Case Reports in Neurological Medicine最新文献_第6页

Efgartigimod as Rescue Medication in a Patient with Therapy-Refractory Myasthenic Crisis. 将依夫加替莫德作为治疗难治性肌无力危象患者的救治药物

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Case Reports in Neurological Medicine Pub Date : 2024-06-14 eCollection Date: 2024-01-01 DOI: 10.1155/2024/9455237

Omar Alhaj Omar, Norma J Diel, Stefan T Gerner, Anna Mück, Hagen B Huttner, Heidrun H Krämer-Best

{"title":"Efgartigimod as Rescue Medication in a Patient with Therapy-Refractory Myasthenic Crisis.","authors":"Omar Alhaj Omar, Norma J Diel, Stefan T Gerner, Anna Mück, Hagen B Huttner, Heidrun H Krämer-Best","doi":"10.1155/2024/9455237","DOIUrl":"https://doi.org/10.1155/2024/9455237","url":null,"abstract":"Myasthenic crises (MC) are potentially life-threatening acute exacerbations of myasthenia gravis (MG) characterized by profound muscle weakness, bulbar symptoms, and potential for respiratory failure. Intravenous immunoglobulins (IVIG) and plasma exchange (PLEX) are conventional treatments for myasthenic exacerbations. Recently, new therapeutic options for generalized acetylcholine-receptor antibody positive (AchR+) MG were approved as an add-on therapy. They mainly consist of complement C5 inhibitors such as eculizumab and ravulizumab and neonatal Fc receptor antagonists such as efgartigimod with the approval of more options pending, e.g., zilucoplan and rozanolixizumab. More therapeutic options are in the pipeline. Although the data show a quick and reliable treatment response, these medications have not been studied for the therapy of myasthenic crisis. We present the case of a 57-year-old male with his first episode of generalized myasthenia gravis (MG) and positive acetylcholine-receptor antibodies (AchR+) who was transferred to our neurological intensive care unit with worsening generalized weakness, dysphagia, and respiratory distress. The crisis was triggered by pneumonia due to dysphagia. He was diagnosed with myasthenic crisis and treated with intravenous pyridostigmine, plasmapheresis (PLEX), and continued prednisone. Initial improvement was followed by deterioration, requiring readmission and additional PLEX. After a further decline, efgartigimod was administered, leading to significant improvement within 48 hours, as evidenced by reduced MG-ADL and QMG scores. The patient continued to improve and was stable enough for transfer to a rehabilitation facility. This case illustrates the potential of efgartigimod as a novel treatment for refractory myasthenic crises.","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2024 ","pages":"9455237"},"PeriodicalIF":0.9,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11211016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141466409","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

Chronic Inflammatory Demyelinating Polyradiculoneuropathy with Diplopia Caused by an Alternative Coronavirus Disease 2019 Vaccine. 一种替代性冠状病毒病2019疫苗引发的伴有复视的慢性炎症性脱髓鞘多发性神经病

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Case Reports in Neurological Medicine Pub Date : 2024-06-11 eCollection Date: 2024-01-01 DOI: 10.1155/2024/8584482

Satoshi Saito, Mutsumi Iijima, Misa Seki, Ayato Shimomura, Kazuo Kitagawa

引用次数: 0

Syncope vs. Seizure: Ictal Bradycardia and Ictal Asystole. 晕厥与癫痫发作：心动过缓和心动过速。

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Case Reports in Neurological Medicine Pub Date : 2024-05-06 eCollection Date: 2024-01-01 DOI: 10.1155/2024/1299282

Sumika Ouchida, Kaitlyn Parratt, Armin Nikpour, Greg Fairbrother

{"title":"Syncope vs. Seizure: Ictal Bradycardia and Ictal Asystole.","authors":"Sumika Ouchida, Kaitlyn Parratt, Armin Nikpour, Greg Fairbrother","doi":"10.1155/2024/1299282","DOIUrl":"10.1155/2024/1299282","url":null,"abstract":"Background: Ictal arrhythmia is a rare condition that causes arrhythmic manifestations induced by epileptic seizures, including asystole or bradycardia. Ictal asystole (IA) is a very rare condition found in patients undergoing video-encephalography (EEG) monitoring. It is often related to temporal lobe epilepsy and can cause syncope, which can lead to injury or even death. Case Presentation. Two patients with epilepsy showed symptoms of syncope. Both patients underwent 4-day ambulatory EEG tests and were diagnosed with IA. Following the tests, the patients were implanted with a permanent pacemaker, and one of them underwent a temporal lobectomy. As a result of these procedures, the patients experienced a reduction in episodes of symptomatic syncope.Conclusion: Patients with ictal asystole and symptomatic ictal bradycardia are at increased risk of falls due to seizures. Although there are no specific guidelines for managing this condition, antiseizure medications, epilepsy surgery, and cardiac pacemaker implantation have been effective treatments.","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2024 ","pages":"1299282"},"PeriodicalIF":0.9,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11090674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140916014","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

