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1.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 35(10): 1318-1322, 2021 Oct 15.
Artigo em Chinês | MEDLINE | ID: mdl-34651487

RESUMO

Objective: To investigate the effect of prophylactic C 4, 5 foraminal dilatation in posterior cervical open-door surgery on postoperative C 5 nerve root palsy syndrome. Methods: The clinical data of patients with cervical spondylotic myelopathy (cervical spinal cord compression segments were more than 3) who met the selection criteria between March 2016 and March 2019 were retrospectively analyzed. Among them, 40 patients underwent prophylactic C 4, 5 foraminal dilatation in posterior cervical open-door surgery (observation group) and 40 patients underwent simple posterior cervical open-door surgery (control group). There was no significant difference between the two groups ( P>0.05) in gender, age, disease duration, Nurick grade of spinal cord symptoms, and preoperative diameter of C 4, 5 intervertebral foramen, Japanese Orthopaedic Association (JOA) score, and visual analogue scale (VAS) score. The occurrence of C 5 nerve root paralysis syndrome was recorded and compared between the two groups, including incidence, paralysis time, recovery time, and spinal cord drift. VAS and JOA scores were used to evaluate the improvement of pain and function before operation and at 12 months after operation. Results: The incisions of the two groups healed by first intention, and there was no early postoperative complications such as cerebrospinal fluid leakage. Patients of both groups were followed up 12-23 months, with an average of 17.97 months. C 5 nerve root paralysis syndrome occurred in 8 cases in the observation group (3 cases on the right and 5 cases on the left) and 2 cases in the control group (both on the right). There was significant difference of the incidence (20% vs. 5%) between the two groups ( χ 2=4.114, P=0.043). Except for 1 case in the observation group who developed C 5 nerve root palsy syndrome at 5 days after operation, the rest patients all developed at 1 day after operation; the recovery time of the observation group and the control group were (3.87±2.85) months and (2.50±0.70) months respectively, showing no significant difference between the two groups ( t=-0.649, P=0.104). At 12 months after operation, the JOA score and VAS score of cervical spine in the two groups significantly improved when compared with those before operation ( P<0.05); there was no significant difference in the difference of the cervical spine JOA score and VAS score between at 12 months after operation and before operation and the degree of spinal cord drift between the two groups ( P>0.05). Conclusion: Prophylactic C 4, 5 foraminal dilatation can not effectively prevent and reduce the occurrence of postoperative C 5 root palsy, on the contrary, it may increase its incidence, so the clinical application of this procedure requires caution.


Assuntos
Laminoplastia , Vértebras Cervicais/cirurgia , Dilatação , Humanos , Laminectomia , Paralisia/etiologia , Paralisia/prevenção & controle , Estudos Retrospectivos , Resultado do Tratamento
2.
BMJ Case Rep ; 14(10)2021 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-34642217

RESUMO

A primary intraventricular haemorrhage (PIVH) usually presents with non-localised neurological symptoms since the haematoma is limited to the ventricles. However, it is sometimes associated with focal neurological signs, whose pathophysiologies are not confirmed. Here, we report on a case of PIVH who showed rare manifestations in the acute stage: upward gaze palsy and convergence insufficiency. The CT and MRI showed intraventricular haematoma without evidence of parenchymal haemorrhage, local mass effect around midbrain or hydrocephalus. There had been bilateral papilloedema, and it resolved along with improvement of the ophthalmic symptoms, suggesting a possible causal relation to increased intracranial pressure. The ophthalmic abnormalities suggested injury of the rostral part of the midbrain, especially the region around the dorsal midbrain tectum. It should be known that PIVH is one of the causes of acutely developing upward gaze palsy and convergence insufficiency.


