Clinical Neurology最新文献_第3页

[A case of bacterial intramedullary spinal cord abscess and cauda equina neuritis that resolved with conservative treatment]. 细菌性脊髓髓内脓肿和马尾神经炎经保守治疗消退1例。

Clinical Neurology Pub Date : 2025-06-26 Epub Date: 2025-05-20 DOI: 10.5692/clinicalneurol.cn-002099

Fujio Umehara

{"title":"[A case of bacterial intramedullary spinal cord abscess and cauda equina neuritis that resolved with conservative treatment].","authors":"Fujio Umehara","doi":"10.5692/clinicalneurol.cn-002099","DOIUrl":"10.5692/clinicalneurol.cn-002099","url":null,"abstract":"The patient is a woman in her 70s. Low back pain and left lower limb pain gradually worsened since 1 month ago, urinary retention and bilateral lower limb paralysis appeared and she was admitted to our department. Muscle weakness in both lower limbs, hypoesthesia and pain in both lower limbs predominantly in the right side, and loss of tendon reflexes in both lower limbs were observed. MRI showed severe lumbar deformity as well as swelling of the spinal conus medullaris, ring-shaped contrast effect, and contrast effect of the cauda equina nerve. Diffusion-weighted images of the spinal conus showed multifocal high signal. Cerebrospinal fluid showed 271 cells/mm3 (72% polymorphonuclear cells), 356 ‍mg/dl protein, 15 ‍mg/dl sugar, and negative bacterial culture. Suspecting bacterial intramedullary spinal abscess and cauda equina neuritis, she was started on intravenous Ceftriaxone (CTRX)/ Vancomycin (VCM) and oral MNZ. Thereafter, muscle weakness and sensory disturbance in both lower limbs gradually improved, and the patient was able to walk with a cane one month later. Cerebrospinal fluid and MRI findings gradually normalized. The diagnosis of bacterial intramedullary spinal cord abscess and cauda equina neuritis was made, which improved with conservative treatment.","PeriodicalId":39292,"journal":{"name":"Clinical Neurology","volume":" ","pages":"447-452"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[A case of lymphocytic hypophysitis initially diagnosed as aseptic meningitis]. [1例淋巴细胞性垂体炎最初诊断为无菌性脑膜炎]。

Clinical Neurology Pub Date : 2025-06-26 Epub Date: 2025-05-20 DOI: 10.5692/clinicalneurol.cn-002098

Eito Miura, Uran Komatsubara, Yoshitaka Umeda, Shota Akakabe, Nobuya Fujita, Mutsuo Oyake

引用次数: 0

[An autopsy case of a 76-year-old woman with progressive supranuclear palsy initially presenting with dropped head and clinical features of pure akinesia with gait freezing]. [尸检一例76岁女性进行性核上性麻痹，最初表现为头部下垂，临床表现为纯运动障碍伴步态冻结]。

Clinical Neurology Pub Date : 2025-06-26 Epub Date: 2025-05-20 DOI: 10.5692/clinicalneurol.cn-002088

Ken Yamamoto, Kenji Ishihara, Yukiko Mori, Yasushi Iwasaki, Mari Yoshida, Hidetomo Murakami

