Case Reports in Neurology最新文献

Epileptic encephalopathy due to CACNA1A variant, a case report and diagnostic challenges from resource-limited settings. CACNA1A变体导致的癫痫性脑病，一例病例报告和资源有限环境下的诊断难题。

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Case Reports in Neurology Pub Date : 2024-08-09 DOI: 10.1159/000540799

Hilary Chipongo, Samina Chaki, Ronald Mclarty

{"title":"Epileptic encephalopathy due to CACNA1A variant, a case report and diagnostic challenges from resource-limited settings.","authors":"Hilary Chipongo, Samina Chaki, Ronald Mclarty","doi":"10.1159/000540799","DOIUrl":"https://doi.org/10.1159/000540799","url":null,"abstract":"Introduction\u0000Epilepsy is one of the most common neurological disorders present in sub-Saharan Africa and most of these cases are underdiagnosed due to a lack of resources. Epileptic encephalopathies are a broad spectrum of seizure disorders characterized by epileptic activity itself impairing cognitive and behavioral function more than what is expected from the underlying pathology alone. Epileptic encephalopathy resulting from CACNA1A variant is extremely challenging to treat and prognosis is poor if prompt diagnosis is not made.\u0000Case presentation\u0000This is a 7-year-old male patient of African descent with a history of recurrent seizures since infancy. He has been kept on several anticonvulsants without success to control seizure attacks. Having more than three attacks in a single month despite being on anticonvulsants. EEG (electro-encephalography) was done and genetic studies showed a diagnosis consistent with CACNA1A variant-associated epileptic encephalopathy. Anticonvulsants were revised and a combination of new medications as suggested by current guidelines was initiated and the patient is followed up closely on monthly basis.\u0000Conclusion\u0000Even though it is challenging to treat epileptic encephalopathies especially, one associated with CACNA1A variant all patients initiated with antiepileptic therapy should be followed closely and monitored for control of seizure attacks. Appropriate investigation should be considered if EEG alone does not point out the pathology, such as genetic studies.Early diagnosis is crucial for prognosis of such kind of cases especially in resource-limited settings were diagnostic equipments are scarce. All clinicians in these areas should have high suspicion index in pediatric patients with recurrent seizure attacks to rule epileptic encephalopathies.\u0000\u0000\u0000","PeriodicalId":9639,"journal":{"name":"Case Reports in Neurology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141921774","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

Metamorphopsia with SMART syndrome: A case report. 伴有 SMART 综合征的变性人：病例报告

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Case Reports in Neurology Pub Date : 2024-07-24 DOI: 10.1159/000540417

Luke Flain, Aisha Lay, Eden Gadil, Karlie James, S. Thanancheyan, Stephen Bacchi, Rudy Goh

引用次数: 0

Hyponatremia-induced epileptic seizure provoked by levetiracetam and pain medication intake in a patient with central diabetes insipidus 一名中枢性糖尿病患者因服用左乙拉西坦和止痛药而诱发的低钠血症性癫痫发作

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Case Reports in Neurology Pub Date : 2024-07-22 DOI: 10.1159/000540320

Herbert Nägele, Matthias P. Naegele

引用次数: 0

Status Epilepticus and Low-Grade Glioma in the Pregnant State: Case Report and Ethical Considerations. 孕妇癫痫状态和低级别胶质瘤：病例报告与伦理考虑。

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Case Reports in Neurology Pub Date : 2024-07-17 eCollection Date: 2024-01-01 DOI: 10.1159/000539510

Andrew L Waack, Vito M Lucarelli, Amulya Marellapudi, Alisa Gega, Andrew J Zillgitt, Michael D Staudt

{"title":"Status Epilepticus and Low-Grade Glioma in the Pregnant State: Case Report and Ethical Considerations.","authors":"Andrew L Waack, Vito M Lucarelli, Amulya Marellapudi, Alisa Gega, Andrew J Zillgitt, Michael D Staudt","doi":"10.1159/000539510","DOIUrl":"10.1159/000539510","url":null,"abstract":"Introduction: The pregnant state may cause or exacerbate existing neurological disease. Gliomas appear to be influenced by the physiological changes that occur during pregnancy. The pregnant state may also cause seizures, including status epilepticus. There are currently no defined treatment guidelines to direct clinical decision making, and many of the commonly employed therapies are contraindicated during pregnancy.Case presentation: The current article describes the case of a 40-year-old G3P1101 female at 10 weeks' gestation, who sought medical care for recurrent left hemifacial twitching, eventually leading to nonconvulsive status epilepticus. Intubation and sedation were required to achieve seizure cessation. Imaging revealed a lobulated cystic mass in the right parietal lobe, suspicious for low-grade glioma. Despite thorough explanation of the potential risks, the patient adamantly wished to pursue surgical intervention. An uneventful craniotomy was performed for resection of a low-grade glioma. No patient or fetal complications were encountered, and the patient has not had any reported seizures since surgery.Discussion: Managing complex neurosurgical diseases in pregnant patients provides both clinical and ethical quandaries. We describe the successful management of a patient presenting with status epilepticus caused by an underlying glioma during pregnancy. Although challenging, favorable neurosurgical outcomes are possible during pregnancy.","PeriodicalId":9639,"journal":{"name":"Case Reports in Neurology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11324210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141981811","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

