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Toscana virus encephalitis with reversible self-limiting vasculopathy. 托斯卡纳病毒脑炎伴可逆性自限性血管病变。
IF 2.3
PRACTICAL NEUROLOGY Pub Date : 2025-08-14 DOI: 10.1136/pn-2024-004419
Muhammed Ameen Noushad, Karan Muzumdar, Mahmoud Gouda, Mahika Kamat, Joel Handley
{"title":"Toscana virus encephalitis with reversible self-limiting vasculopathy.","authors":"Muhammed Ameen Noushad, Karan Muzumdar, Mahmoud Gouda, Mahika Kamat, Joel Handley","doi":"10.1136/pn-2024-004419","DOIUrl":"https://doi.org/10.1136/pn-2024-004419","url":null,"abstract":"<p><p>Toscana virus (named after Tuscany, Italy) is an arthropod borne virus transmitted by sandflies. It is common in the Mediterranean region, several southern European countries and some North African countries, but is rare in the UK. Most Toscana virus infections are asymptomatic, but severe infections can have neurological manifestations. Toscana virus encephalitis is an uncommon self-limiting encephalitis with a vasculopathy. We report an elderly man who developed Toscana virus encephalitis and vasculopathy causing multiple ischaemic strokes with evidence of reversible intravascular stenosis, after a brief holiday on a Mediterranean cruise. The diagnosis is confirmed by detecting the presence of the virus in the cerebrospinal fluid (CSF) using real-time reverse transcriptase - PCR (RT-PCR) tests, and by a rise in antibody titres in serum. The treatment of Toscana virus infections is mainly symptomatic. Toscana virus infection should be considered in returning travellers who develop a febrile illness with confusion.</p>","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856619","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
AESOP syndrome: a rare and early indicator of POEMS syndrome. AESOP综合征：POEMS综合征的罕见早期指标。
IF 2.3
PRACTICAL NEUROLOGY Pub Date : 2025-08-14 DOI: 10.1136/pn-2025-004759
Joumana Freiha, Clare Lodwick, Heather Roche, Chinar Osman
{"title":"AESOP syndrome: a rare and early indicator of POEMS syndrome.","authors":"Joumana Freiha, Clare Lodwick, Heather Roche, Chinar Osman","doi":"10.1136/pn-2025-004759","DOIUrl":"https://doi.org/10.1136/pn-2025-004759","url":null,"abstract":"<p><p>Adenopathy and an extensive skin patch overlying a plasmacytoma (AESOP) syndrome is a rare condition characterised by an erythemato-violaceous patch on the skin, accompanied by an underlying solitary plasmacytoma. It may give an early clue for the diagnosis of polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, skin changes (POEMS) syndrome, an uncommon multisystem disorder driven by plasma cell dyscrasia. We describe a 62-year-old man with sensorimotor peripheral neuropathy, unintentional weight loss and a persistent skin rash. Diagnostic findings, including elevated vascular endothelial growth factor, an immunoglobulin A kappa paraprotein and a skin/sternal biopsy, led to the diagnosis of AESOP and POEMS syndrome. This case underscores the importance of early recognition of AESOP syndrome as a potential lifesaving clue for the early diagnosis of POEMS syndrome.</p>","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856688","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
Chorea after cardiac surgery. 心脏手术后的舞蹈病。
IF 2.3
PRACTICAL NEUROLOGY Pub Date : 2025-08-14 DOI: 10.1136/pn-2025-004716
Petr Hollý, Petr Dušek, Petra Reková, Manuela Vaneckova, Tereza Uhrová, Hana Brožová
{"title":"Chorea after cardiac surgery.","authors":"Petr Hollý, Petr Dušek, Petra Reková, Manuela Vaneckova, Tereza Uhrová, Hana Brožová","doi":"10.1136/pn-2025-004716","DOIUrl":"https://doi.org/10.1136/pn-2025-004716","url":null,"abstract":"<p><p>Chorea after cardiac surgery (formerly post-pump chorea) is a common complication in children (estimated prevalence of 0.6%-3%) but is rare in adults; when it does occur, it is often permanent and less responsive to treatment. A 47-year-old woman developed chorea in all limbs following cardiac surgery for a pseudoaneurysm of the anastomosis along with thrombectomy of the prosthetic aortic valve (after Bentall's procedure in the past). MR scan of brain showed bilateral basal ganglia abnormalities, which partially resolved over 3 months. Despite initial treatments, her condition worsened until switching to haloperidol.</p>","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856618","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