Assuntos
Transtornos da Motilidade Ocular , Hemorragia Cerebral/complicações , Hemorragia Cerebral/diagnóstico por imagem , Ventrículos Cerebrais , Humanos , Mesencéfalo , Transtornos da Motilidade Ocular/diagnóstico , Transtornos da Motilidade Ocular/etiologia , Paralisia
3.
Unfallchirurg ; 124(10): 823-831, 2021 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-34542653

RESUMO

BACKGROUND: Traumatic nerve injuries are associated with a high morbidity and long rehabilitation times. The extent of a nerve lesion and the related regeneration potential can often only be estimated during the course, whereby the time window for successful surgical interventions is limited. OBJECTIVE: The incidence and distribution of traumatic nerve lesions are reported. Algorithms for treatment decisions are presented. MATERIAL AND METHODS: Statistics from the German TraumaRegister DGU® as well as international registers were evaluated. The results of basic research and expert recommendations for diagnostics and treatment are discussed. RESULTS AND CONCLUSION: A strategic approach to conservative and surgical treatment of traumatic nerve injuries depending on the extent of injury and resulting regeneration potential is recommended. In conjunction with the clinical course, electrophysiology and imaging diagnostics, e.g. nerve sonography, can help to differentiate between neurapraxia, axonotmesis and neurotmesis.


Assuntos
Traumatismos dos Nervos Periféricos , Humanos , Incidência , Paralisia , Traumatismos dos Nervos Periféricos/diagnóstico , Traumatismos dos Nervos Periféricos/cirurgia , Ultrassonografia
4.
BMJ Case Rep ; 14(9)2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34479886

RESUMO

A 16-year-old patient presented with sudden-onset difficulty in swallowing food especially for liquids with nasal regurgitation and rhinolalia with no history of fever and limb weakness. Examination revealed bilateral palatal palsy with absence of gag reflex. Other neurological examinations were normal. Investigations were done to rule out any known pathology leading to such a presentation. The symptoms were attributed to an idiopathic acute-onset-acquired bilateral palatal palsy, in the absence of any identifiable cause. This is a rare presentation in adolescent age with no case reported in the literature so far in this age group. Medical management was started and patient showed complete improvement within 2 weeks of his symptoms. Early diagnosis and aggressive management of this condition lead to a favourable prognosis.


Assuntos
Palato , Paralisia , Adolescente , Humanos , Debilidade Muscular , Paralisia/diagnóstico , Paralisia/etiologia , Distúrbios da Fala
5.
Int J Infect Dis ; 111: 310-312, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34492394

RESUMO

OBJECTIVES: Facial nerve palsy (or Bell's palsy) has occasionally been reported following the administration of coronavirus disease 2019 (COVID-19) mRNA vaccines (BNT162b2 and mRNA-1273). Our study investigated such cases using a large self-reporting database from the USA (Vaccine Adverse Event Reporting System [VAERS]). METHODS: A disproportionality analysis, adjusted for age and sex, was conducted for VAERS reports from individuals who were vaccinated at the age of 18 years or over, between January 2010 and April 2021. RESULTS: The analysis revealed that the adverse events following immunization (AEFI) of facial nerve palsy, after administration of COVID-19 mRNA vaccines, was significantly highly reported, both for BNT162b2 (reporting odds ratio [ROR] 1.84; 95% confidence interval [CI] 1.65-2.06) and mRNA-1273 (ROR 1.54; 95% CI 1.39-1.70). These levels were comparable to that following influenza vaccination reported before the COVID-19 pandemic (ROR 2.04; 95% CI 1.76-2.36). CONCLUSIONS: Our pharmacovigilance study results suggest that the incidence of facial nerve palsy as a non-serious AEFI may be lower than, or equivalent to, that for influenza vaccines. This information might be of value in the context of promoting worldwide vaccination, but needs to be validated in future observational studies.


