , Imunossupressores/administração & dosagem , Injeções Intravenosas , Imageamento por Ressonância Magnética , Masculino , Meningite/etiologia , Metilprednisolona/uso terapêutico , Pessoa de Meia-Idade , Neurite Óptica/etiologia , Prednisolona/uso terapêuticoRESUMO
To our knowledge, the occlusion of arteries and platelet hyperaggregation have not been reported in patients with malignant mesothelioma. However, venous thromboembolism, especially in the pulmonary vasculature in association with thrombocytosis and hyperfibrinogenemia, are commonly noticed in this disorder. Furthermore, we detected enhanced platelet aggregation in a case of malignant peritoneal mesothelioma with internal carotid artery occlusion in whom there were postsplenectomy thrombocytosis and hyperfibrinogenemia. The possible mechanisms of ICA occlusion in this patient, including the role of MPM and postsplenectomy state, thrombocytosis, platelet functional changes, and other factors were investigated and discussed.
Assuntos
Trombose das Artérias Carótidas/etiologia , Mesotelioma/cirurgia , Neoplasias Peritoneais/cirurgia , Esplenectomia/efeitos adversos , Trombocitose/complicações , Trombocitose/etiologia , Adulto , Trombose das Artérias Carótidas/diagnóstico por imagem , Artéria Carótida Interna , Humanos , Imageamento por Ressonância Magnética , Masculino , Mesotelioma/complicações , Neoplasias Peritoneais/complicações , Agregação Plaquetária , Radiografia , Fatores de RiscoRESUMO
Rheumatoid arthritis is a systemic disease in which cerebral and eye involvement is neither common nor fully understood. Although it is rarely the cause of pachymeningitis and optic neuritis, rheumatoid arthritis should always be kept in mind in these two conditions. We present a 52-year-old male with an 8 month history of rheumatoid arthritis who was referred to the neurology department with headache and decreasing vision and was diagnosed as having rheumatoid pachymeningitis and optic neuritis on the basis of MRI findings.
Assuntos
Artrite Reumatoide/complicações , Meningite/etiologia , Neurite Óptica/etiologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Meningite/diagnóstico , Pessoa de Meia-Idade , Neurite Óptica/diagnósticoRESUMO
BACKGROUND: Akinetic mutism is a behavioral state wherein a patient seems to be awake but does not move or speak. Several patients are reported to have developed mutism after posterior fossa surgery. We present a patient who developed akinetic mutism after total excision of a choroid plexus papilloma of the fourth ventricle, and who was treated with bromocriptine. CASE DESCRIPTION: An 18-year-old woman was admitted with akinetic mutism, which had developed 6 days after posterior fossa surgery. She had had no neurologic deficit in the first 5 days after surgery and could communicate with her family. Despite antioedematous therapy and daily lumbar punctures to drain cerebrospinal fluid, there was no clinical improvement after she entered the akinetic mute state. Brain magnetic resonance revealed ventriculomegaly; brain single photon emission computed tomography revealed bilateral reduction of perfusion in the frontal region. Because daily lumbar drainage did not result in clinical improvement, shunt placement was not considered. Bromocriptine therapy was begun at a dose of 2x2.5 mg; 24 hours later, the patient started to speak and move her upper extremities. Further improvement occurred over the following week when the dose was increased to 3x2.5 mg. Bromocriptine was replaced with a placebo to determine whether the neurologic improvement was caused by the medicine. The patient's neurologic status deteriorated progressively; therefore, bromocriptine was restarted and she was discharged from the hospital. During the 6 months of follow-up, the patient has remained in good health. CONCLUSIONS: The etiology of akinetic mutism is not clear. Monoaminergic pathways, particularly dopaminergic cell groups, are most probably involved in this syndrome, because bromocriptine has a dramatic effect on these patients, as demonstrated in our case.
Assuntos
Bromocriptina/uso terapêutico , Neoplasias do Ventrículo Cerebral/cirurgia , Plexo Corióideo , Agonistas de Dopamina/uso terapêutico , Transtornos dos Movimentos/tratamento farmacológico , Transtornos dos Movimentos/etiologia , Mutismo/tratamento farmacológico , Mutismo/etiologia , Procedimentos Neurocirúrgicos/efeitos adversos , Papiloma/cirurgia , Complicações Pós-Operatórias/tratamento farmacológico , Adolescente , Feminino , Humanos , Complicações Pós-Operatórias/etiologiaRESUMO
Neurological disorders may be seen in end-stage renal disease patients due to uraemia or to complications of dialysis. A dysequilibrium syndrome may be seen, usually soon after or towards the end of haemodialysis. This group of patients has no particular findings on MRI. On the other hand, the osmotic demyelination syndrome has definitive MRI findings, not to date reported with the dysequilibrium syndrome. We report a patient with end-stage renal disease and the dysequilibrium syndrome who showed findings of osmotic demyelination on MRI. The patient had a convulsion after a first haemodialysis, with quadriparesis and hyperactive deep tendon reflexes and bilateral Babinski signs. The upper motor neurone signs lasted for a week. Meanwhile, he was also dysarthric and had dysphagia. He recovered neurologically without any residuum following appropriate treatment and there was improvement on MRI.
Assuntos
Encefalopatias/diagnóstico , Falência Renal Crônica/diagnóstico , Imageamento por Ressonância Magnética , Mielinólise Central da Ponte/diagnóstico , Diálise Renal , Desequilíbrio Hidroeletrolítico/diagnóstico , Adulto , Encéfalo/patologia , Humanos , Masculino , Exame Neurológico , Ponte/patologiaAssuntos
Morte Encefálica , Doadores de Tecidos , Obtenção de Tecidos e Órgãos , Adulto , Idoso , Morte Encefálica/diagnóstico , Angiografia Cerebral , Eletroencefalografia , Potenciais Evocados Auditivos do Tronco Encefálico , Humanos , Masculino , Pessoa de Meia-Idade , Doadores de Tecidos/legislação & jurisprudência , Obtenção de Tecidos e Órgãos/legislação & jurisprudência , Tomografia Computadorizada de Emissão de Fóton Único , Turquia , Ultrassonografia Doppler TranscranianaRESUMO
Congenital muscular dystrophy (CMD) is a heterogeneous group of disorders which is associated with more or less degrees of cerebral involvement. There are four separate entities within CMD nosology. Among these Fukuyama's CMD (FCMD) is highly prevalent in Japan, whereas the classic form with normal or subnormal intelligence, also known as the occidental type, covers the vast majority of cases in the West. We report a case of FCMD seen in a Turkish child.