Novel SLC18A2 Variant in Infantile Dystonia-Parkinsonism Type 2. 婴儿肌张力障碍-帕金森氏症 2 型中的新型 SLC18A2 变体

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Case Reports in Neurological Medicine Pub Date : 2024-04-30 eCollection Date: 2024-01-01 DOI: 10.1155/2024/4767647

Sakari Kaasalainen, Harri Arikka, Mika H Martikainen, Valtteri Kaasinen

{"title":"Novel SLC18A2 Variant in Infantile Dystonia-Parkinsonism Type 2.","authors":"Sakari Kaasalainen, Harri Arikka, Mika H Martikainen, Valtteri Kaasinen","doi":"10.1155/2024/4767647","DOIUrl":"10.1155/2024/4767647","url":null,"abstract":"Infantile dystonia-parkinsonism type 2 (PKDYS2) is a rare inherited autosomal recessive movement disorder with onset in infancy. The disease is associated with a mutation in the solute carrier family 18 member A2 gene (SLC18A2). There are reports of trials with dopaminergic drugs and the condition of patients given levodopa almost always worsens and dopamine agonists give varying degrees of benefit to some. Here, we report a PKDYS2 patient with a new variant in the SLC18A2 gene who underwent multiple trials of pharmacotherapy. The abnormalities in development and neurological examination of the case were first noted at the age of 2 months, and after a series of treatment attempts (e.g., with antiepileptics) and diagnostic procedures, the diagnosis of PKDYS2 was determined when whole exome sequencing (WES) at age 6, revealed a homozygous pathologic variant NM_003054.4:c.1107dup, p.(Val370Serfs∗91) in the SLC18A2 gene. The patient then received treatment with multiple dopaminergic drugs (e.g., levodopa, pramipexole, and methylphenidate). The patient with PKDYS2 harbored a new variant in SLC18A2. The phenotype of the patient resembles that of some previously reported patients with PKDYS2. The patient received minor benefits from certain dopaminergic drugs, such as pramipexole, but side effects led to the discontinuation of tested medications.","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2024 ","pages":"4767647"},"PeriodicalIF":0.9,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11074866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140875941","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 Symptomatic Intraluminal Internal Carotid Artery Thrombus in a Patient with Essential Thrombocythemia Surgically Treated by CEA. 原发性血小板增多症患者经CEA手术治疗并发腔内症状性颈内动脉血栓1例。

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Case Reports in Neurological Medicine Pub Date : 2023-11-24 eCollection Date: 2023-01-01 DOI: 10.1155/2023/9152009

Satoshi Takahashi, Masahiro Katsumata, Hirotsugu Nogawa, Kento Takahara, Jin Nakahara, Masahiro Toda

引用次数: 0

Penetrating Head Injury by a Hit of Rake in a Child: A Case Report and Literature Review. 儿童耙击致头部穿透伤1例报告及文献复习。

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Case Reports in Neurological Medicine Pub Date : 2023-11-18 eCollection Date: 2023-01-01 DOI: 10.1155/2023/9921985

Issa Ibrahim Assoumane, Nicaise Kpègnon Agada, Rabiou Maman Sani, Aminath Kélani

{"title":"Penetrating Head Injury by a Hit of Rake in a Child: A Case Report and Literature Review.","authors":"Issa Ibrahim Assoumane, Nicaise Kpègnon Agada, Rabiou Maman Sani, Aminath Kélani","doi":"10.1155/2023/9921985","DOIUrl":"https://doi.org/10.1155/2023/9921985","url":null,"abstract":"Background: A penetrating head injury (PHI) refers to a situation where a projectile has breached the cranium but does not exit it. It constitutes about 0.4% of all head injuries. Several nonmissile materials inserting the skull have been reported. But to our knowledge, never before has any case of PHI caused by a hit of rake been reported. We report a first case of PHI caused by a rake in a child; then, we relate our experience with its management and discuss the relevant literature. Cases Description. A 5-year-old boy has been admitted with a rake embedded in his head. That occurred during a violent play with a neighbor. At presentation, the child was alert; there was no neurological deficit. The rake was embedded in the parietal regions on each side of the midline. The head Computed Tomography (CT) scan performed showed a biparietal hyperdensity from either side of the midline with a metal artifact. In the operating room, after a transversal incision joining the 2 tips of the object, we performed successively bone flaps; object extraction; debridement; duraplasty; and closing. The outcome was uneventful.Conclusion: This is the first case of PHI by a rake. The surgical management constitutes the main challenging point.","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2023 ","pages":"9921985"},"PeriodicalIF":0.9,"publicationDate":"2023-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10676273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138458121","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

Generalized Extension of Referred Trigeminal Pain due to Greater Occipital Nerve Entrapment 枕大神经卡压引起的牵涉性三叉神经痛的广泛性延伸

Case Reports in Neurological Medicine Pub Date : 2023-11-11 DOI: 10.1155/2023/1099222