Assuntos
Paralisia de Bell , COVID-19 , Vacinas contra Influenza , Adolescente , Adulto , Sistemas de Notificação de Reações Adversas a Medicamentos , Paralisia de Bell/epidemiologia , Vacinas contra COVID-19/efeitos adversos , Nervo Facial , Humanos , Vacinas contra Influenza/efeitos adversos , Pandemias , Paralisia , RNA Mensageiro/genética , SARS-CoV-2 , Adulto Jovem
6.
A A Pract ; 15(8): e01514, 2021 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-34415241

RESUMO

Peripheral nerve blocks for postoperative pain management in distal radius fracture fixation with volar locking plates can cause undesirable motor paralysis. We performed bilateral ultrasound-guided selective sensory nerve blocks to the lateral cutaneous nerve of the forearm, superficial branch of the radial nerve, and anterior interosseous nerve for a patient undergoing bilateral distal radius fracture fixation with volar locking plates. This case report describes the first successful use of this ultrasound-guided selective sensory nerve block, which provided satisfactory postoperative analgesia and preserved the patient's motor function following distal radius fracture fixation with volar locking plates.


Assuntos
Analgesia , Bloqueio Nervoso , Fraturas do Rádio , Fixação Interna de Fraturas , Humanos , Paralisia , Rádio (Anatomia) , Fraturas do Rádio/cirurgia , Ultrassonografia de Intervenção
7.
Ann Plast Surg ; 87(3): 316-323, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34397520

RESUMO

BACKGROUND: Neurolysis techniques have been adapted for decompression of peripheral nerves in multiple locations, including the common peroneal nerve (CPN) at the fibular neck. The aim of this study was to conduct a systematic review and meta-analysis to summarize the clinical outcomes of neurolysis for the management of peroneal nerve palsy (PNP). METHODS: Preferred Reporting Systems for Systematic Reviews and Meta-Analyses guidelines were followed for this meta-analysis. Four databases were queried, and randomized clinical trials, cohort studies, case-control studies, and case series with n > 10 published in English that evaluated clinical outcomes of neurolysis for the treatment of PNP and foot drop were included. Two reviewers completed screening and data extraction. Methodological quality was evaluated using the Newcastle-Ottawa Scale. RESULTS: A total of 493 articles were identified through literature search. Title and abstract screening identified 39 studies for full-text screening. Ten articles met the inclusion criteria for qualitative analysis, and 8 had complete data for meta-analysis.Overall, there were 368 patients (370 nerves) who had neurolysis of the CPN for PNP, of which 59.2% (n = 218) were men and 40.8% (n = 150) were women. The mean age of the patients was 47.1 years (SD, 10.0 years), mean time to surgery was 9.65 months (SD, 6.3 months), and mean follow-up time was 28 months (SD, 14.0 months). The median preoperative Medical Research Council (MRC) score was 1 (IQR 0, 3), with 42.2% (n = 156) having MRC score of 0. The median postoperative MRC score was 5 (IQR 4, 5), with 53.9% (n = 199) having MRC score of 5. Complications of neurolysis of the peroneal nerve for treatment of PNP included postoperative infection (0.54%, n = 2), wound dehiscence (0.27%, n = 1), hematoma (0.54%, n = 2), bleeding (0.27%, n = 1), relapse of PNP (0.27%, n = 1), and 1 case of mortality due to sepsis. CONCLUSIONS: Our meta-analysis shows that neurolysis of the CPN is safe and improves ankle dorsiflexion strength in patients with PNP. Future studies should use a standardized method of measuring sensory outcomes, and studies of higher levels of evidence are needed to better assess the clinical outcomes of neurolysis for treatment of PNP.


Assuntos
Neuropatias Fibulares , Feminino , Fíbula , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Neurocirúrgicos , Paralisia , Nervo Fibular/cirurgia , Neuropatias Fibulares/cirurgia
9.
J Infect Public Health ; 14(9): 1198-1200, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34416597

RESUMO

We report the case of a 10-year-old boy with acute-onset diplopia and ptosis in the right eye. CR was positive for SARS-CoV-2. The patient was managed successfully with corticosteroids. We highlight the need for heightened suspicion of occult COVID-19 infection among children presenting with unusual III nerve palsy.


