Case Reports in Neurology最新文献

{"title":"Encephalitis as a Clinical Manifestation of COVID-19: A Case Series.","authors":"Muhammad Hammad Sharif, Madeeha Khaleeque, Asad Ali Khan, Muhammad Hassan Jan, Atif Ahmed, Nida Latif, Abdul Qadir, Muhammad Hanif, Amjid Iqbal","doi":"10.1159/000530926","DOIUrl":"10.1159/000530926","url":null,"abstract":"<p><p>COVID-19 is a novel virus which causes a variety of clinical manifestations in the body, some of which are yet to be discovered. The main aim of our study is to highlight the neurological manifestations of COVID-19 as it is still new to the medical world, and to emphasize the fact that the physicians have to be wary of the possibility that patients affected by COVID-19 can present with encephalitis. Only a few studies are available so far regarding the neurological manifestations of this novel virus which highlights the need for this study. We present a case series of 4 patients who were found to have COVID-19 encephalitis. There is still no disease-defining test for diagnosis so the mainstay of diagnosis is exclusion of all the common causes of encephalitis. Brain magnetic resonance imaging and cerebrospinal fluid analysis performs an ancillary in the diagnostic tools. Our study also supports the use of IV tocilizumab (4-8 mg/kg) and IV methylprednisolone (0.5-2 mg/kg) as possible treatment options with good results, as the patients described in our case series responded well to these medications.</p>","PeriodicalId":9639,"journal":{"name":"Case Reports in Neurology","volume":"15 1","pages":"131-139"},"PeriodicalIF":0.7,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b7/95/crn-2023-0015-0001-530926.PMC10359675.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10221356","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}

{"title":"Thirty-Year Follow-Up of Early Onset Amyotrophic Lateral Sclerosis with a Pathogenic Variant in SPTLC1.","authors":"Aparna Ajjarapu, Shawna M E Feely, Michael E Shy, Christina Trout, Stephan Zuchner, Steven A Moore, Katherine D Mathews","doi":"10.1159/000530974","DOIUrl":"10.1159/000530974","url":null,"abstract":"<p><p>Dominant mutations in <i>serine palmitoyltransferase long chain base subunit 1</i> (<i>SPTLC1</i>)<i>,</i> a known cause of hereditary sensory autonomic neuropathy type 1 (HSAN1), are a recently identified cause of juvenile amyotrophic lateral sclerosis (JALS) with slow progression. We present a case of <i>SPTLC1-</i>associated JALS followed for 30 years. She was initially evaluated at age 22 years for upper extremity weakness. She experienced gradual decline in muscle strength with development of weakness and hyperreflexia in lower extremities and diffuse fasciculations in the upper extremities at 26 years. She lost independent ambulation at age 45 years. Pulmonary function declined from a forced vital capacity of 94% predicted at 27 years to 49% predicted at 47 years, and she was hospitalized twice for respiratory failure. To our knowledge, this is the longest documented follow-up period of JALS caused by a de novo pathogenic variant in <i>SPTLC1</i>.</p>","PeriodicalId":9639,"journal":{"name":"Case Reports in Neurology","volume":"15 1","pages":"146-152"},"PeriodicalIF":0.7,"publicationDate":"2023-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1e/97/crn-2023-0015-0001-530974.PMC10368087.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10241006","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}

