Neurohospitalist最新文献_第9页

Focal Status Epilepticus and Extreme Delta Brush Associated With Thrombotic Thrombocytopenic Purpura. 与血栓性血小板减少性紫癜相关的局灶性癫痫状态和极度德尔塔刷状反应

IF 1

Neurohospitalist Pub Date : 2024-07-01 Epub Date: 2024-04-01 DOI: 10.1177/19418744241245454

Lauren E Yap, Huanwen Chen, Sarah Ganji, Samuel E Calabria, Edwin J Serrano, Andrew B Stemer, Francis G Tirol, Noushin Jazebi

引用次数: 0

Anti-LGI-1 Limbic Encephalitis and Autoimmune Epilepsy Following a Third Dose of COVID-19 Vaccination: A Case Report. 接种第三剂 COVID-19 疫苗后出现抗 LGI-1 边缘脑炎和自身免疫性癫痫：病例报告。

IF 1

Neurohospitalist Pub Date : 2024-07-01 Epub Date: 2024-02-20 DOI: 10.1177/19418744241234100

Gerry Mullan, Michael Kinney

引用次数: 0

Clinical Reasoning: A 38-Year-Old Woman Presenting With Acute Hyperkinetic Movements of Her Right Arm. 临床推理：一名 38 岁女性出现急性右臂过度运动。

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Neurohospitalist Pub Date : 2024-07-01 Epub Date: 2024-03-18 DOI: 10.1177/19418744241240524

Dylan Ryan, Tasnim Mushannen, Scott Le

引用次数: 0

Super Refractory Status Epilepticus Improved After Emergency Use of Ganaxolone: Case Report. 紧急使用甘珀酸后，超级难治性癫痫状态得到改善：病例报告。

IF 1

Neurohospitalist Pub Date : 2024-07-01 Epub Date: 2024-02-20 DOI: 10.1177/19418744241232181

Jody Manners, Emily Jusuf, Gunjan Y Parikh, Maciej Gasior, Henrikas Vaitkevicius, Nicholas A Morris

引用次数: 0

Short Report: Clinical Features and Epilepsy Monitoring in an Adult With 22q11.2 Deletion Syndrome. 简短报告：一名 22q11.2 缺失综合征成人的临床特征和癫痫监测。

IF 1

Neurohospitalist Pub Date : 2024-07-01 Epub Date: 2024-01-17 DOI: 10.1177/19418744241228618

Mike W Zhang, Stephanie T Bustros, Tyler E Gaston, Maria Descartes, Shruti P Agnihotri

{"title":"Short Report: Clinical Features and Epilepsy Monitoring in an Adult With 22q11.2 Deletion Syndrome.","authors":"Mike W Zhang, Stephanie T Bustros, Tyler E Gaston, Maria Descartes, Shruti P Agnihotri","doi":"10.1177/19418744241228618","DOIUrl":"10.1177/19418744241228618","url":null,"abstract":"Background: 22q11.2 microdeletion is the most common microdeletion syndrome in humans with a prevalence of 13 per 100 000 live births, and it is a multisystem condition with variable phenotypic presentations.Methods: We present a case of an adult patient with Dandy-Walker syndrome who presented to our epilepsy clinic with 2 years of new-onset seizures and cognitive decline and 1 year of psychotic symptoms.Results: Patient had a non-revealing autoimmune and malignancy work-up. Continuous scalp vEEG study showed bursts of 1-2 Hz generalized fronto-centrally predominant spike or polyspike and slow wave discharges. Several myoclonic jerks were time-locked with the generalized discharges indicative of cortical myoclonus. MRI brain revealed periventricular nodular heterotopia in addition to findings suggestive of Dandy-Walker syndrome. Array-based comparative genomic hybridization demonstrated a 22q11.2 microdeletion seen in 22q11.2 deletion syndrome.Conclusion: Our case illustrates the challenges of diagnosing genetic disorders in adults especially when the initial diagnosis is dependent on a number of factors, including the patient's age, the severity of the phenotypic features, and the awareness of the physician.","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":"14 3","pages":"273-277"},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11181976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421374","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

Trismus as the Initial Presentation of Anti-Hu Paraneoplastic Neurological Syndrome. 作为抗胡副肿瘤性神经综合征最初表现的 "三体症"。

IF 1

Neurohospitalist Pub Date : 2024-07-01 Epub Date: 2024-03-04 DOI: 10.1177/19418744241237593

Witoon Mitarnun, Metha Apiwattanakul, Narin Chindavech, Benyapha Sombat, Suttanon Jantapatsakun, Pheeracha Sornnuwat