Young stroke as a late complication of cranial irradiation. 年轻脑卒中作为颅脑照射的晚期并发症。
IF 2.3
PRACTICAL NEUROLOGY Pub Date : 2025-08-14 DOI: 10.1136/pn-2025-004772
Emily Rushton-Smith, Usman Khan
{"title":"Young stroke as a late complication of cranial irradiation.","authors":"Emily Rushton-Smith, Usman Khan","doi":"10.1136/pn-2025-004772","DOIUrl":"https://doi.org/10.1136/pn-2025-004772","url":null,"abstract":"","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856620","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
Haemophagocytic lymphohistiocytosis precipitated by lamotrigine. 拉莫三嗪引起的噬血细胞性淋巴组织细胞增多症。
IF 2.3
PRACTICAL NEUROLOGY Pub Date : 2025-08-12 DOI: 10.1136/pn-2025-004724
Amelia Holloway, Isobel Weinberg, Gerald Coakley, Maria Leandro, Corinne Fisher, Coziana Ciurtin, William Stern, Guy Leschziner, Jessica Manson, Aisling S Carr
{"title":"Haemophagocytic lymphohistiocytosis precipitated by lamotrigine.","authors":"Amelia Holloway, Isobel Weinberg, Gerald Coakley, Maria Leandro, Corinne Fisher, Coziana Ciurtin, William Stern, Guy Leschziner, Jessica Manson, Aisling S Carr","doi":"10.1136/pn-2025-004724","DOIUrl":"https://doi.org/10.1136/pn-2025-004724","url":null,"abstract":"<p><p>Haemophagocytic lymphohistiocytosis (HLH) is a rare and life-threatening hyperinflammatory syndrome of uncontrolled systemic inflammation. In 2018, the US Food and Drug Administration issued a safety warning of the risk of HLH after starting lamotrigine. Early recognition and prompt and effective immunosuppression, alongside trigger identification, are essential for a good outcome in HLH. We report two cases of HLH temporally associated with lamotrigine initiation. Both patients had presented with refractory fever, falling cell counts and hyperferritinaemia-the hallmark 3Fs of HLH-and were admitted to critical care with multiorgan failure within 10 days of starting lamotrigine. They received treatment for HLH with intravenous corticosteroids, immunoglobulin and anakinra; lamotrigine was withdrawn. Both patients recovered fully following protracted hospital admissions and remain stable on alternative antiseizure medication. HLH is a very rare but life-threatening complication of lamotrigine therapy. Appropriate consent and clinical vigilance are relevant to clinicians using lamotrigine in clinical practice.</p>","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849300","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
Prolonged and recurrent reversible cerebral vasoconstriction syndrome in the postpartum period. 产后长期复发的可逆性脑血管收缩综合征。
IF 2.3
PRACTICAL NEUROLOGY Pub Date : 2025-08-12 DOI: 10.1136/pn-2025-004594
Cheran Elangovan, Linda Sherine Alfred, Nariman Noorbakhsh-Sabet, Shree Shanmathi Selvaraj Gandhirajhu, Nitin Goyal, Balaji Krishnaiah
{"title":"Prolonged and recurrent reversible cerebral vasoconstriction syndrome in the postpartum period.","authors":"Cheran Elangovan, Linda Sherine Alfred, Nariman Noorbakhsh-Sabet, Shree Shanmathi Selvaraj Gandhirajhu, Nitin Goyal, Balaji Krishnaiah","doi":"10.1136/pn-2025-004594","DOIUrl":"https://doi.org/10.1136/pn-2025-004594","url":null,"abstract":"<p><p>Reversible cerebral vasoconstriction syndrome (RCVS) can develop in the early postpartum period and generally has a good prognosis. A 35-year-old woman developed postpartum RCVS, which had started as severe headache after a blood transfusion; a diagnostic cerebral angiogram showed diffuse vasospasm of intracranial vessels. Her clinical course was complicated by subarachnoid haemorrhage, strokes, seizure and recurrent vasospasm, which lasted for 4 weeks. The vasospasm was refractory to nifedipine and nimodipine but improved with intra-arterial verapamil, followed by oral verapamil and magnesium oxide.</p>","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849301","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
Brain abscess with concurrent infection: tuberculosis and aspergillosis. 脑脓肿并发感染：结核和曲霉病。