{"title":"Cytotoxic Lesions beyond the Corpus Callosum Following Acute Meningoencephalitis and Mycoplasma Pneumoniae Infection: A Case Report and Literature Review.","authors":"Kuan-Hsien Lu, Te-Chang Wu, Poh-Shiow Yeh","doi":"10.1159/000530944","DOIUrl":"10.1159/000530944","url":null,"abstract":"<p><p>Cytotoxic lesions of the corpus callosum (CLOCCs) are secondary lesions associated with a variety of clinical causes. The presence of a small and reversible lesion in the splenium of corpus callosum with restricted diffusion on cranial magnetic resonance imaging is the defining feature. The clinical-radiological manifestations have been documented as mild and reversible. Severer presentations were scarcely reported. In this report, we described a 25-year-old man with preceding fever, worsening somnolence, and convulsions. He was diagnosed with acute meningoencephalitis and <i>Mycoplasma pneumonia</i>e infection after workups. After medical treatments, he had neurological deterioration and progressing CLOCCs from a small oval lesion in the center of splenium extending to the whole corpus callosum and bilaterally adjacent white matter. The patient received intravenous methylprednisolone and immunoglobulin successively, and his neurological conditions improved. The CLOCCs, not always mild and reversible, could present with severe clinicoradiological features.</p>","PeriodicalId":9639,"journal":{"name":"Case Reports in Neurology","volume":"15 1","pages":"113-119"},"PeriodicalIF":0.7,"publicationDate":"2023-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4e/06/crn-2023-0015-0001-530944.PMC10368104.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10241005","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}

{"title":"The Inverse Lhermitte Phenomenon Suggests Nitrous Oxide-Induced Myelopathy: Case Report and Review of the Literature.","authors":"Sonali Sharma, Michael Benatar, Steven Herskovitz, Volkan Granit","doi":"10.1159/000529325","DOIUrl":"10.1159/000529325","url":null,"abstract":"<p><p>Nitrous oxide-induced myelopathy is a relatively well-known clinical entity. Less well-known, however, is the rare inverse Lhermitte phenomenon, where neck flexion elicits an ascending, rather than descending, electric shock-like sensation. This is a characteristic symptom and sign that may occur in nitrous oxide toxicity. In this article, we present the case of a patient who was admitted to our hospital with suspected Guillain-Barré syndrome due to her ascending numbness and unsteady gait. We describe her examination and laboratory features leading to the correct diagnosis, along with a historical review of the various subtypes of the Lhermitte phenomenon and the pathophysiology of nitrous oxide-induced myelopathy.</p>","PeriodicalId":9639,"journal":{"name":"Case Reports in Neurology","volume":"15 1","pages":"81-86"},"PeriodicalIF":0.7,"publicationDate":"2023-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10294243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9792477","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}

{"title":"Isoniazid-Induced Psychosis in a Patient with Pulmonary Tuberculosis: A Case Report.","authors":"Shreshth Khanna, Suchita Pant, Harsh Khanna","doi":"10.1159/000530779","DOIUrl":"10.1159/000530779","url":null,"abstract":"<p><p>Isoniazid is one of the most important drugs in the management of pulmonary tuberculosis; of all the antituberculous drugs, it is one of the most commonly implicated drugs in drug-induced psychosis. We report a case of isoniazid-induced psychosis in a 31-year-old patient with pulmonary tuberculosis.</p>","PeriodicalId":9639,"journal":{"name":"Case Reports in Neurology","volume":"15 1","pages":"76-80"},"PeriodicalIF":0.7,"publicationDate":"2023-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10294240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9792476","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}

{"title":"Can Growth Hormone Lead to a Faster Recovery from Guillain-Barré Syndrome? Case Report of the First Therapeutic Use in One Patient.","authors":"Felix Amereller, Jochen Schopohl, Sylvère Störmann, Katharina Schilbach, Martin Bidlingmaier, Martin Fischer, Peter Rieckmann, Philipp Gulde","doi":"10.1159/000530065","DOIUrl":"10.1159/000530065","url":null,"abstract":"<p><p>Although the prognosis in Guillain-Barré syndrome (GBS) is generally good, protracted and incomplete courses of recovery can be a heavy burden. Animal studies suggest growth hormone (GH) treatment could stimulate myelin repair and thus accelerate functional recovery in acute polyneuropathy. We report on the first use of GH in GBS. Our objective was to monitor safety and tolerability as well as to evaluate the effect of an off-label GH therapy during recovery from GBS in 1 patient. A 28-year-old male with flaccid tetraparesis caused by pure motor GBS was treated off-label with GH (1 mg/day) for 10 weeks. Muscle strength was measured regularly before, during, and after the treatment over a total span of 330 days. Serum levels of IGF-I were assessed before, during, and after GH treatment. Changes in strength gain were used as the main parameter of efficacy. No side effects of GH treatment were observed. Serum IGF-I increased from 177 ng/mL at baseline to an average of 342 ng/mL (normal range 78-270 ng/mL) during treatment. Prior to GH administration, strength (<i>R</i>² = 0.99, <i>p</i> < 0.01) was associated with time, representing the natural course of recovery. During GH treatment, the slope of strength gain increased (Glass' ∆ = 1.08, <i>p</i> < 0.01). The association between alterations of strength gain and IGF-I serum levels reached trend level (<i>R</i>² = 0.36, <i>p</i> = 0.09). In this single case, GH treatment seemed to be associated with faster muscular strength gain. Controlled studies are needed in order to establish GH as a potential therapeutic approach in motor GBS.</p>","PeriodicalId":9639,"journal":{"name":"Case Reports in Neurology","volume":"1 1","pages":"163-171"},"PeriodicalIF":0.7,"publicationDate":"2023-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10601620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41339793","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}

