Brain and Development Case Reports最新文献_第2页

A case of developmental and epileptic encephalopathy with spike-and-wave activation in sleep with structural etiology treated with corpus callosotomy 结构性病因伴睡眠尖波激活的发展性癫痫性脑病行胼胝体切开术治疗1例

Brain and Development Case Reports Pub Date : 2025-03-12 DOI: 10.1016/j.bdcasr.2025.100072

Haruka Nakata , Kiyohiro Kim , Shu Hamada , Kengo Kora , Ichiro Kuki , Noritsugu Kunihiro , Takehiro Uda , Toshiro Maihara

{"title":"A case of developmental and epileptic encephalopathy with spike-and-wave activation in sleep with structural etiology treated with corpus callosotomy","authors":"Haruka Nakata , Kiyohiro Kim , Shu Hamada , Kengo Kora , Ichiro Kuki , Noritsugu Kunihiro , Takehiro Uda , Toshiro Maihara","doi":"10.1016/j.bdcasr.2025.100072","DOIUrl":"10.1016/j.bdcasr.2025.100072","url":null,"abstract":"<div><h3>Background</h3><div>Developmental and epileptic encephalopathy with spike-and-wave activation in sleep (DEE-SWAS) is often refractory to antiseizure medications and steroids, and a longer disease duration is associated with intellectual disabilities. Surgical treatment is sometimes performed; however, there have been few reports of corpus callosotomy.</div></div><div><h3>Case presentation</h3><div>The patient was a 5-year-old girl; at 16 months of age, she experienced seizures that began in her left upper limb and then spread throughout her body. Since then, she has had recurrent episodes. Electroencephalography (EEG) revealed spike-and-wave discharges in the right occipital region. Brain magnetic resonance imaging showed right ventricular enlargement and hemosiderin deposition in the right thalamus. Around the age of 3, she became hyperactive and unable to speak. At 4 years of age, atypical absence seizures appeared and EEG during sleep showed continuous generalized spike-and-wave complexes, leading to the diagnosis of DEE-SWAS. At the time of diagnosis, her developmental quotient (DQ) was 51. However, despite medical treatment, including adrenocorticotropic hormone therapy, she was resistant to these interventions, and her DQ decreased to 39 within approximately 1 year. A total corpus callosotomy was performed at the age of 5 years and 5 months. Postoperatively, epileptic seizures were controlled and the epileptiform discharges was lateralized to the right hemisphere. Additionally, developmental improvements were observed, including increased speech and the ability to anticipate the need for defecation.</div></div><div><h3>Conclusion</h3><div>Early corpus callosotomy can improve seizures and intellectual outcomes in patients with drug-resistant DEE-SWAS with focal lesions that can take time to resolve spontaneously.</div></div>","PeriodicalId":100196,"journal":{"name":"Brain and Development Case Reports","volume":"3 2","pages":"Article 100072"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143611079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Two Chinese children with COVID-19 related acute encephalopathy with restricted diffusion 2例中国儿童新冠肺炎相关急性脑病扩散受限

Brain and Development Case Reports Pub Date : 2025-03-07 DOI: 10.1016/j.bdcasr.2025.100070

Wing Ki CHAN, Eric Kin Cheong YAU, Mike Yat Wah KWAN, Grace Sui Fun NG, Kit Yan LEUNG