Assuntos
COVID-19 , Diplopia , Criança , Diplopia/diagnóstico , Diplopia/etiologia , Humanos , Masculino , Nervo Oculomotor , Paralisia , SARS-CoV-2
10.
Neuropsychologia ; 161: 107998, 2021 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-34419490

RESUMO

Attention allows pieces of information stored in visuospatial short-term memory (VSSTM) to be selectively processed. Previous studies showed that shifts of attention in VSSTM in response to a retro-cue are accompanied by eye movements in the direction of the position of the memorized item although there is nothing left to look at. This finding raises the possibility that shifts of attention in VSSTM are underpinned by mechanisms originally involved in the planning and control of eye movements. To explore this possibility, we investigated the ability of an individual with congenital horizontal gaze paralysis (HGP2) to shift her attention horizontally or vertically toward a memorized item within VSSTM using a retro-cue paradigm. As efficient oculomotor programming is not innate but requires some trial and error learning and adaptation to develop, congenital paralysis prevents this development. Consequently, if shifts of attention in VSSTM rely on the same mechanisms as those supporting the programming of eye movements, then horizontal congenital gaze paralysis should necessarily prevent typical retro-cueing effect in the paralyzed axis. At odds with this prediction, HGP2 showed a typical retro-cueing effect in her paralyzed axis. This original finding indicates that selecting an item within VSSTM does not depend on the ability to program a saccade.


Assuntos
Movimentos Oculares , Memória de Curto Prazo , Atenção , Sinais (Psicologia) , Feminino , Fixação Ocular , Humanos , Paralisia , Movimentos Sacádicos
11.
BMC Musculoskelet Disord ; 22(1): 614, 2021 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-34246250

RESUMO

BACKGROUND: C5 nerve root paralysis is a nonnegligible complication after posterior cervical spine surgery (PCSS). The cause of its occurrence remains controversial. The purpose of this study was to analyse the incidence of and risk factors for C5 nerve root paralysis after posterior cervical decompression. METHODS: We retrospectively analysed the clinical data of 640 patients who underwent PCSS in the Department of Orthopaedics, Affiliated Hospital of Qingdao University from September 2013 to September 2019. According to the status of C5 nerve root paralysis after surgery, all patients were divided into paralysis and normal groups. Univariate and multivariate analyses were used to determine the independent risk factors for C5 nerve root paralysis. A receiver operating characteristic (ROC) curve was used to demonstrate the discrimination of all independent risk factors. RESULTS: Multivariate logistic regression analysis revealed that male sex, preoperative cervical spine curvature, posterior longitudinal ligament ossification, and preoperative C4/5 spinal cord hyperintensity were independent risk factors for paralysis, whereas the width of the intervertebral foramina was an independent protective factor for paralysis. The area under the curve (AUC) values of the T2 signal change at C4-C5, sex, cervical foramina width, curvature and posterior longitudinal ligament ossification were 0.706, 0.633, 0.617, 0.637, and 0.569, respectively. CONCLUSIONS: Male patients with C4-C5 intervertebral foramina stenosis, preoperative C4-C5 spinal cord T2 high signal, combined with OPLL, and higher preoperative cervical spine curvature are more likely to develop C5 nerve root paralysis after surgery. Among the above five risk factors, T2 hyperintensity change in C4-C5 exhibits the highest correlation with C5 paralysis and strong diagnostic power. It seems necessary to inform patients who have had cervical spine T2 hyperintensity before surgery of C5 nerve root paralysis after surgery, especially those with altered spinal cord T2 signals in the C4-C5 segment.