Endovascular Mechanical Thrombectomy for Ischemic Stroke Treatment in the Setting of Aortic Dissection: Case Report. 治疗主动脉夹层缺血性脑卒中的血管内机械取栓术：病例报告。

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Case Reports in Neurology Pub Date : 2024-06-21 eCollection Date: 2024-01-01 DOI: 10.1159/000539441

Luis Alberto Cruz-Saavedra, Jeet Patel, Daniel Siragusa, Scott L Silliman

{"title":"Endovascular Mechanical Thrombectomy for Ischemic Stroke Treatment in the Setting of Aortic Dissection: Case Report.","authors":"Luis Alberto Cruz-Saavedra, Jeet Patel, Daniel Siragusa, Scott L Silliman","doi":"10.1159/000539441","DOIUrl":"10.1159/000539441","url":null,"abstract":"Introduction: Acute ischemic stroke can occur in the setting of aortic dissection. Information concerning the utility of endovascular mechanical thrombectomy as an intervention for patients with aortic dissection who are experiencing an acute stroke due to large vessel occlusion is limited to a few case reports. Case series of patients presenting with this clinical situation are needed to further investigate the potential utility of this procedure when patients with acute ischemic stroke and aortic dissection are encountered.Case presentation: We report a patient with a chronic Stanford type A aortic dissection with dissection extension into the left common carotid artery and left internal carotid artery who had a good clinical outcome following mechanical thrombectomy for a symptomatic middle cerebral artery occlusion. We also review other cases in which endovascular mechanical thrombectomy was conducted in patients with aortic dissection and acute ischemic stroke and discuss the potential risks and benefits of carotid artery stenting in this clinical situation.Conclusion: The rate of successful arterial recanalization in patients with aortic dissection, large vessel occlusion, and acute ischemic stroke treated with mechanical thrombectomy is high. The intervention has been associated with good neurological outcomes and a low rate of procedure-related complications. Additional case series are needed to help discern if our observations are present in a broader array of patients in order to identify which patients are most likely to benefit from mechanical thrombectomy.","PeriodicalId":9639,"journal":{"name":"Case Reports in Neurology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626173","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 Rare Case of Coronavirus Disease 2019 Encephalitis Mimicking Creutzfeldt-Jacob Disease in an Immunocompromised Patient: A Case Report. 一例罕见的模仿克雅氏症的冠状病毒病 2019 年脑炎病例：病例报告。

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Case Reports in Neurology Pub Date : 2024-06-13 eCollection Date: 2024-01-01 DOI: 10.1159/000539741

Naveenkumar Nallathambi, Shriganesh P Naidu, Yogesh S, Balamanikandan P, Adithyan C, Navvin S, Hariharan Seshadri, Mohanapriya N, Suriya Prakash

{"title":"A Rare Case of Coronavirus Disease 2019 Encephalitis Mimicking Creutzfeldt-Jacob Disease in an Immunocompromised Patient: A Case Report.","authors":"Naveenkumar Nallathambi, Shriganesh P Naidu, Yogesh S, Balamanikandan P, Adithyan C, Navvin S, Hariharan Seshadri, Mohanapriya N, Suriya Prakash","doi":"10.1159/000539741","DOIUrl":"10.1159/000539741","url":null,"abstract":"Introduction: Coronavirus disease 2019 (COVID-19) encephalitis is characterized by viral entry into the brain, resulting in inflammation and a cascade of neuronal damage. Clinical manifestations include headaches, seizures, and movement disorders. A mortality rate of 20% and infrequent presentation make COVID-19 encephalitis a diagnostic challenge.Case presentation: We hereby present the case of a 55-year-old man with a history of diabetes mellitus (potential impact on COVID-19 severity discussed in the supplementary material) presenting with altered sensorium, swelling in the left eye, and involuntary jerky limb movements. Neurological examination revealed neck rigidity, myoclonic jerks, and an extensor plantar response. Brain magnetic resonance imaging (MRI) was performed, which revealed cortical enhancement in the bifrontal, temporal, and occipital lobes. Rapid progression of myoclonus, altered sensorium, and cortical enhancement on MRI suggested Creutzfeldt-Jacob disease. After a thorough workup, the diagnosis was COVID-19 encephalitis with rhino-orbital mucormycosis. The treatment regimen consisted of adequate glycemic control, remdesivir injection, intravenous and retroorbital liposomal amphotericin, and levetiracetam. The patient's condition improved, and he was eventually discharged.Conclusion: This case illustrates the uncommon presentation of COVID-19 with neurological involvement and emphasizes the value of history-taking, neuroimaging, and cerebrospinal fluid analysis. A high index of suspicion is critical for a prompt diagnosis and initiating therapy.","PeriodicalId":9639,"journal":{"name":"Case Reports in Neurology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626170","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