{"title":"[An autopsy case of a 76-year-old woman with progressive supranuclear palsy initially presenting with dropped head and clinical features of pure akinesia with gait freezing].","authors":"Ken Yamamoto, Kenji Ishihara, Yukiko Mori, Yasushi Iwasaki, Mari Yoshida, Hidetomo Murakami","doi":"10.5692/clinicalneurol.cn-002088","DOIUrl":"10.5692/clinicalneurol.cn-002088","url":null,"abstract":"We present a case of a 76-year-old woman diagnosed with pathologically confirmed progressive supranuclear palsy (PSP) with pallido-nigral-luysial atrophy, who initially presented with a dropped head. Upon her first visit, neurophysiological and neuroradiological examinations provided no definitive cause, and the tactile trick was effective, leading to a diagnosis of cervical dystonia. Trihexyphenidyl treatment had no effect, but her condition gradually improved over 3 years. By age 74, she developed gait freezing without muscle rigidity or tremor. Dopamine-transporter scintigraphy revealed reduced tracer uptake in the bilateral corpus striata, prompting the diagnosis of pure akinesia with gait freezing (PAGF). At age 76, the patient developed retrocollis, muscle rigidity in all extremities, and recurrent temporomandibular dislocation. She eventually died from aspiration pneumonia after several years of illness. At autopsy, the brain weighed 1,370 ‍g. Macroscopic examination showed atrophy of the pallidum and subthalamic nucleus and depigmentation of the substantia nigra. Histopathological analysis revealed degeneration with 4-repeat tau pathology in the substantia nigra, globus pallidus, and subthalamic nucleus, along with tufted astrocytes in the globus pallidus and putamen, confirming a pathological diagnosis of pallido-nigral-luysial atrophy-type PSP. We suggest that the clinical presentation of PAGF correlates well with the pathological findings of pallido-nigral-luysial atrophy. While dystonia in PSP is typically observed in the limbs, blepharospasm, or retrocollis, only two other cases of PSP with a dropped head have been reported. The pathophysiological mechanism remains unclear, but we hypothesize that 4-repeat tau pathology in the globus pallidus may contribute to the development of cervical dystonia. Further neuropathological studies are needed to confirm this hypothesis.","PeriodicalId":39292,"journal":{"name":"Clinical Neurology","volume":" ","pages":"436-440"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Anti-leucine-rich glioma-inactivated 1 (LGI1) encephalitis diagnosed from T₁ signal intensity changes in basal ganglia: a case report and literature review]. 【基底节T1信号强度变化诊断抗富亮氨酸胶质瘤失活1 （LGI1）脑炎1例报告及文献复习】。

Clinical Neurology Pub Date : 2025-06-26 Epub Date: 2025-05-20 DOI: 10.5692/clinicalneurol.cn-002084

Takanobu Kita, Hiroaki Okada, Yoshiyuki Nakai, Masahiro Kanai, Keiji Yamaguchi

引用次数: 0

[Summarising a case you experienced: how to create understandable and effective slides]. [总结你经历过的一个案例：如何制作容易理解和有效的幻灯片]。

Clinical Neurology Pub Date : 2025-06-26 Epub Date: 2025-05-23 DOI: 10.5692/clinicalneurol.cn-002104

Akiyuki Hiraga

引用次数: 0

Syphilitic gummas affecting brain and spinal cord: a case report. 影响脑和脊髓的梅毒牙龈1例。

Clinical Neurology Pub Date : 2025-06-26 Epub Date: 2025-05-20 DOI: 10.5692/clinicalneurol.cn-002105

Hikari Kondo, Toru Watanabe, Kazuyoshi Kobayashi, Amane Araki, Kazuhiro Hara, Keizo Yasui

{"title":"Syphilitic gummas affecting brain and spinal cord: a case report.","authors":"Hikari Kondo, Toru Watanabe, Kazuyoshi Kobayashi, Amane Araki, Kazuhiro Hara, Keizo Yasui","doi":"10.5692/clinicalneurol.cn-002105","DOIUrl":"10.5692/clinicalneurol.cn-002105","url":null,"abstract":"Syphilitic gumma is a rare manifestation of neurosyphilis that can cause mass lesions in the central nervous system. We present an atypical case of a 53-year-old man presenting with syphilitic gummas affecting both the brain and spinal cord. The patient presented with right facial numbness, worsening back pain, gait disturbances, and lower-limb weakness. Serological tests were positive for syphilis, and cerebrospinal fluid analysis showed elevated cell count, protein concentration, and positive syphilis tests. Brain and spinal cord MRI revealed dural-based enhancing mass lesions in the right middle cerebellar peduncle and conus medullaris. The patient underwent posterior decompression and biopsy of the conus medullaris. Histopathological findings excluded malignancy and were consistent with syphilitic gumma. The patient received intravenous benzylpenicillin, followed by oral amoxicillin, resulting in partial improvement of neurological symptoms and gradual regression of the lesions on follow-up MRI. This case highlights the importance of considering syphilitic gumma in the differential diagnosis of intracranial and spinal cord lesions in patients with syphilis. Prompt antibiotic treatment and serial MRI imaging are crucial for managing this condition.","PeriodicalId":39292,"journal":{"name":"Clinical Neurology","volume":" ","pages":"453-458"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical characteristics of hemiplegic migraine: a clinical study of 163 cases in a tertiary care headache centre. 偏瘫性偏头痛的临床特征：163例三级保健头痛中心的临床研究。