Assuntos
Vértebras Cervicais , Paralisia , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/cirurgia , Descompressão Cirúrgica/efeitos adversos , Feminino , Humanos , Masculino , Paralisia/diagnóstico , Paralisia/epidemiologia , Paralisia/etiologia , Estudos Retrospectivos , Fatores de Risco , Raízes Nervosas Espinhais/diagnóstico por imagem , Raízes Nervosas Espinhais/cirurgia
12.
Childs Nerv Syst ; 37(9): 2865-2871, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34196747

RESUMO

PURPOSE: This study aimed to investigate the gross motor functions including head control, midline crossing, and rolling, and the relationship between these developmental skills and upper extremity skill quality in children with neonatal brachial plexus palsy (NBPP). METHODS: A total of 106 children with NBPP, aged 10-18 months, were included in this study. Injury severity was determined with the Narakas Classification. The gross motor function measurement lying and rolling sub-scale was used to evaluate gross motor functions including head control, midline crossing, and rolling, while the Quality of Upper Extremity Skills Test was applied to assess the upper extremity skill quality. The assessments were performed only once during routine physiotherapy controls. RESULTS: As the severity of injury increased, developmental skill capacity decreased and upper extremity skill quality deteriorated (ps = 0.0001). There was a strong positive correlation between these developmental skills and upper extremity skill quality (ps = 0.0001). CONCLUSION: Developmental skills are affected by NBPP. Rehabilitation programs aimed at increasing the quality of upper extremity skills should be included in neurodevelopmental treatment approaches.


Assuntos
Neuropatias do Plexo Braquial , Plexo Braquial , Paralisia do Plexo Braquial Neonatal , Criança , Humanos , Recém-Nascido , Paralisia , Extremidade Superior
13.
J Hand Surg Eur Vol ; 46(7): 705-707, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34289724

RESUMO

The widespread use of the operating microscope for nerve repairs has inspired operative treatment for obstetric paralysis. For a long time, the standard treatment has been based on early nerve surgery. However, the generally accepted strategy for treating obstetric paralysis is far from satisfactory. The main sequels we have observed are due to incorrect treatment of the deficits or due to devastating early nerve surgery. Therefore, a different approach should be considered and designed to prevent and treat the main deficits. After examining over 1000 non-operated patients over almost four decades and in three different countries, I have never encountered anyone who has not recovered active contraction of shoulder muscles or relatively strong elbow flexion. Therefore, I recommend not to have early nerve surgery.


Assuntos
Neuropatias do Plexo Braquial , Articulação do Cotovelo , Paralisia Obstétrica , Feminino , Humanos , Paralisia , Gravidez , Amplitude de Movimento Articular
14.
Jpn J Ophthalmol ; 65(5): 644-650, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34251547

RESUMO

PURPOSE: To study the effect of eye dominance on excyclotorsion in unilateral superior oblique palsy (USOP). STUDY DESIGN: Retrospective clinical study METHODS: Objective excyclotorsion was measured as the disc-to-fovea angle by fundus photography OU. Subjective excyclotorsion was determined with a major amblyoscope based on the difference in the earth vertical and subjective visual vertical. Eye dominance was determined by the hole-in-the-card method. A p-value ≤ 0.05 was considered statistically significant. SUBJECTS: Data of 24 USOP patients were retrospectively collected. The diagnosis was mainly made by the Parks 3-step method, history and the presence of characteristic excyclotorsion. When possible, orbital magnetic resonance imaging findings were obtained. RESULTS: The median angle of objective excyclotorsion in the paretic eyes was significantly larger than in the nonparetic eyes. Both median angles of objective/subjective excyclotorsion in the dominant eye were significantly smaller than those of the non-dominant eye. Patients were subdivided into two groups: group A, those whose paretic eye was the dominant eye (n = 13); group B, those whose paretic eye was the non-dominant eye (n = 11). The objective/subjective excyclotorsional angles of the paretic eye were significantly larger than of the non-paretic eye only in group B. CONCLUSION: In USOP the angle of excyclotorsion in the dominant eye is smaller than in the non-dominant eye. This may imply that the vertical sense of visual space is mainly adapted to the dominant eye, keeping the subjective vertical close to the earth vertical.