{"title":"Two Chinese children with COVID-19 related acute encephalopathy with restricted diffusion","authors":"Wing Ki CHAN, Eric Kin Cheong YAU, Mike Yat Wah KWAN, Grace Sui Fun NG, Kit Yan LEUNG","doi":"10.1016/j.bdcasr.2025.100070","DOIUrl":"10.1016/j.bdcasr.2025.100070","url":null,"abstract":"<div><h3>Introduction</h3><div>Acute encephalopathy with biphasic seizure and late restricted diffusion (AESD) is a clinico-radiological syndrome with specific seizure pattern and delayed change in diffusion-weighted magnetic resonance imaging (MRI) of brain. Coronavirus disease 2019 (COVID-19) infection had been reported in association with neurological conditions or complications including AESD. Hereby we described two paediatric cases of definite AESD related to COVID-19 infection.</div></div><div><h3>Case reports</h3><div>Case-1 was a healthy 17-month-old boy presented with clusters of febrile status epilepticus on Day 1. His conscious state remained impaired despite initial seizure cessation. Seizures recurred on Day 6 and MRI brain showed extensive restricted diffusion over bilateral subcortical and deep white matter. He had significant motor regression and developed dystonia and intractable epilepsy subsequently. Case-2 was a 3-year-old girl with underlying developmental delay admitted for fever, coryza and status epilepticus on Day 2 illness. She improved initially but had seizure recurrence and deterioration in sensorium on Day 6. MRI brain showed restricted diffusion over bilateral fronto-temporo-parietal subcortical white matter with relative sparing over peri-rolandic region. Her function returned to baseline upon recovery. COVID-19 infection-associated AESD was diagnosed in both cases and they had been treated with immunotherapies including tocilizumab during acute disease.</div></div><div><h3>Conclusion</h3><div>Prompt seizure control and early immunotherapies are mainstay of treatment for AESD. Worse outcome was observed in patient with elevated interleukin-6 (IL-6) level in serum and cerebrospinal fluid, longer seizure duration in first-phase and more extensive MRI involvement in second-phase of disease. Early use of IL-6 receptor antibody did not improve the neurological outcome in patient with severe disease.</div></div>","PeriodicalId":100196,"journal":{"name":"Brain and Development Case Reports","volume":"3 2","pages":"Article 100070"},"PeriodicalIF":0.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143563632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A child with four episodes of recurrent reversible splenial lesions without an MYRF variant 无MYRF变异的四次复发可逆性脾脏病变的儿童

Brain and Development Case Reports Pub Date : 2025-03-05 DOI: 10.1016/j.bdcasr.2025.100067

Haruna Mitsuya , Mitsuru Kashiwagi , Takuya Tanabe , Chizu Oba , Hirokazu Kurahashi , Akihisa Okumura , Akira Ashida

{"title":"A child with four episodes of recurrent reversible splenial lesions without an MYRF variant","authors":"Haruna Mitsuya , Mitsuru Kashiwagi , Takuya Tanabe , Chizu Oba , Hirokazu Kurahashi , Akihisa Okumura , Akira Ashida","doi":"10.1016/j.bdcasr.2025.100067","DOIUrl":"10.1016/j.bdcasr.2025.100067","url":null,"abstract":"<div><h3>Background</h3><div>Only a few cases of mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) recur. The clinical findings of familial and/or MERS type 2 recurrent cases involving the myelin regulatory factor (<em>MYRF</em>) gene have recently been clarified, but it is unclear how the clinical findings of recurrent cases without an <em>MYRF</em> variant differ from those of cases with an <em>MYRF</em> pathogenic variant.</div></div><div><h3>Case presentation</h3><div>A 5-year-old girl with healthy parents and no previous developmental problems experienced four episodes of reversible splenial lesions. Each episode was observed with three to six recurrent seizures and persistent disturbance of consciousness. Based on magnetic resonance imaging (MRI) findings, the diagnosis was MERS type 2 in two episodes, MERS type 1 in one episode, and MERS type 2 lesions in one episode.</div></div><div><h3>Discussion</h3><div>Recurrent seizures, nonfamilial occurrence, recurrent lesions of different types, isolated splenial lesions in the corpus callosum (CC), and limited spread of white matter lesions were the characteristics of this case. Recurrent lesions of different types and lesions that do not always involve the entire CC or both genial and splenial lesions in the CC may characterize recurrent MERS cases without an <em>MYRF</em> variant. Further comparative investigations should be conducted with a larger number of patients to clarify the differences in clinical findings.</div></div>","PeriodicalId":100196,"journal":{"name":"Brain and Development Case Reports","volume":"3 2","pages":"Article 100067"},"PeriodicalIF":0.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sensory tricks initiating before skin contact: New observations in drug-induced tardive dystonia 皮肤接触前开始的感觉障碍：药物引起的迟发性肌张力障碍的新观察

Brain and Development Case Reports Pub Date : 2025-02-26 DOI: 10.1016/j.bdcasr.2025.100068