Jung-woo Hyung, Byung-chul Son

{"title":"Generalized Extension of Referred Trigeminal Pain due to Greater Occipital Nerve Entrapment","authors":"Jung-woo Hyung, Byung-chul Son","doi":"10.1155/2023/1099222","DOIUrl":"https://doi.org/10.1155/2023/1099222","url":null,"abstract":"We report a very rare case of referred pain caused by greater occipital nerve (GON) entrapment, inducing spontaneous pain in the whole body as well as in the trigeminal nerve region of the face and head. It has already been reported that entrapment of the GON can induce referred pain in the ipsilateral limb as well as the ipsilateral hemiface. A 42-year-old female patient presented with chronic pain in her gums, jaw angle, submandibular region, retro-auricular suboccipital, and temporo-occipital vertex that had been ongoing for four years. As the patient’s head pain and facial pain became severe, severe spontaneous pain occurred in the arm, waist, and both lower extremities. This patient’s pain in the occipital and neck, spontaneous pain in the face, jaw, and whole body improved with decompression of the GON. Anatomical basis of pain referral to the facial trigeminal area caused by chronic GON entrapment is convergence of nociceptive inflow from high cervical C1–C3 structures and trigeminal orofacial area in the dorsal horn of the cervical spinal cord from the C2 segment up to the medullary dorsal horn (MDH). The major afferent contribution among the suboccipital and high cervical structure is mediated by spinal root C2 that is peripherally represented by the GON. Chronic noxious input from GON entrapment can cause sensitization and hypersensitivity in second order neurons in the trigeminocervical complex (TCC) and MDH in the caudal trigeminal nucleus and high cervical cord. Generalized extension of referred pain due to GON entrapment is thought to involve two possible pathophysiologies. One is the possibility that generalized pain is caused by sensitization of third-order nociceptive neurons in the thalamus. Another speculation is that spontaneous pain may occur throughout the body due to dysfunction of the descending brain stem pain-modulating pathway by sensitization and hyperexcitation of the MDH and trigeminal brainstem sensory nuclear complex (TBSNC).","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"41 12","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135041972","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

Inadvertent Intrathecal Administration of Digoxin, with Review of the Literature. 鞘内注射地高辛不慎，文献复习。

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Case Reports in Neurological Medicine Pub Date : 2023-10-20 eCollection Date: 2023-01-01 DOI: 10.1155/2023/4034919

Burton J Tabaac, Ian O T Laughrey, Hany F Ghali

引用次数: 0

Alzheimer's Type Neuropathological Changes in a Patient with Depression and Anxiety: A Case Report and Literature Review of Neuropathological Correlates of Neuropsychiatric Symptoms in Alzheimer's Disease. 抑郁症和焦虑症患者的阿尔茨海默型神经病理学变化：阿尔茨海默病神经精神症状的神经病理学相关性的病例报告和文献综述。

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Case Reports in Neurological Medicine Pub Date : 2023-10-11 eCollection Date: 2023-01-01 DOI: 10.1155/2023/5581288

Sumit Das

{"title":"Alzheimer's Type Neuropathological Changes in a Patient with Depression and Anxiety: A Case Report and Literature Review of Neuropathological Correlates of Neuropsychiatric Symptoms in Alzheimer's Disease.","authors":"Sumit Das","doi":"10.1155/2023/5581288","DOIUrl":"https://doi.org/10.1155/2023/5581288","url":null,"abstract":"Alzheimer's disease (AD) is classified as a tauopathy and is the most common neuropathological correlate of dementia/cognitive impairment. AD is neuropathologically characterized by the presence of beta-amyloid immunoreactive senile plaques and tau positive neurofibrillary tangles. Neuropsychiatric symptoms of AD however continue to be underscored, and therefore, neuropathological correlates of these neuropsychiatric symptoms are not readily studied. Presented here is a case of 60-year-old female who initially presented with anxiety and depression, and continued to be the predominant symptoms although mild cognitive impairment was noted as per the available clinical notes. Postmortem examination of the brain revealed severe Alzheimer's type neuropathological changes, which included significant tau and beta-amyloid pathology in limbic regions, which were thought to represent correlates of the patient's depression and anxiety. This case report illustrates the possible neuropathological correlates of neuropsychiatric symptoms in patients with AD. The author hopes that such a case will promote more in-depth studies into the pathophysiology of neuropsychiatric manifestations in AD.","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2023 ","pages":"5581288"},"PeriodicalIF":0.9,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10584483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49674661","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

Anti-3-Hydroxy-3-Methylglutaryl-Coenzyme A Reductase Immune-Mediated Necrotizing Myopathy following mRNA SARS-CoV-2 Vaccination. mRNA SARS-CoV-2疫苗接种后抗3-羟基-3-甲基戊二酰辅酶A还原酶免疫介导的坏死性肌病

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Case Reports in Neurological Medicine Pub Date : 2023-01-01 DOI: 10.1155/2023/7061783

Marta Rodrigues de Carvalho, Myrian Mathildes Sá de Deus Rocha, Vinícius Alves Bezerra, Maciel Eduardo de Pontes, Maria Cristina Del Negro, Julio Salgado Antunes, Vinícius Viana Abreu Montanaro, Rubens Nelson Morato Fernandez

引用次数: 2