1/53. Mononeuropathy of the deep palmar branch of the ulnar nerve. A case occurring in a diabetic woman.A diabetic woman developed mononeuropathy of the deep palmar branch of the ulnar nerve six months following repetitive palmar trauma. The illness was initially incorrectly diagnosed as motor neuron disease, emphasizing the importance of accurate diagnosis of diseases that cause wasting of intrinslc muscles in the hand.- - - - - - - - - - ranking = 1keywords = illness (Clic here for more details about this article) |
2/53. Neurological complications of acute and persistent Epstein-Barr virus infection in paediatric patients.Neurological complications of Epstein-Barr virus (EBV) have been reported almost exclusively in the course of acute primary infections. The role of EBV in paediatric neurological disease was investigated prospectively over a 2-year period, searching for acute primary, chronic, and reactivated EBV infections. Active EBV infections were diagnosed in 10/48 patients, including two with acute primary EBV infections (cranial neuritis and cerebellitis), one with chronic active infection (T/NK cell lymphoma with cranial neuritis), and seven with reactivated infections. Among these seven patients, three showed "Alice in Wonderland" syndrome, one facial nerve palsy, one progressive macrocephaly, and two prolonged encephalitic illness. The prognosis was good except for the patient with lethal T/NK cell lymphoma and the two girls with encephalitic illness. Despite steroid treatment, these girls suffered prolonged cognitive impairment and epileptic seizures. Both developed left-sided hippocampal atrophy, and one of them hippocampal sclerosis. Like primary infections, reactivated EBV infections cause neurological complications in a considerable number of paediatric patients, lead to serious long-term complications, and may contribute to the pathogenesis of hippocampal lesions.- - - - - - - - - - ranking = 2keywords = illness (Clic here for more details about this article) |
3/53. The neurobehavioural consequences of St. Louis encephalitis infection.BACKGROUND: St. Louis encephalitis (SLE) is a relatively common cause of neurological illness, yet little is known about its cognitive and psychosocial consequences. PURPOSE: To describe the cognitive, emotional, psychophysiological, and psychosocial consequences of SLE infection. METHOD: A comprehensive neuropsychological and psychophysiological evaluation of a high functioning woman 6 weeks and 1 year after acute SLE infection is presented. The focus and course of rehabilitation is also examined. RESULTS: The primary cognitive consequences of SLE infection involved attention, working memory, speed of processing, and cognitive efficiency. depression was also observed. Psychometric testing suggested that these deficits largely resolved after 1 year. CONCLUSIONS: SLE produces neurocognitive deficits which are reflected in both psychometric and psychophysiologic measures and functional status. Psychometric and vocational improvement were observed over 1 year. However, the normal vocational return came at a significant psychosocial cost. This case emphasizes the importance of a comprehensive neuropsychological evaluation and illustrates the importance of an integrated rehabilitation programme.- - - - - - - - - - ranking = 1keywords = illness (Clic here for more details about this article) |
4/53. A fatal case of west nile virus infection in a bone marrow transplant recipient.west nile virus (WNV) can cause severe, potentially fatal neurological illnesses, which include encephalitis, meningitis, guillain-barre syndrome, and anterior myelitis. Because of the short viremic phase, WNV infection is most commonly diagnosed by detection of immunoglobulin m antibody to WNV in serum or cerebrospinal fluid (CSF). We describe a patient with T cell lymphoma who had undergone a T cell-depleted bone marrow transplantation and developed fatal WNV infection. The results of serological tests of blood samples and of CSF tests were negative. diagnosis was made postmortem by a positive result of reverse-transcriptase polymerase chain reaction (ABI 7700; TaqMan) for WNV in stored CSF and serum samples.- - - - - - - - - - ranking = 1keywords = illness (Clic here for more details about this article) |
5/53. rhabdomyolysis, acute renal failure, and multiple focal neuropathies after drinking alcohol soaked with centipede.Many Chinese like to drink alcohol soaked with creatures for promoting health. This study reports a 49-year-old male who presented with multiple focal neuropathies of the upper limbs, coagulopathy, erythematous swelling of the bilateral upper extremities and trunk with bullous skin lesions, and rhabdomyolysis associated with acute renal failure after drinking alcohol soaked with centipede. Soaking a centipede, Scolopendra subspinipes mutilans, in 53% alcohol, produced the wine. Supportive treatment was administered, and the skin lesions and renal failure improved with subsequent neurologic deficit during the week following initial presentation. Alcohol binge or immobilization was the likely cause of neuropathy, bullous skin lesions and rhabdomyolysis in the patient. However, there is a possibility that centipede venom also contributed to the illness in this patient.- - - - - - - - - - ranking = 1keywords = illness (Clic here for more details about this article) |