Assuntos
Músculos Oculomotores , Estrabismo , Dominância Ocular , Movimentos Oculares , Humanos , Músculos Oculomotores/diagnóstico por imagem , Paralisia , Fotografação , Estudos Retrospectivos , Estrabismo/diagnóstico
15.
J Card Surg ; 36(10): 3921-3923, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34260766

RESUMO

Hemidiaphragm paralysis (HP) is a potential complication of cardiac surgery. While most patients are either asymptomatic or have mild symptoms, some are at risk of developing life-threatening hypercapnia. We present a case of a patient who developed HP after tricuspid valve replacement. Diaphragm plication was deferred due to underlying comorbidities, but over time she developed severe hypercapnic respiratory failure requiring intensive care unit admission. Chronic noninvasive ventilation therapy (NIV) was initiated, which improved her symptoms and hypercapnia and prevented further hospitalizations. For patients with iatrogenic HP unable to undergo diaphragm plication, Pulmonology referral for initiation of NIV should be strongly considered.


Assuntos
Ventilação não Invasiva , Insuficiência Respiratória , Diafragma/cirurgia , Feminino , Humanos , Hipercapnia , Paralisia , Estudos Prospectivos , Insuficiência Respiratória/etiologia , Insuficiência Respiratória/terapia
16.
Lakartidningen ; 1182021 07 06.
Artigo em Sueco | MEDLINE | ID: mdl-34228809

RESUMO

Patients with Covid-19 can experience neurological complications, for example cranial nerve palsy. We present a case with a patient treated for severe Covid-19 infection. She was intubated for 16 days and was ventilated in the prone-position for several hours a day during her care in the intensive care unit (ICU). She developed paralysis of the left facial nerve, observed while intubated. After extubation the patient was hoarse and had dysphagia and examination showed paralysis of the left hypoglossal nerve with the tongue deviating to the left and of the left vagus nerve causing a paralysis of the left vocal cord. It is impossible to know whether the paralysis of the three cranial nerves was due to direct damage by the Covid-19 virus or due to compression of the nerves during the ICU care. As facial nerve palsy has been shown to be more common in patients with Covid-19, we believe that the paralysis in our patient was due to a combination of both.


Assuntos
COVID-19 , Doenças dos Nervos Cranianos , Doenças dos Nervos Cranianos/terapia , Nervos Cranianos , Feminino , Humanos , Paralisia/etiologia , Paralisia/terapia , SARS-CoV-2
17.
BMJ Case Rep ; 14(7)2021 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-34226254

RESUMO

Spinal cord ischaemia is a rare condition in children in which imaging diagnosis can be difficult and treatment guidelines are not well established. We describe a case of a previously healthy 13-year-old girl admitted to the emergency department with an acute flaccid paralysis of the lower limbs, abdominal and dorsal pain, and bladder dysfunction. A few hours earlier, she had been playing on a swing with hyperextension and an arched back position. Spinal cord MRI was normal in the first hours, but ischaemic signs were described in a second examination performed some hours later. We discuss the extensive investigation for differential diagnosis and the management of this case.


Assuntos
Traumatismos da Medula Espinal , Isquemia do Cordão Espinal , Adolescente , Criança , Feminino , Humanos , Imageamento por Ressonância Magnética , Paralisia , Medula Espinal , Isquemia do Cordão Espinal/diagnóstico , Isquemia do Cordão Espinal/etiologia
18.
J Med Case Rep ; 15(1): 380, 2021 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-34325739