Miwa Hagita , Masaya Kubota

{"title":"Sensory tricks initiating before skin contact: New observations in drug-induced tardive dystonia","authors":"Miwa Hagita , Masaya Kubota","doi":"10.1016/j.bdcasr.2025.100068","DOIUrl":"10.1016/j.bdcasr.2025.100068","url":null,"abstract":"<div><h3>Introduction</h3><div>Dystonia is a movement disorder characterized by involuntary, sustained, or intermittent muscle contractions that often involve abnormalities in sensorimotor integration. Sensory tricks, in which a new sensory input can temporarily correct erroneous motor output, are hallmarks of dystonia. However, the underlying mechanism remains unclear. Here, we report a case of drug-induced tardive dystonia in which the sensory trick effect began <em>before</em> physical contact, providing new insights into its anticipatory processes.</div></div><div><h3>Case report</h3><div>A 17-year-old boy with intellectual disabilities, autism, and behavioral disorders developed torticollis and scoliosis after prolonged treatment with risperidone and levomepromazine. The symptoms included neck muscle co-contraction, leftward rotation, and compensatory scoliosis. A sensory trick was observed; light hand contact with the occiput improved the symptoms. However, the video analysis revealed that symptom relief began during arm movements <em>before</em> physical contact. This suggests the role of proprioception, motor preparation, and motor imagery in the sensory trick phenomenon. Discontinuation of the antipsychotics gradually resolved the symptoms.</div></div><div><h3>Conclusion</h3><div>This report highlights a crucial observation: sensory tricks begin before actual tactile contact, emphasizing the role of proprioceptive signals and motor planning in symptom relief. Anticipatory sensory processing suggests a broader mechanism that extends beyond tactile stimulation. These findings deepen our understanding of sensory tricks in dystonia and their neurophysiological basis, providing insights that could inform therapeutic strategies such as occupational therapy or biofeedback tailored to patients' self-discovered techniques for managing dystonia.</div></div>","PeriodicalId":100196,"journal":{"name":"Brain and Development Case Reports","volume":"3 1","pages":"Article 100068"},"PeriodicalIF":0.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143486610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case of severe spinal muscular atrophy type 1 resistant to specific treatment due to a missense variant in the Tudor domain of SMN1 由于SMN1都铎结构域的错义变异，1型严重脊髓性肌萎缩症对特异性治疗产生抗性

Brain and Development Case Reports Pub Date : 2025-02-12 DOI: 10.1016/j.bdcasr.2025.100066

Tsuyoshi Aihara , Yuichi Abe , Atsushi Nishioka , Itaru Hayakawa

{"title":"A case of severe spinal muscular atrophy type 1 resistant to specific treatment due to a missense variant in the Tudor domain of SMN1","authors":"Tsuyoshi Aihara , Yuichi Abe , Atsushi Nishioka , Itaru Hayakawa","doi":"10.1016/j.bdcasr.2025.100066","DOIUrl":"10.1016/j.bdcasr.2025.100066","url":null,"abstract":"<div><h3>Introduction</h3><div>Spinal muscular atrophy (SMA) is a genetic disorder characterized by muscle weakness and atrophy due to degeneration of anterior horn cells in the spinal cord. It typically results from the allele deletion of <em>SMN1</em> alleles (null-<em>SMN1</em>). With the implementation of newborn screening for SMA (SMA-NBS), most null-<em>SMN1</em> patients are diagnosed in a presymptomatic stage.</div></div><div><h3>Case report</h3><div>A full-term male infant initially had a negative SMA-NBS result but presented with muscle weakness within his first month. By two months, genetic testing identified a single allele deletion and a point variant in the Tudor domain of <em>SMN1</em>, along with three copies of <em>SMN2</em>, confirming SMA type I. The patient was treated with onasemnogene abeparvovec (OA) gene therapy. However, despite the presence of three SMN2 copies and OA treatment, he eventually required respiratory support, including tracheostomy and mechanical ventilation. At one year and seven months, risdiplam therapy was initiated.</div></div><div><h3>Conclusion</h3><div>SMA patients with <em>SMN1</em> variants may bypass SMA-NBS and can develop severe SMA, depending on variant type, regardless of <em>SMN2</em> copy number.</div></div>","PeriodicalId":100196,"journal":{"name":"Brain and Development Case Reports","volume":"3 1","pages":"Article 100066"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case of selective developmental impairment of musical ability: Tone, beat, and chord deafness 选择性发育性音乐能力障碍一例：音、拍、和弦聋

Brain and Development Case Reports Pub Date : 2025-01-31 DOI: 10.1016/j.bdcasr.2025.100064

