Acta neurologica Taiwanica最新文献

{"title":"Guillain-Barre Syndrome-Like Polyneuropathy Induced by Immune Checkpoint Inhibitors: A Case Report.","authors":"Bo-Kang Cheng, Chien-An Ko, Chun-Lin Kuo, Te-Chi Nai, Wei Lin, Chung-Hsing Chou, Yueh-Feng Sung","doi":"10.4103/ANT.ANT_112_0090","DOIUrl":"10.4103/ANT.ANT_112_0090","url":null,"abstract":"<p><strong>Abstract: </strong>Over the past decade, immune checkpoint inhibitors (ICIs) have emerged as a crucial therapeutic option for treating various malignancies. Nivolumab, an ICI, is a monoclonal antibody directed against programmed cell death protein 1. However, many studies indicate that ICIs can lead to various immune-related adverse events (irAEs), with neurological irAEs accounting for approximately 1%-5% of these cases. Neurological adverse events such as Guillain-Barre syndrome (GBS) are rare but life threatening. This report presents the case of a 72-year-old male diagnosed with sarcomatoid squamous cell carcinoma of the trachea, who was admitted with rapid-onset weakness of the upper limbs 7 days following the latest nivolumab treatment. These symptoms progressed quickly to quadriplegia and respiratory failure, requiring intubation and mechanical ventilation. Serum antiganglioside antibodies were positive for immunoglobulin (Ig) M-GM1, IgM-GD1b, and IgG-GM3. His clinical symptoms improved significantly after steroid and intravenous immunoglobulin treatment. This rare and atypical case highlights the complexity of ICI-related GBS. Early recognition of associated symptoms is crucial for timely and appropriate treatment.</p>","PeriodicalId":93852,"journal":{"name":"Acta neurologica Taiwanica","volume":"34 1","pages":"35-39"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112701","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}

{"title":"Nasopharyngeal Carcinoma with Spinal Cord Metastasis and Secondary Syringomyelia: A Case Report.","authors":"Wei-Chieh Chan, Yen-Chung Chen, Jin-Chin Lin, Chin-San Liu, Shey-Lin Wu, Chi-Hsiang Tung, Kun-Tu Yeh","doi":"10.4103/ANT.ANT_112_0073","DOIUrl":"10.4103/ANT.ANT_112_0073","url":null,"abstract":"<p><strong>Abstract: </strong>Nasopharyngeal cancer with central nervous system metastases is rare. True metastasis to the distal regions of the central nervous system, especially the spinal cord, is incredibly uncommon, although tumor invasion to intracranial locations through the skull base can be prevalent. We report on a 45-year-old male who had been suffering from progressive unsteady gait and numbness of lower limbs for 3 weeks. The numbness eventually ascended to the thigh area and the patient required a wheelchair. His muscle power was normal. Magnetic resonance imaging showed multiple enhancing nodular lesions in the thoracolumbar spinal cord with mild mass effect, causing diffuse syringomyelia and cord edema. Metastasis was confirmed by pathology after tumor excision. The patient underwent concurrent radiotherapy and steroid therapy, after which he eventually could walk with crutches. Due to the complexity and rarity of such case, the standard treatment for this type of disease is unclear. Management should be individualized and multidisciplinary.</p>","PeriodicalId":93852,"journal":{"name":"Acta neurologica Taiwanica","volume":"34 1","pages":"32-34"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112776","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}

{"title":"Intramedullary Cavernoma with Hematomyelia and Unusual Clinical Findings of Brown-Sequard Syndrome: A Case Report.","authors":"Jinesh Mukesh Shah, Nijanth Manohararaj, Koh Yeow Hoay","doi":"10.4103/ANT.ANT_112_0082","DOIUrl":"10.4103/ANT.ANT_112_0082","url":null,"abstract":"<p><strong>Abstract: </strong>We aim to report an extremely rare case of a primary thoracic intramedullary cavernoma with Brown-Sequard syndrome (BSS), its transcranial magnetic stimulation (TMS)/somatosensory evoked potential (SSEP) neurophysiology tests, and their localizing value. A 53-year-old Chinese male with a history of multiple arteriovenous malformations (AVMs) presented with an intermittent 3-year history of the left lower limb weakness with recent worsening and findings of dissociated sensory loss. Neurophysiological testing showed prolonged central motor conduction time to his left lower limb on TMS while tibial SSEP showed prolonged P37 latencies. Magnetic resonance imaging spine showed a T4-5 intramedullary expansile enhancing cord lesion, suggestive of a thoracic cavernoma, with surrounding acute hematomyelia and cord edema from C7 to T6. A spinal angiogram did not reveal any vascular malformation. He was conservatively treated for possible T4-5 cavernoma with hematomyelia. Repeat imaging showed complete resolution of edema with a T3-5 internal T2-weighted hyperintensity and residual susceptibility focus likely representing a cavernoma that had bled with no evidence of AVM. A repeat tibial SSEP still showed prolonged tibial SSEPs, but TMS was now normal. Primary thoracic intramedullary cavernomas may be a rare cause of BSS. TMS and SSEP may have a role in the diagnostic evaluation of BSS.</p>","PeriodicalId":93852,"journal":{"name":"Acta neurologica Taiwanica","volume":"34 1","pages":"40-42"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112796","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}