6/53. rehabilitation of the cancer patient: experience in a neurological unit.We performed a retrospective review of all patients admitted to a neurological rehabilitation unit over a 5-year period to identify the benefits and problems associated with inpatient rehabilitation of patients with a life-limiting illness. Twenty-one patients (14 men; mean age 54 years) with primary or nonprimary neurological malignancy resulting in disability were studied. For each patient the following data was extracted: gender, age, diagnosis, source of referral, mechanism of disability, prognosis at time of referral, length of inpatient stay, disability on admission and discharge, and the place of discharge. All patients made functional gains, and all but 2 were discharged home. One patient died and 4 required readmission to an acute unit because of worsening discomfort or debility within a month of discharge. patients with life-limiting illness resulting in neurological disability can benefit from inpatient rehabilitation. Optimal management of such patients demands careful liaison with palliative care teams.- - - - - - - - - - ranking = 2keywords = illness (Clic here for more details about this article) |
7/53. lidocaine as an adjunct to hyperbaric therapy in decompression illness: a case report.A recreational scuba diver with nervous system decompression illness had a poor response to hyperbaric therapy. On the basis of available and supportive in vivo data, he was then given a continuous infusion of lidocaine (serum levels, low therapeutic range: 6.4-9.1 mumol/liter). Within 24 h of the start of this infusion he experienced a full resolution of his neurologic deficits. His symptoms recurred 3 days later, but again completely resolved after further hyperbaric therapy and concurrent administration of lidocaine (serum levels: 6.9-9.1 mumol/liter). This observation supports the need to conduct trials of lidocaine as an adjunct to hyperbaric therapy in decompression illness.- - - - - - - - - - ranking = 6keywords = illness (Clic here for more details about this article) |
8/53. Postmalaria neurologic syndrome: a case report.Neurologic signs and symptoms are common in acute malarial infection. However, after the parasites have been cleared from the blood and patients recover full consciousness, neurologic or psychiatric symptoms may occur or recur within 2 months after the acute illness. This phenomenon is called "postmalaria neurologic syndrome" (PMNS). We present a 50-year-old man who returned from the Republic of malawi and soon developed plasmodium falciparum malaria. Cerebral malaria, renal failure, hepatic failure, diffuse intravascular coagulation with thrombocytopenia, and upper gastrointestinal bleeding were noted during the acute stage. He was admitted to the infectious diseases ward and treated for 3 weeks. He was free from clinical general symptoms and parasites in blood smear when discharged. However, 2 weeks after discharge, he began to experience severe headache, dizziness, diplopia, mild hand tremor, unsteady gait, and easy falling. When readmitted to the neurologic ward, he presented with irritability, delirium, visual hallucination, and strange behavior. neurologic examination was normal except for mild general weakness and evident truncal ataxia when walking. brain magnetic resonance imaging revealed no structural lesions, and electroencephalography showed diffuse cortical dysfunction. Cerebral spinal fluid profile exhibited cytoalbuminologic dissociation. brain single photon emission computed tomography showed diffuse cerebral parenchymal disorder. Nerve conduction studies revealed early sensory predominant polyneuropathy. The unsteadiness persisted for the initial 2 weeks of hospitalization until corticosteroid was administered. Intravenous methylprednisolone (80 mg/day) was continued for 3 days, followed by oral prednisolone (45 mg/day). His unsteadiness improved gradually after medication, and he absconded from the hospital on the 9th day of corticosteroid treatment with clear consciousness and free ambulation. The manifestation of PMNS is diverse and may present as an acute confusional state or psychosis, generalized seizure, fine tremors, cerebellar syndromes, postural hypotension, or malarial polyneuritis. Although the neurologic syndrome is primarily self-limited in most cases, corticosteroid may be beneficial in reversing PMNS.- - - - - - - - - - ranking = 1keywords = illness (Clic here for more details about this article) |
9/53. syphilis: a disease to exclude in diagnosing sarcoidosis.A 37-year-old man was referred to our institution for assessment of possible sarcoidosis with involvement of the central nervous system. Before referral, he experienced a systemic illness that persisted for several months, during which time ocular and pulmonary noncaseating granulomas were identified. sarcoidosis with involvement of the central nervous system was tentatively diagnosed. Because of several inconsistencies in the preliminary diagnosis of sarcoidosis, further assessment was pursued, and syphilis was diagnosed. Herein we emphasize the useful clinical features for distinguishing syphilis from sarcoidosis and review the clinical manifestations of pulmonary syphilis.- - - - - - - - - - ranking = 1keywords = illness (Clic here for more details about this article) |
10/53. Animal illness and human emotion. Neurologic problems.Clients' decisions are based on the veterinarian's ability to familiarize them with nervous system disease. Unfortunately, the nervous system does not lend itself to complete examination without advanced neurodiagnostic tests. These tests usually require general anesthesia, may be invasive, and often require advanced training. Therefore, a logical and orderly approach to animals with neurologic disease should be mastered. Problems can be avoided by educating the client about the extent of neurologic disease, the working diagnosis, pros and cons of diagnostic and therapeutic options, and a plan of action should unanticipated problems arise.- - - - - - - - - - ranking = 4keywords = illness (Clic here for more details about this article) |
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