{"title":"Trismus as the Initial Presentation of Anti-Hu Paraneoplastic Neurological Syndrome.","authors":"Witoon Mitarnun, Metha Apiwattanakul, Narin Chindavech, Benyapha Sombat, Suttanon Jantapatsakun, Pheeracha Sornnuwat","doi":"10.1177/19418744241237593","DOIUrl":"10.1177/19418744241237593","url":null,"abstract":"A 73-year-old man presented with subacute trismus and pancerebellar dysfunction. Brain imaging and routine blood test results were unremarkable. Chest computed tomography revealed an indistinctly enhancing 4.7 × 2.5 × 1.8-cm3 pulmonary mass in the right upper lung, with enlarged right paratracheal and hilar lymph nodes. Biopsy of the right supraclavicular lymph node confirmed metastatic carcinoma, with differential diagnoses of small cell carcinoma and poorly differentiated carcinoma, indicating lung cancer as the primary source. Paraneoplastic immunohistochemistry screening revealed anti-Hu antibodies in the serum at a titer of 1:7680 (normal range <1:240) and in the cerebrospinal fluid (CSF) at a titer of 1:256 (normal range <1:2). The line blot method yielded positive results for anti-Zic4 antibodies in serum, with a titer of >1:10 (normal range <1:10), whereas CSF anti-Zic4 was negative (normal range <1:2). The patient developed non-responsive hospital-acquired pneumonia and respiratory failure, and discharged himself against medical advice. This rare case indicates that trismus can be an initial manifestation of anti-Hu paraneoplastic neurological syndrome, and emphasizes the importance of clinical awareness.","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":"14 3","pages":"336-338"},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11181965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421376","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

Elsberg Syndrome With Albuminocytologic Dissociation - A Guillain-Barré Syndrome Mimic or Guillain-Barré Syndrome Variant? 伴有白蛋白细胞学分离的埃尔斯伯格综合征--吉兰-巴雷综合征的拟态还是吉兰-巴雷综合征的变异？

IF 1

Neurohospitalist Pub Date : 2024-07-01 Epub Date: 2024-02-20 DOI: 10.1177/19418744241233621

Joseph M Ferrara, Courtney Litchmore, Smit Shah, Jeffery Myers, Khalil Ali

引用次数: 0

Neuromyelitis Optica Spectrum Disorder Resembling Wernicke's Encephalopathy: A Case Report and Review of the Literature. 类似韦尼克脑病的神经脊髓炎谱系障碍：病例报告与文献综述。

IF 1

Neurohospitalist Pub Date : 2024-04-01 Epub Date: 2024-01-16 DOI: 10.1177/19418744241228004

Sloan Lynch, Nil Saez Calveras, Anik Amin

{"title":"Neuromyelitis Optica Spectrum Disorder Resembling Wernicke's Encephalopathy: A Case Report and Review of the Literature.","authors":"Sloan Lynch, Nil Saez Calveras, Anik Amin","doi":"10.1177/19418744241228004","DOIUrl":"https://doi.org/10.1177/19418744241228004","url":null,"abstract":"We describe a case of Neuromyelitis Optica Spectrum Disorder (NMOSD) mimicking Wernicke's Encephalopathy (WE) to highlight an atypical presentation of NMOSD. A 39-year-old female presented with subacute encephalopathy and progressive ophthalmoplegia. Her MRI revealed T2 hyperintensities involving the mammillary bodies, periaqueductal grey matter, medial thalami, third ventricle, and area postrema. Whole blood thiamine levels were elevated and she did not improve with IV thiamine. CSF was notable for lymphocytic pleocytosis and elevated protein. She tested positive for serum Aquaporin-4 (AQP4) antibody. Subsequent imaging revealed multilevel lesions in the cervical and thoracic spinal cord. Her CSF GFAP antibody also came back positive. She steadily and significantly improved after high-dose IV steroids and plasmapheresis. She later started on chronic rituximab therapy. This represents a unique case of NMOSD presenting with the classical clinical and imaging features of WE, as opposed to the typical presenting symptoms of NMOSD. As such, demyelinating disorders should be considered when there is concern for diencephalic and midline pathologies, particularly without classic WE risk factors. Conversely, clinicians should be aware of secondary nutritional complications arising from severe area postrema syndrome.","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":"14 2","pages":"213-217"},"PeriodicalIF":1.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11040630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856233","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

Impact of the COVID-19 Pandemic on Inpatient Utilization for Acute Neurologic Disease. 新冠肺炎疫情对急性神经系统疾病住院患者利用的影响