{"title":"The Diagnosis of Signal Recognition Particle-Associated Immune-Mediated Necrotizing Myopathy Requires the Exclusion of Possible Differential Diagnose.","authors":"Josef Finsterer","doi":"10.4103/ant.ANT-D-24-00002","DOIUrl":"https://doi.org/10.4103/ant.ANT-D-24-00002","url":null,"abstract":"","PeriodicalId":93852,"journal":{"name":"Acta neurologica Taiwanica","volume":"34 1","pages":"52-53"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112941","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}

{"title":"Cerebral Amyloid Angiopathy-Related Inflammation.","authors":"Ting-Yi Tseng, Kuei-Hong Kuo, Tzu-Hsien Lai","doi":"10.4103/ANT.ANT_112_0099","DOIUrl":"https://doi.org/10.4103/ANT.ANT_112_0099","url":null,"abstract":"","PeriodicalId":93852,"journal":{"name":"Acta neurologica Taiwanica","volume":"34 1","pages":"48-49"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112684","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}

{"title":"Personal Protective Equipment and Headaches: A Cross-sectional Study among Healthcare Professionals in A Military Hospital in Bangladesh.","authors":"Muhammad Rezeul Huq, Ahad Mahmud Khan, Ghulam Kawnayn, Md Musab Khalil, Md Ismail Chowdhury, Mahin Binte Anwar, Timir Ranjan Mahanta","doi":"10.4103/ANT.ANT_112_0106","DOIUrl":"10.4103/ANT.ANT_112_0106","url":null,"abstract":"<p><strong>Background: </strong>During the COVID-19 pandemic, healthcare professionals took various protective measures including personal protective equipment (PPE) such as masks, eyewear, and protective jumpsuits. These protective devices may pose certain health hazards, such as headaches.</p><p><strong>Objectives: </strong>This study aims to find out the association between new-onset headaches (de novo) or exacerbation of preexisting headaches in military healthcare professionals using PPE.</p><p><strong>Materials and methods: </strong>A total of 209 healthcare professionals participated in this cross-sectional observational study. Data were collected on headaches before and after using PPE through a self-administered questionnaire.</p><p><strong>Results: </strong>Most participants were young with a mean age of 26.7 ± 5.6 years. The number of male participants was almost twice that of females (64.6%). de novo headache occurred in 88 participants (47.6%). Previous primary headaches were present in 24 patients, of whom 83.3% experienced exacerbation of primary headaches after using PPE. Doctors and nurses suffered from headaches significantly more than the other healthcare workers (P < 0.001). N95 mask usage was significantly associated with headaches (P < 0.001). In addition, the combination of masks, specifically surgical and N95 combination, was also associated with headaches (P = 0.019 and P < 0.001, respectively). Use of eye protection, irrespective of type was found to be associated with headaches (P < 0.05). Additional PPE, such as the protective jumpsuits, was also associated with headaches (P < 0.001). Our study did not find any significant association between headaches and the duration of hours of usage of masks or protective eyewear (P > 0.05).</p><p><strong>Conclusions: </strong>Masks, eye protective gear, and additional protective gown use are associated with new-onset headaches or exacerbation of previous headaches. These protective devices should be redesigned not compromising safety and to increase comfort and compliance.</p>","PeriodicalId":93852,"journal":{"name":"Acta neurologica Taiwanica","volume":"34 1","pages":"13-19"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112937","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}