{"title":"Contraversive Ocular Tilt Reaction with Contralesional Pseudo-Abducens Palsy in a Patient with Thalamomesencephalic Stroke.","authors":"Mohamad Fateh Dabbagh, Lina Okar, Dirk Deleu, Boulenouar Mesraoua","doi":"10.1159/000531085","DOIUrl":"10.1159/000531085","url":null,"abstract":"<p><p>We report a patient presenting with unique neuroophthalmological features of contraversive ocular tilt reaction and concomitant contralesional pseudo-abducens palsy. Magnetic resonance imaging confirmed the presence of an acute infarct in the right thalamomesencephalic region. We discuss the clinical topography of these unique neuroophthalmological findings.</p>","PeriodicalId":9639,"journal":{"name":"Case Reports in Neurology","volume":"15 1","pages":"140-145"},"PeriodicalIF":0.7,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a7/68/crn-2023-0015-0001-531085.PMC10368092.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9882787","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}

{"title":"Utilizing Reduced Labeled Proton Clearance to Identify Preclinical Alzheimer Disease with 3D ASL MRI.","authors":"Charles R Joseph,&nbsp;Alec Kreilach,&nbsp;Victoria Ashley Reyna,&nbsp;Thomas Ashton Kepler,&nbsp;Brittany Viola Taylor,&nbsp;Jubin Kang,&nbsp;Dallas McCorkle,&nbsp;Nicholas L Rider","doi":"10.1159/000530980","DOIUrl":"https://doi.org/10.1159/000530980","url":null,"abstract":"<p><p>Addressing the seminal pathophysiology in Alzheimer disease (AD) is the next logical focus for effective intervention, given the initial disappointing and more recent possibly encouraging results of monoclonal antibody trials. Endothelial cell dysfunction-induced blood-brain barrier leak with associated prolonged capillary mean transit time (cMTT) and glymphatic outflow dysfunction is the most proximal events in the degeneration cascade. Sensitive and reproducible markers are required to both identify early disease and assess future treatment trial outcomes. Two participants, with mild cognitive impairment (MCI) and one with AD, were evaluated clinically prior to MRI in this small case series report. From seven 3D turbo gradient and spin echo (TGSE) pulsed arterial spin echo (PASL) MRI sequences six homologous region of interest in bitemporal, bifrontal, and biparietal lobes for each sequence were examined and plotted against time. By choosing late perfusion times during cMTT phase of perfusion linear analysis of signal decay could be utilized. A reference axial FLAIR sequence was also obtained. Slope of the linear analysis correlated to the rate of labeled proton clearance with reduced clearance occurring in AD participants compared to normal participants in our previous study. Whether similar differences in clearance rate extend to either MCI or early AD was investigated. Participants were categorized by clinical phenotype before MRI and compared to previously published phenotype cohorts: <i>n</i> = 18 normal/healthy, <i>n</i> = 6 AD, <i>n</i> = 3 MCI. Significant differences in labeled proton clearance rates between AD and MCI/control phenotypes within bilateral temporal lobes (left <i>p</i> = 0.004, right <i>p</i> = 0.002) and within bilateral frontal lobes AD versus controls (left <i>p</i> = 0.001, right <i>p</i> = 0.008) and AD versus MCI (left <i>p</i> = 0.001, right <i>p</i> = 0.001) were found. This noninvasive MRI technique has potential for identifying MCI transition to AD.</p>","PeriodicalId":9639,"journal":{"name":"Case Reports in Neurology","volume":"15 1","pages":"177-186"},"PeriodicalIF":0.7,"publicationDate":"2023-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10603764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71410887","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}