Clinical Neurology Pub Date : 2025-05-27 Epub Date: 2025-04-25 DOI: 10.5692/clinicalneurol.cn-002070

Daisuke Danno, Paul Shanahan, Manjit Matharu

{"title":"Clinical characteristics of hemiplegic migraine: a clinical study of 163 cases in a tertiary care headache centre.","authors":"Daisuke Danno, Paul Shanahan, Manjit Matharu","doi":"10.5692/clinicalneurol.cn-002070","DOIUrl":"10.5692/clinicalneurol.cn-002070","url":null,"abstract":"Objective: Although population-based studies of hemiplegic migraine (HM) exist, large-scale clinic-based studies focusing on the detailed clinical characteristics of HM have not been reported. This study aims to define the clinical characteristics of HM in a tertiary care headache centre.Methods: A retrospective analysis was conducted based on the medical records of HM patients.Patients: This study included 163 consecutive HM patients who visited the National Hospital for Neurology and Neurosurgery between 2006 and 2013.Results: According to the diagnostic criteria of International Classification of Headache Disorders (ICHD-3β), 142 patients were diagnosed with HM. Although 21 patients did not satisfy the diagnostic criteria, migrainous headaches with repetitive hemiparesis were reported and other disorders were excluded, hence these patients were clinically diagnosed with HM. The temporal progression of aura symptoms was atypical in 40 patients. The median duration of hemiparesis was 24 hours (interquartile range: 3-60 hours) which was far longer than that of previous population-based studies. The lifetime experience of an episode of motor aura exceeding 72 hours was reported in 51.6%. Hemiparesis was observed without full recovery in 9 patients (5.5%).Conclusions: In many HM patients, the temporal progression of aura symptoms was diverse compared to typical descriptions in the literature, and the aura symptoms sustained longer than reported in the population-based study.","PeriodicalId":39292,"journal":{"name":"Clinical Neurology","volume":" ","pages":"338-351"},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Intravenous glucose infusion may have caused refeeding syndrome in a patient with advanced amyotrophic lateral sclerosis]. 【静脉输注葡萄糖可能引起晚期肌萎缩性侧索硬化症患者的再进食综合征】。

Clinical Neurology Pub Date : 2025-05-27 Epub Date: 2025-04-25 DOI: 10.5692/clinicalneurol.cn-002086

Naoki Yamahara, Nobuaki Yoshikura, Iwasa Yuhei, Takayoshi Shimohata

引用次数: 0

[Current trends in multiple sclerosis/neuromyelitis optica spectrum disorder therapy: considerations for domestic administration and personalized therapy]. [多发性硬化症/视神经脊髓炎谱系障碍治疗的当前趋势：对国内管理和个性化治疗的考虑]。

Clinical Neurology Pub Date : 2025-05-27 Epub Date: 2025-05-09 DOI: 10.5692/clinicalneurol.cn-002095

Masami Tanaka

引用次数: 0

[Factors associated with fatigue in patients with Parkinson's disease]. [帕金森病患者疲劳的相关因素]。

Clinical Neurology Pub Date : 2025-05-27 Epub Date: 2025-04-25 DOI: 10.5692/clinicalneurol.cn-002061

Kanako Kurihara, Takayasu Mishima, Koichi Nagaki, Yoshio Tsuboi

引用次数: 0