Masayuki Satoh , Yoshito Mizoguchi , Katsuyuki Matsui , Makiko Abe , Ken-ichi Tabei

{"title":"A case of selective developmental impairment of musical ability: Tone, beat, and chord deafness","authors":"Masayuki Satoh , Yoshito Mizoguchi , Katsuyuki Matsui , Makiko Abe , Ken-ichi Tabei","doi":"10.1016/j.bdcasr.2025.100064","DOIUrl":"10.1016/j.bdcasr.2025.100064","url":null,"abstract":"<div><h3>Introduction</h3><div>This report explores a rare case of musical disability, highlighting the profound impact it can have on an individual's life.</div></div><div><h3>Case presentation</h3><div>Because of the necessity of a medical note for school, a 21-year-old right-handed man received an evaluation at our institute for his musical abilities, which have been severely impaired since birth. He complained about a complete inability to march and dance in time with music. Moreover, his singing was off-key, though he did not notice this on his own. He made a great effort to improve his musical skills with his parents and teachers, but was unable to, which led him to accept these deficits as a personal characteristic. Neurological examination revealed no abnormal findings in his motor, sensory, and coordination systems. His cognitive functions, including general intelligence, memory, constructional ability, frontal lobe, and executive function, were normal. Brain magnetic resonance imaging/magnetic resonance angiography (MRI/MRA) scans were also normal. Neuromusicological assessments revealed severe impairments in pitch perception and expression; rhythm, meter, and beat perception and expression; and chord perception. He was diagnosed with tone, beat, and chord deafness. He also had difficulty perceiving the esthetic characteristics of music, though he did still enjoy listening to it.</div></div><div><h3>Conclusion</h3><div>These musical challenges caused trouble to the patient in many school and daily life scenarios, and the symptoms were often difficult to be understood by teachers. Thus, it is important to raise awareness of such symptoms and conditions, particularly among educators.</div></div>","PeriodicalId":100196,"journal":{"name":"Brain and Development Case Reports","volume":"3 1","pages":"Article 100064"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143148724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hypertension due to ACTH treatment for lissencephaly with a novel PAFAH1B1 variant 用一种新的PAFAH1B1变体ACTH治疗无脑畸形引起的高血压

Brain and Development Case Reports Pub Date : 2025-01-30 DOI: 10.1016/j.bdcasr.2025.100065

Natsumi Ida , Yoshifusa Abe , Ryo Karato , Madoka Shirai , Kaori Kamijo , Mariko Takase , Takeshi Shimizu , Rei Ebata , Takeshi Mikawa , Mitsuhiro Kato

{"title":"Hypertension due to ACTH treatment for lissencephaly with a novel PAFAH1B1 variant","authors":"Natsumi Ida , Yoshifusa Abe , Ryo Karato , Madoka Shirai , Kaori Kamijo , Mariko Takase , Takeshi Shimizu , Rei Ebata , Takeshi Mikawa , Mitsuhiro Kato","doi":"10.1016/j.bdcasr.2025.100065","DOIUrl":"10.1016/j.bdcasr.2025.100065","url":null,"abstract":"<div><h3>Background</h3><div>Many patients with lissencephaly present with infantile epileptic spasms syndrome (IESS) or West syndrome and require adrenocorticotrophic hormone (ACTH) treatment. The difference of adverse events of ACTH treatment between lissencephaly and other disorders is unknown.</div></div><div><h3>Case presentation</h3><div>We report the case of an infant with lissencephaly and IESS followed by severe hypertension with cardiac hypertrophy after ACTH treatment, requiring continuous administration of antihypertensive drugs. The infant was delivered at 39 weeks of gestation with a birth weight of 2484 g and was admitted to the neonatal intensive care unit for transient tachypnea. Brain MRI showed posterior predominant agyria compatible to classical lissencephaly grade 2. He harbored a novel <em>de novo</em> variant of <em>PAFAH1B1</em> or <em>LIS1</em> gene, c.485G>A, p. (Gly162Asp). At the age of 5 months, he developed epileptic spasms with hypsarrhythmia on electroencephalogram, leading to the diagnosis of IESS. ACTH and vitamin B6 treatments were effective for seizures and hypsarrhythmia. However, the patient had hypertension (138/100 mmHg) and cardiac hypertrophy and required continuous administration of nicardipine intravenously(0.6–1.0 μg/kg/min).</div></div><div><h3>Conclusion</h3><div>Patients with lissencephaly might be susceptible to severe cardiac adverse events with ACTH treatment.</div></div>","PeriodicalId":100196,"journal":{"name":"Brain and Development Case Reports","volume":"3 1","pages":"Article 100065"},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143148723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hemorrhagic shock and encephalopathy syndrome with hemophagocytic lymphohistiocytosis pathology caused by cytomegalovirus infection 巨细胞病毒感染所致嗜血球淋巴组织细胞增多症的失血性休克脑病综合征