IF 2.3
PRACTICAL NEUROLOGY Pub Date : 2025-08-10 DOI: 10.1136/pn-2025-004634
Shivam Mirg, Jasmine Parihar, Deepti Vibha, Ajay Garg, Gagandeep Singh, Urvashi Singh, M C Sharma, Manjari Tripathi
{"title":"Brain abscess with concurrent infection: tuberculosis and aspergillosis.","authors":"Shivam Mirg, Jasmine Parihar, Deepti Vibha, Ajay Garg, Gagandeep Singh, Urvashi Singh, M C Sharma, Manjari Tripathi","doi":"10.1136/pn-2025-004634","DOIUrl":"https://doi.org/10.1136/pn-2025-004634","url":null,"abstract":"<p><p>Brain abscess is rarely caused by coinfection with different pathogens. A middle-aged immunocompetent woman developed right-sided focal motor seizures with Todd's palsy. Brain imaging identified a frontal ring-enhancing lesion for which she started antitubercular therapy and corticosteroids. However, on tapering the corticosteroids, she developed a right-sided hemiparesis with increased lesion size. Excision biopsy identified coinfection with <i>Mycobacterium tuberculosis</i> and <i>Aspergillus spp</i> She recovered well with antitubercular and antifungal agents. Coinfections with multiple pathogens pose diagnostic challenges due to overlapping or non-specific clinical and radiological features. This case underscores the importance of tissue diagnosis to enable appropriate therapy.</p>","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817794","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
Fatiguable camptocormia as a presenting feature of myasthenia gravis in the elderly. 疲劳性喜树症是老年重症肌无力的一个表现特征。
IF 2.3
PRACTICAL NEUROLOGY Pub Date : 2025-08-07 DOI: 10.1136/pn-2025-004670
Mervyn Qi Wei Poh, Christen Lim, Joy Vijayan
{"title":"Fatiguable camptocormia as a presenting feature of myasthenia gravis in the elderly.","authors":"Mervyn Qi Wei Poh, Christen Lim, Joy Vijayan","doi":"10.1136/pn-2025-004670","DOIUrl":"https://doi.org/10.1136/pn-2025-004670","url":null,"abstract":"","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805022","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
Diffuse large B-cell lymphoma masquerading as demyelination. 伪装成脱髓鞘的弥漫性大b细胞淋巴瘤。
IF 2.3
PRACTICAL NEUROLOGY Pub Date : 2025-08-05 DOI: 10.1136/pn-2025-004606
Christopher Paisey, Christy Kaiyamo, Chun Lap Pang, Gurjit Chohan
{"title":"Diffuse large B-cell lymphoma masquerading as demyelination.","authors":"Christopher Paisey, Christy Kaiyamo, Chun Lap Pang, Gurjit Chohan","doi":"10.1136/pn-2025-004606","DOIUrl":"https://doi.org/10.1136/pn-2025-004606","url":null,"abstract":"<p><p>Patients with predominantly neurological symptoms and signs as their first manifestation of diffuse large B cell lymphoma (DLBCL) represent a diagnostic challenge. We present the clinical course, imaging findings and postmortem pathological correlates of a patient first presenting to neurology with symptoms relating to DLBCL. He died before confirmation of the diagnosis despite early suspicion of central nervous system (CNS) lymphoma and relevant investigation. The diagnosis was confirmed at postmortem by immunohistochemistry of spinal and brain lesions. MRI showing CNS lesions consistent with demyelination is common and lymphoma is rarely the cause. However, when there is high clinical suspicion, tissue diagnosis should be sought whether by skin, lymph node or brain biopsy.</p>","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790282","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
Giant macroprolactinoma: reversible visual loss with medical therapy. 巨催乳素瘤：药物治疗的可逆性视力丧失。
IF 2.3
PRACTICAL NEUROLOGY Pub Date : 2025-08-04 DOI: 10.1136/pn-2025-004645
Javier García-Bardera, Carmen Teresa Sánchez-Guillen, María Pampillón-Albert, Blanca Domingo-Gordo
{"title":"Giant macroprolactinoma: reversible visual loss with medical therapy.","authors":"Javier García-Bardera, Carmen Teresa Sánchez-Guillen, María Pampillón-Albert, Blanca Domingo-Gordo","doi":"10.1136/pn-2025-004645","DOIUrl":"https://doi.org/10.1136/pn-2025-004645","url":null,"abstract":"","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785565","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
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