{"title":"Neuromyelitis Optica Spectrum Disorders Mimicking Wernicke's Encephalopathy: A Difficult Differential Diagnosis.","authors":"Hussein Algahtani, Bader Shirah, Fawzia Alahmri, Nawal Abdelghaffar, Saeed A Alqahtani","doi":"10.4103/ANT.ANT_112_0071","DOIUrl":"10.4103/ANT.ANT_112_0071","url":null,"abstract":"<p><strong>Abstract: </strong>Neuromyelitis optica spectrum disorders (NMOSD) encompass a spectrum of immunomediated diseases presenting with diverse syndromes. Conversely, Wernicke's encephalopathy denotes an acute neurological condition stemming from severe thiamine (Vitamin B1) deficiency. We report a unique case of NMOSD manifesting with clinical and radiological characteristics resembling Wernicke's encephalopathy, exhibiting unresponsiveness to thiamine therapy and subsequent clinical deterioration. Our report highlights an atypical and rare presentation of NMOSD, initially confounded by changes on magnetic resonance imaging attributed to thiamine deficiency, delaying appropriate management during the early hospitalization period. While brain abnormalities are frequently documented in NMOSD, the occurrence of vertigo as an inaugural symptom is seldom reported. The patient demonstrated recovery following aggressive therapeutic interventions, including pulse steroids, plasma exchange, and rituximab therapy. Our case underscores the importance of considering NMOSD in patients displaying clinical and radiological features reminiscent of Wernicke's encephalopathy, particularly when thiamine replacement fails to elicit a response. Clinicians must recognize this unusual presentation of NMOSD promptly and initiate aggressive therapeutic measures. Early diagnosis assumes critical significance to promptly commence aggressive immunomodulatory therapy.</p>","PeriodicalId":93852,"journal":{"name":"Acta neurologica Taiwanica","volume":"34 1","pages":"43-47"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112853","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}

{"title":"Cerebral Infarction with Cerebral Thrombosis in Crohn's Disease: A Case Report.","authors":"Niharika Reddy, Sarkis Morales Vidal","doi":"10.4103/ANT.ANT_112_0068","DOIUrl":"10.4103/ANT.ANT_112_0068","url":null,"abstract":"<p><strong>Abstract: </strong>We describe a case report of a young male with Crohn's disease who presented with cerebral infarction and cerebral thrombosis. The patient's Crohn's disease had been in remission for 7 years without any recurrent strokes during this period. Our case highlights the need to consider inflammatory bowel disease as a potential cause of stroke in young patients and underscores the importance of managing the condition to reduce recurrent stroke risk.</p>","PeriodicalId":93852,"journal":{"name":"Acta neurologica Taiwanica","volume":"34 1","pages":"28-31"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112685","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}

{"title":"Lafora Disease Presenting with Ataxia and DM1: A Case Study.","authors":"Ramin Khanalizadeh, Kosar Karimi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Here we presented a rare case of Lafora disease with neuropathy, ataxia and progression of symptoms into type one DM, GTCS and myoclonus during years. We believe that it is important to keep the diagnosis of Lafora disease in mind in every child presenting with myoclonus especially when mental and cerebellar deficits develop as well. Keywords: Drug-resistant seizure, Ataxia, Myoclonic jerky movements, Lafora.</p>","PeriodicalId":93852,"journal":{"name":"Acta neurologica Taiwanica","volume":"33(4) ","pages":"181-183"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916541","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}

{"title":"Cure the Incurable: Update of Treatment in Inherited Neuromuscular Disorders.","authors":"Cheng-Hao Yu, Kuan-Lin Lai","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Originally thought to be incurable, huge therapeutic progress has been made in recent years in the field of inherited neuromuscular disorders. Approaches aiming to rescue the underlying pathophysiology, i.e. loss-of-function or gain-of-function mutations, have been developed via end-product replacement or gene delivery/modulation, with promising results. In the review, advanced treatment in some of the inherited neuromuscular disorders will be discussed. On the other hand, it has been found more than 1000 genes are responsible for the clinical diversities in this group of diseases, and finding a way which owns the therapeutic potential to various diseases is the optimal goal. The discovery of CRISPR-Cas9 system in the last decade offers such an opportunity and is under rigorous investigation. This important issue will also be discussed. Keywords: CRISPR-Cas9, gene therapy, gene delivery/modulation, inherited neuromuscular disorders, therapeutic advances.</p>","PeriodicalId":93852,"journal":{"name":"Acta neurologica Taiwanica","volume":"33(4) ","pages":"129-135"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916540","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}