At Home “Tips” for Headache Management: The Use of Self-Trendelenburg to Help Determine the Cause of Worsening Headaches: A Case Series 在家治疗头痛的 "小窍门"：使用自我俯卧撑帮助确定头痛加剧的原因：病例系列

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Case Reports in Neurology Pub Date : 2024-06-10 DOI: 10.1159/000539615

Todd D. Rozen

{"title":"At Home “Tips” for Headache Management: The Use of Self-Trendelenburg to Help Determine the Cause of Worsening Headaches: A Case Series","authors":"Todd D. Rozen","doi":"10.1159/000539615","DOIUrl":"https://doi.org/10.1159/000539615","url":null,"abstract":"In office use of the Trendelenburg position has been shown to be a beneficial clinical tool to help decipher if a CSF pressure/volume component is part of the underlying etiologic process for a patient’s persistent headache. Utilizing the Trendelenburg position at home could potentially be an additional diagnostic tool for the treating headache physician. Our headache practice has been using at home self-Trendelenburg for the past two years and will present the clinical scenarios in which it seems to be the most helpful utilizing a case series of patients.\u0000These include:\u00001. In those who just had a lumbar puncture and call for worsening headaches and do not have an obvious orthostatic component. \u00002. In those who had a spinal epidural blood patch for a presumed CSF leak and state there was no improvement. \u00003. In those who are on daily preventive CSF volume lowering medications and call in with worsening headaches. \u00004. In those with known CSF pressure dependent headaches high or low but who are not on daily preventive CSF volume modulatory medications.\u00005. In those with a history of migraine or other primary headache disorder to see if a new type of headache is possibly from a CSF leak or an abnormal reset of CSF pressure to an elevated state. \u00006. In those with triggered only headaches like cough or exertional headache. \u0000Utilizing at home self-Trendelenburg can provide valuable information for the treating headache physician on possible underlying headache etiology and can guide specific treatment strategies. Its simplicity and quick declaration of results is very patient pleasing. \u0000","PeriodicalId":9639,"journal":{"name":"Case Reports in Neurology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141361629","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

Paradoxical Kinesia Induced by Nightmare: Unique Case Report and Insights regarding the Neural Mechanism Based on Human and Rat Studies. 梦魇诱发的反常运动：独特的病例报告以及基于人类和大鼠研究的神经机制启示。

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Case Reports in Neurology Pub Date : 2024-05-30 eCollection Date: 2024-01-01 DOI: 10.1159/000539548

Jorge Gelvane Tostes, Mateus Dal Fabbro, David J Pedrosa, Norberto Cysne Coimbra, Rainer Schwarting, Liana Melo-Thomas

{"title":"Paradoxical Kinesia Induced by Nightmare: Unique Case Report and Insights regarding the Neural Mechanism Based on Human and Rat Studies.","authors":"Jorge Gelvane Tostes, Mateus Dal Fabbro, David J Pedrosa, Norberto Cysne Coimbra, Rainer Schwarting, Liana Melo-Thomas","doi":"10.1159/000539548","DOIUrl":"10.1159/000539548","url":null,"abstract":"Introduction: Bradykinesia, characterized by slowed movement, stands out as a primary symptom observed in individuals with Parkinson's disease (PD). Nonetheless, there are instances where PD patients exhibit sudden and effective movements despite the presence of bradykinesia. This phenomenon, referred to as paradoxical kinesia, has remained a subject of interest for neuroscientists, who have struggled to unravel its underlying neural mechanisms for decades.Case presentation: We describe a patient who is suffering from advanced PD. The patient has severe motor limitations, including difficulty rising from bed and walking, as well as cognitive decline and visual impairment. However, an interesting occurrence took place during a nightmare episode. Surprisingly, the patient was able to get out of bed and quickly run away from the perceived threat within the nightmare, without any assistance.Conclusion: This report presents the first documented case of paradoxical kinesia induced by nightmares in a patient with PD. This phenomenon raises questions about the neurological mechanisms involved, which are still not fully understood. Based on existing research conducted on both animal and human subjects, we propose that after processing the emotion of fear, the brain aversive system activates motor outputs to generate appropriate behavior. Thus, the brain aversive system converts the emotion of fear into action through projections from the inferior colliculus to motor-related areas such as the mesencephalic locomotor region, pontine nuclei, and substantia nigra.","PeriodicalId":9639,"journal":{"name":"Case Reports in Neurology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626174","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