Brain and Development Case Reports Pub Date : 2025-01-28 DOI: 10.1016/j.bdcasr.2025.100062

Shinji Harada , Masahiro Nishiyama , Mao Mizuta , Masaki Shimizu , Azusa Maruyama , Hiroshi Kurosawa , Yasuo Nakagishi

{"title":"Hemorrhagic shock and encephalopathy syndrome with hemophagocytic lymphohistiocytosis pathology caused by cytomegalovirus infection","authors":"Shinji Harada , Masahiro Nishiyama , Mao Mizuta , Masaki Shimizu , Azusa Maruyama , Hiroshi Kurosawa , Yasuo Nakagishi","doi":"10.1016/j.bdcasr.2025.100062","DOIUrl":"10.1016/j.bdcasr.2025.100062","url":null,"abstract":"<div><h3>Background</h3><div>Hemorrhagic shock and encephalopathy syndrome (HSES) is a severe, rare condition with poor prognosis primarily affecting infants and young children. Symptoms include fever, shock, encephalopathy, watery diarrhea, bleeding tendency, and hepatic and renal dysfunction; however, the etiology of HSES remains unknown. We present the case of an infant who developed HSES after initial cytomegalovirus (CMV) infection, suggesting the pathogenesis of hemophagocytic lymphohistiocytosis (HLH).</div></div><div><h3>Case presentation</h3><div>A 56-day-old male infant was admitted to the intensive care unit due to circulatory failure and convulsive seizures. Suspecting septic shock, the infant was initially treated with catecholamines, continuous midazolam for sedation, and antibiotics. Although the seizures had temporarily ceased after admission, the patient experienced recurrent convulsive seizures on day 2 and was administered multiple antiepileptic drugs. Despite these treatments, the patient developed refractory status epilepticus, necessitating thiamylal anesthetic therapy. The initial blood, urine, and cerebrospinal fluid cultures were negative. The patient met the criteria for HSES (encephalopathy, shock, disseminated intravascular coagulopathy, watery diarrhea, cytopenia, acidemia, hepatic and renal dysfunction, and negative blood and cerebrospinal fluid cultures). Furthermore, the patient fulfilled the criteria for HLH (fever, cytopenia, hypertriglyceridemia, hypofibrinogenemia, and elevated ferritin and soluble interleukin-2 receptor levels), with prior CMV infection implicated as a potential trigger.</div></div><div><h3>Conclusion</h3><div>We encountered an infant who developed HSES with HLH secondary to a CMV infection. This study provides new insights into the pathogenesis of HSES involving the HLH pathology.</div></div>","PeriodicalId":100196,"journal":{"name":"Brain and Development Case Reports","volume":"3 1","pages":"Article 100062"},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Brain and Development Case Reports Pub Date : 2025-01-25 DOI: 10.1016/j.bdcasr.2025.100063

Mami Akamatsu , Gen Furukawa , Masayuki Hirai , Midori Yamada , Ayami Yoshikane , Naoko Ishihara , Hiroki Kurahashi , Tetsushi Yoshikawa