IF 0.9

Neurohospitalist Pub Date : 2024-01-01 Epub Date: 2023-08-17 DOI: 10.1177/19418744231196984

Alexander Yoo, Elan L Guterman, David Y Hwang, Robert G Holloway, Benjamin P George

{"title":"Impact of the COVID-19 Pandemic on Inpatient Utilization for Acute Neurologic Disease.","authors":"Alexander Yoo, Elan L Guterman, David Y Hwang, Robert G Holloway, Benjamin P George","doi":"10.1177/19418744231196984","DOIUrl":"10.1177/19418744231196984","url":null,"abstract":"Background and Objective: The initial months of the Corona Virus 2019 (COVID-19) pandemic resulted in decreased hospitalizations. We aimed to describe differences in hospitalizations and related procedures across neurologic disease. Methods: In our retrospective observational study using the California State Inpatient Database and state-wide population-level estimates, we calculated neurologic hospitalization rates for a control period from January 2019 to February 2020 and a COVID-19 pandemic period from March to December 2020. We calculated incident rate ratios (IRR) for neurologic hospitalizations using negative binomial regression and compared relevant procedure rates over time. Results: Population-based neurologic hospitalization rates were 29.1 per 100,000 (95% CI 26.9-31.3) in April 2020 compared to 43.6 per 100,000 (95% CI 40.4-46.7) in January 2020. Overall, the pandemic period had 13% lower incidence of neurologic hospitalizations per month (IRR 0.87, 95% CI 0.86-0.89). The smallest decreases were in neurotrauma (IRR 0.92, 95% CI 0.89-0.95) and neuro-oncologic cases (IRR 0.93, 95% CI 0.87-0.99). Headache admissions experienced the greatest decline (IRR 0.62, 95% CI 0.58-0.66). For ischemic stroke, greater rates of endovascular thrombectomy (5.6% vs 5.0%; P < .001) were observed in the pandemic. Among all neurologic disease, greater rates of gastrostomy (4.0% vs 3.5%; P < .001), intubation/mechanical ventilation (14.3% vs 12.9%, P < .001), and tracheostomy (1.4 vs 1.2%; P < .001) were observed during the pandemic. Conclusions: During the first months of the COVID-19 pandemic there were fewer hospitalizations to varying degrees for all neurologic diagnoses. Rates of procedures indicating severe disease increased. Further study is needed to determine the impact on triage, patient outcomes, and cost consequences.","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":"1 1","pages":"13-22"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10790622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41468783","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

Neuromyelitis Optica Spectrum Disorder Management in the Setting of Chronic Hepatitis B and Latent Tuberculosis: A Case Report. 慢性乙型肝炎和潜伏性肺结核患者视神经脊髓炎谱系障碍的治疗：一例报告。

IF 0.9

Neurohospitalist Pub Date : 2023-10-01 Epub Date: 2023-05-04 DOI: 10.1177/19418744231171464

Dylan Sadowsky, Kevin Delijani, William Davis, Amy Safadi, Petra Brayo, Benjamin Osborne

{"title":"Neuromyelitis Optica Spectrum Disorder Management in the Setting of Chronic Hepatitis B and Latent Tuberculosis: A Case Report.","authors":"Dylan Sadowsky, Kevin Delijani, William Davis, Amy Safadi, Petra Brayo, Benjamin Osborne","doi":"10.1177/19418744231171464","DOIUrl":"10.1177/19418744231171464","url":null,"abstract":"Neuromyelitis Optica Spectrum Disorder (NMOSD) is an inflammatory autoimmune disorder of the central nervous system, with optic neuritis and transverse myelitis as its most common presentations. Although immunomodulatory treatment options for NMOSD have expanded, preventing reactivation of latent infections in patients can be both a therapeutic challenge and a special consideration for the neurohospitalist in an inpatient setting. We present a challenging case of a NMOSD patient who presented to the emergency department with worsening weakness and numbness in the setting of an NMOSD pseudo-relapse, later found to have untreated latent tuberculosis (TB) and chronic hepatitis B (HBV). She was briefly treated with high-dose IV methylprednisolone, which was stopped after her symptoms and imaging became more consistent with a pseudo-relapse. After confirmation that neither HBV nor TB had reactivated, the patient was discharged on isoniazid and entecavir. A month later, the patient's symptoms were stable, and she was started on inebilizumab for relapse prevention of NMOSD. This case report is the first to highlight the therapeutic complexities of managing NMOSD that requires immunosuppression in the setting of preventing reactivation of both TB and HBV.","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":"13 4","pages":"361-363"},"PeriodicalIF":0.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10494824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10239186","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