RESUMO
This study aimed to retrospectively review the frequency and clinical features of 13 patients with progressive supranuclear palsy (PSP) and idiopathic normal pressure hydrocephalus (iNPH). All patients were found to have PSP-Richardson's syndrome (PSP-RS). Shunt surgery was effective in 5 of 11 patients (45.5%). A comparison of these 5 patients who responded to shunt surgery versus the remaining 6 patients revealed a significant difference in the reduction of frontal lobe blood flow on cerebral perfusion single-photon emission computed tomography (SPECT) (P = 0.018). These results suggest that PSP-RS is common in patients with PSP and iNPH and indicate the usefulness of cerebral perfusion SPECT in estimating the effect of shunt surgery.
Assuntos
Hidrocefalia de Pressão Normal , Paralisia Supranuclear Progressiva , Humanos , Paralisia Supranuclear Progressiva/diagnóstico por imagem , Paralisia Supranuclear Progressiva/cirurgia , Hidrocefalia de Pressão Normal/diagnóstico por imagem , Hidrocefalia de Pressão Normal/cirurgia , Estudos Retrospectivos , Lobo FrontalRESUMO
Long-lasting meningitis complicated by N-methyl-d-aspartate receptor (NMDAR) encephalitis has not been discussed widely in the literature. Herein, we present two cases of anti-NMDAR encephalitis preceded by meningitis. The patients had 60- and 22-day periods of preceding meningitis, which improved with intravenous methylprednisolone and plasmapheresis. No tumors were detected in either of the patients. Although meningitis preceding anti-NMDAR encephalitis is not rare, our patients, especially those who had it for a duration of 60 days, had longer durations of meningitis. This manuscript foregrounds that anti-NMDAR encephalitis might be included in the differential diagnosis of long-lasting meningitis.
Assuntos
Encefalite Antirreceptor de N-Metil-D-Aspartato , Meningite , Humanos , Encefalite Antirreceptor de N-Metil-D-Aspartato/complicações , Encefalite Antirreceptor de N-Metil-D-Aspartato/diagnóstico por imagem , Encefalite Antirreceptor de N-Metil-D-Aspartato/terapia , Metilprednisolona/uso terapêutico , Meningite/complicações , Plasmaferese , Receptores de N-Metil-D-AspartatoRESUMO
Recent studies have demonstrated that atypical parkinsonism can be presented in autoimmune encephalitis and paraneoplastic neurological syndromes. However, it is unclear which anti-neural antibodies are involved and when these diseases should be suspected. To address these clinical questions, we conducted a scoping review and analyzed 38 articles. The literature shows that many anti-neural antibodies, including unknown ones, have been reported in progressive supranuclear palsy, corticobasal syndrome, and multiple system atrophy. Moreover, the following symptoms and signs suggest the possibility of autoimmune encephalitis and paraneoplastic neurological syndromes: early onset, acute or subacute progression, the presence of a neoplasm, significant weight loss, abnormal cerebrospinal fluid findings, the absence of typical brain magnetic resonance imaging findings, and the existence of atypical physical examination signs.
Assuntos
Doenças Autoimunes do Sistema Nervoso , Encefalite , Síndromes Paraneoplásicas , Transtornos Parkinsonianos , Paralisia Supranuclear Progressiva , Humanos , Transtornos Parkinsonianos/diagnóstico , Transtornos Parkinsonianos/etiologia , Encefalite/diagnóstico , Encefalite/etiologia , Paralisia Supranuclear Progressiva/diagnósticoRESUMO
An 86-year-old man was diagnosed with bulbar type of amyotrophic lateral sclerosis (ALS). He underwent a bumper-tube type of gastrostomy due to dysphagia 16 months after the onset of ALS. Twenty months after the onset, he developed dyspnea due to anemia. Upper gastrointestinal endoscopy showed a gastric ulcer contralateral to the gastrostomy site with bumper indentation from the gastrostomy tube. Patients with ALS might develop gastric ulceration due to mechanical stimulation with a percutaneous endoscopic gastrostomy tube.