RESUMO

BACKGROUND: Varicella zoster virus is a Deoxyribonucleic acid (DNA) virus exclusively affecting humans. Reactivation of varicella zoster virus causes herpes zoster with vesicular eruptions in a restricted dermatomal distribution. Peripheral motor neuropathy is a very rare complication of varicella zoster virus. CASE PRESENTATION: A 57-year-old previously well Sri Lankan female presented with acute onset painful weakness of the left upper limb with a preceding history of a febrile illness. Subsequently she developed vesicular eruptions in the dermatomal distribution of cervical 5, 6, and 7. Electromyography was suggestive of acute denervation of cervical 5, 6, and 7 myotomes. Diagnosis of zoster-associated brachial plexopathy was made, and the patient was treated with acyclovir, steroids, and analgesics. She made a good recovery. CONCLUSION: Brachial plexus neuritis due to varicella zoster infection should be considered in an acute monoparesis of a limb as it is a treatable and reversible condition.


Assuntos
Herpes Zoster , Acidente Vascular Cerebral , Aciclovir/uso terapêutico , Feminino , Herpes Zoster/complicações , Herpes Zoster/diagnóstico , Herpes Zoster/tratamento farmacológico , Herpesvirus Humano 3 , Humanos , Pessoa de Meia-Idade , Paralisia/diagnóstico , Paralisia/etiologia , Acidente Vascular Cerebral/diagnóstico
19.
J Assoc Physicians India ; 69(1): 78-79, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34227783

RESUMO

Introduction: COVID-19 is a pandemic affecting mainly respiratory and gastrointestinal system. Severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) binds angiotensin converting enzyme 2 (ACE-2) of renin-angiotensin system (RAS) resulting in hypokalaemia. We hereby report the a of hypokalaemic paralysis induced by COVID-19. Case: A 56 years old male with no co-morbidities presented with fever (2days), weakness in bilateral lower limbs (1 day). His had severe hypokalaemia with serum potassium of 2.05 mEq/L. RT-PCR of nasopharyngeal swab for SARS-CoV- 19 was positive. He was diagnosed as a case of hypokalaemic paralysis induced by COVID-19 infection. Conclusion: We suggest that during this pandemic era if a COVID-19 patient presents with paralysis, hypokalaemia induced paralysis should be kept in the differential diagnosis. What is known: COVID-19 infection leads to hypokalemia. What is new: Hypokalaemic paralysis as a manifestation of COVID-19.


Assuntos
COVID-19 , Hipopotassemia , Humanos , Hipopotassemia/etiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Paralisia/etiologia , SARS-CoV-2
20.
Aust Vet J ; 99(10): 432-444, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34258761

RESUMO

OBJECTIVE: To report the temporal and spatial distribution of rainbow lorikeets presenting with lorikeet paralysis syndrome (LPS) and their clinicopathologic and pathologic findings, exposure to toxins, and response to treatment. METHODS: Records of lorikeets admitted in 2017 and 2018 to facilities in south-east Queensland (QLD) were reviewed and LPS and non-LPS cases were mapped and their distribution compared. Plasma biochemistries and complete blood counts were done on 20 representative lorikeets from south-east QLD and Grafton, New South Wales (NSW). Tissues from 28 lorikeets were examined histologically. Samples were tested for pesticides (n = 19), toxic elements (n = 23), botulism (n = 15) and alcohol (n = 5). RESULTS: LPS occurred in warmer months. Affected lorikeets were found across south-east QLD. Hotspots were identified in Brisbane and the Sunshine Coast. Lorikeets had a heterophilic leucocytosis, elevated muscle enzymes, uric acid and sodium and chloride. Specific lesions were not found. Exposure to cadmium was common in LPS and non-LPS lorikeets. Treated lorikeets had a 60-93% See Table 2 depending on severity of signs. CLINICAL SIGNIFICANCE: The primary differential diagnosis for lorikeets presenting with lower motor neuron signs during spring, summer and autumn in northern NSW and south-east Queensland should be LPS. With supportive care, prognosis is fair to good.


Assuntos
Papagaios , Animais , New South Wales , Paralisia/veterinária , Prognóstico , Queensland
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