{"title":"CACNA1A-related familial hemiplegic migraine presenting with prolonged impaired consciousness","authors":"Mami Akamatsu , Gen Furukawa , Masayuki Hirai , Midori Yamada , Ayami Yoshikane , Naoko Ishihara , Hiroki Kurahashi , Tetsushi Yoshikawa","doi":"10.1016/j.bdcasr.2025.100063","DOIUrl":"10.1016/j.bdcasr.2025.100063","url":null,"abstract":"<div><h3>Background</h3><div>Familial hemiplegic migraine (FHM) is a subtype of migraine with three identified causative genes: <em>CACNA1A</em>, <em>ATP1A2</em>, and <em>SCN1A</em>. However, diagnosis and treatment of FHM are challenging because of the wide phenotypic variation. We describe a family with genetically diagnosed <em>CACNA1A</em>-related FHM1 in which the proband presented with acute encephalopathy-like symptoms.</div></div><div><h3>Case presentation</h3><div>The proband was a 10-year-old girl admitted to our hospital with headache, paresthesia, frequent vomiting, and impaired consciousness. Blood test results and brain imaging were unremarkable, but she had persistent impaired consciousness. Electroencephalography indicated cerebral dysfunction. Consequently, she was treated with intravenous methylprednisolone pulse therapy and intravenous immune globulin for suspected acute encephalopathy. After treatment, her level of consciousness gradually improved, but headache persisted. Detailed interviews revealed that several maternal relatives had similar symptoms; the proband's younger sister subsequently developed headaches and paralysis. Given these findings, we conducted genetic counseling and familial genetic analysis with informed consent, which led to the diagnosis of <em>CACNA1A</em>-related FHM1. The proband started acetazolamide therapy, which successfully prevented the recurrence of attacks. This genetic information was also beneficial for managing the mother's and sister's conditions.</div></div><div><h3>Conclusion</h3><div>In the proband, FHM attacks were severe and occurred at a young age, making genetic diagnosis particularly important. Genetic diagnosis was useful in understanding the symptoms and guiding management for the patient as well as affected family members.</div></div>","PeriodicalId":100196,"journal":{"name":"Brain and Development Case Reports","volume":"3 1","pages":"Article 100063"},"PeriodicalIF":0.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143148727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Examination of two cases with severe motor and intellectual disabilities who died due to acute pancreatitis and review of the literature 2例严重运动及智力障碍患者死于急性胰腺炎的检查及文献复习

Brain and Development Case Reports Pub Date : 2025-01-17 DOI: 10.1016/j.bdcasr.2024.100061

Shungo Fujiki , Emiko Kobayashi , Kuniko Tokoro , Sotaro Yuzawa , Eiji Matsukuma , Atsushi Imamura , Hideo Kaneko

{"title":"Examination of two cases with severe motor and intellectual disabilities who died due to acute pancreatitis and review of the literature","authors":"Shungo Fujiki , Emiko Kobayashi , Kuniko Tokoro , Sotaro Yuzawa , Eiji Matsukuma , Atsushi Imamura , Hideo Kaneko","doi":"10.1016/j.bdcasr.2024.100061","DOIUrl":"10.1016/j.bdcasr.2024.100061","url":null,"abstract":"<div><h3>Background</h3><div>Children with severe motor and intellectual disabilities (SMID) experience numerous serious physical health problems and comorbidities. Children with SMID require long-term care from a multidisciplinary team, including rehabilitation. Acute pancreatitis is a life-threating comorbidity in children with SMID. Risk factors for acute pancreatitis in patients with SMID include the absence of voluntary movement, requirement of respiratory devices, panhypopituitarism, thermoregulatory dysfunction, oral administration of valproic acid, gallstones, and low serum albumin levels.</div></div><div><h3>Case presentation</h3><div>We encountered two children with SMID who had been followed at our facility and hospital for an extended period. Both patients were at high risk for developing pancreatitis, particularly after undergoing ventilator support following tracheostomy and the introduction of gastrostomy feeding. In both cases, the diagnosis was triggered by changes in vital signs, such as an increase in heart rate, and confirmed by imaging findings consistent with acute pancreatitis. Both patients faced challenges with enteral nutrition after developing pancreatitis, as attempts to restart it led to relapse of pancreatitis. Ultimately, both patients experienced severe outcomes.</div></div><div><h3>Conclusion</h3><div>Efforts to prevent pancreatitis onset are crucial. When changes in a child's physical condition are suspected, especially in children with SMID who have risk factors, pancreatitis should be considered in the differential diagnosis. Regular blood tests should include serum amylase levels. Once pancreatitis is diagnosed, treatment should closely follow established guidelines. Additionally, all staff involved in the care of children with SMID should be aware of the prevalence of acute pancreatitis in this population.</div></div>","PeriodicalId":100196,"journal":{"name":"Brain and Development Case Reports","volume":"3 1","pages":"Article 100061"},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0