{"title":"Intracranial Stenosis Treated with Stenting in Patients with Suspected Cerebral Vasculitis: Two Case Reports.","authors":"Gabriele Vandelli, Laura Giacobazzi, Ludovico Ciolli, Maria Luisa Dell'Acqua, Laura Vandelli, Livio Picchetto, Francesca Rosafio, Giuseppe Maria Borzì, Riccardo Ricceri, Stefano Meletti, Stefano Vallone, Carlo Salvarani, Marco Sebastiani, Federico Sacchetti, Luca Verganti, Stefano Merolla, Gabriele Zelent, Guido Bigliardi","doi":"10.1159/000529942","DOIUrl":"10.1159/000529942","url":null,"abstract":"<p><p>Central nervous system vasculitis (CNSV) is an uncommon and poorly understood form of vasculitis. Early recognition is important because medical treatment might improve the outcome. However, randomized clinical trials on CNSV treatment do not exist. Endovascular treatment has been reported in few cases, but no data exist for intracranial stenting. We report 2 cases of patients with suspected CNSV and recurrent clinical episodes, treated with intracranial stenting. A 48-year-old man had relapsing episodes of right hemiparesis. Neuroradiological exams showed severe left carotid terminus stenosis. Despite immunosuppressive therapy, neuroradiological follow-up exams showed a worsening of the aforementioned stenosis with many transient episodes of weakness in the right limbs and aphasia. A 64-year-old woman had a sudden onset of dysarthria and transient aphasia. Neuroradiological exams showed a severe arterial stenosis involving the origin of left anterior cerebral artery and middle cerebral artery (MCA). Despite dual antiplatelet therapy, she presented an acute onset of severe aphasia, due to an occlusion of the left carotid terminus and proximal MCA. In both cases, endovascular procedure and intracranial stenting was performed, with marked improvement of cerebral blood flow. No more clinical episodes were reported. Intracranial stenting may be a valid therapeutic option in selected patients with CNSV and involvement of medium or large size vessels with clinical worsening despite best medical treatment.</p>","PeriodicalId":9639,"journal":{"name":"Case Reports in Neurology","volume":"15 1","pages":"100-107"},"PeriodicalIF":0.7,"publicationDate":"2023-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5c/37/crn-2023-0015-0001-529942.PMC10355127.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9855103","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}

{"title":"Sustained, Effortless Weight Loss after Damage to the Left Frontoinsular Cortex: A Case Report.","authors":"Benjamin D Reasoner, Aaron D Boes, Joel C Geerling","doi":"10.1159/000529533","DOIUrl":"10.1159/000529533","url":null,"abstract":"<p><p>This case report highlights a possible consequence of damage to the left frontoinsular region. A 53-year-old woman with chronic obesity and headaches presented with seizure, leading to the discovery and resection of a large sphenoid wing meningioma. Postoperative brain imaging revealed loss of the left frontoinsular cortex and portions of the underlying white matter, claustrum, and striatum. Throughout her adult life, this patient had tried and failed to lose weight, but after surgery, she no longer desired to eat large meals, and without effort, her body mass index decreased from 38.6 (85th percentile) to 24.9 (25th percentile). Combined with previous research implicating the insular cortex in interoception, appetite, and drug-related urges, her reduced hunger and effortless weight loss after resection of the left frontoinsular cortex suggest that this region of the human brain may play a role in hunger-related urges that contribute to overeating.</p>","PeriodicalId":9639,"journal":{"name":"Case Reports in Neurology","volume":"15 1","pages":"63-68"},"PeriodicalIF":0.7,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10051042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9240389","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}