Case Report: Treatment of Akinetic Mutism after Unilateral Anterior Cerebral Artery Infarction with Methylphenidate and Levodopa/Benserazide. 病例报告：用哌醋甲酯和左旋多巴/苄丝肼治疗单侧大脑前动脉梗塞后的动眼神经障碍。

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Case Reports in Neurology Pub Date : 2024-05-28 eCollection Date: 2024-01-01 DOI: 10.1159/000539033

Julia Zibold, Moritz Luigi Schmidbauer, Johannes Wischmann, Konstantinos Dimitriadis

{"title":"Case Report: Treatment of Akinetic Mutism after Unilateral Anterior Cerebral Artery Infarction with Methylphenidate and Levodopa/Benserazide.","authors":"Julia Zibold, Moritz Luigi Schmidbauer, Johannes Wischmann, Konstantinos Dimitriadis","doi":"10.1159/000539033","DOIUrl":"10.1159/000539033","url":null,"abstract":"Introduction: Akinetic mutism is a severe state of impaired volition that can result from a stroke. Its therapeutic evidence relies on single case reports that used atomoxetine or levodopa with variable latency and efficacy.Case presentation: We present the case of a 54-year-old woman who developed akinetic mutism after infarction in the territory of the right anterior cerebral artery, successfully treated with methylphenidate and levodopa/benserazide. Clinical examination showed a patient lacking any spontaneous speech and movement while opening her eyes and fixating. Suspecting akinetic mutism after a comprehensive diagnostic work-up, we started an individual therapy attempt with methylphenidate 10 mg and levodopa/benserazide 100/25 mg twice daily. Both drugs affect the dopaminergic and noradrenergic transmission in the frontal-subcortical circuit, compromised in akinetic mutism. We saw rapid and sustained improvement in her volitional actions, devoid of side effects. Finally, the patient was actively communicating and moving her limbs.Conclusion: We discuss the patient's favorable clinical course in response to the synergistic combination of methylphenidate and levodopa/benserazide, emerging as a promising treatment strategy, and provide a brief literature review of treatment options in akinetic mutism following stroke.","PeriodicalId":9639,"journal":{"name":"Case Reports in Neurology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11250274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626172","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

Acute Leriche Syndrome Mimicking Spinal Cord Infarction: A Case Report. 模仿脊髓梗死的急性莱里切综合征：病例报告

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Case Reports in Neurology Pub Date : 2024-05-24 eCollection Date: 2024-01-01 DOI: 10.1159/000539456

Takamichi Kanbayashi, Sonoko Tanaka, Kiyoshi Matsukura, Masahiro Sonoo, Shunsuke Kobayashi

{"title":"Acute Leriche Syndrome Mimicking Spinal Cord Infarction: A Case Report.","authors":"Takamichi Kanbayashi, Sonoko Tanaka, Kiyoshi Matsukura, Masahiro Sonoo, Shunsuke Kobayashi","doi":"10.1159/000539456","DOIUrl":"10.1159/000539456","url":null,"abstract":"Introduction: Acute Leriche syndrome is a rare but potentially life-threatening condition. Pain, pallor, and coldness of the lower extremities serve as clues for suspecting Leriche syndrome. However, the absence of these findings may pose a diagnostic challenge.Case presentation: An 83-year-old man presented at our emergency department with a complaint of sudden-onset paraparesis. Initially, spinal cord infarction was suspected due to clinical course and neurological findings, but thoracolumbar MRI showed normal findings. On admission, symptoms associated with aortoiliac occlusion were not present, except for muscle atrophy in the thigh. CT angiography revealed aortoiliac occlusion, leading to a diagnosis of Leriche syndrome.Conclusion: Leriche syndrome should be considered as a potential differential diagnosis in patients with acute paraparesis. Muscle atrophy of the lower limbs disproportionate to the clinical course may be the clue for suspecting acute Leriche syndrome with symptoms related to atherosclerotic occlusion which are inconspicuous.","PeriodicalId":9639,"journal":{"name":"Case Reports in Neurology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11250112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626171","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