Cases reported "Neuritis"

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1/10. Complicated paraneoplastic neurological syndromes: a report of two patients with small cell or non-small cell lung cancer.

    Paraneoplastic neurological syndromes are frequently associated in patients with small cell lung cancer (SCLC) and antineuronal antibodies are involved in the autoimmune mechanism. Multiple syndromes are sometimes complicated in a single patient with SCLC. However, little is known about non-SCLC-associated neurological manifestations. We report two patients with complicated paraneoplastic neurological syndromes. Patient 1 showed paraneoplastic limbic encephalitis (PLE), paraneoplastic sensory neuropathy (PSN) and lambert-eaton myasthenic syndrome (LEMS) associated with SCLC. Patient 2 developed opsoclonus-ataxia and probable PLE associated with non-SCLC. Analysis of various antineuronal antibodies revealed that anti-Hu and P/Q-type voltage-gated calcium channel (VGCC) antibodies were positive in Patient 1 but any antibodies were not in Patient 2. Brain MRI demonstrated high intensity signals in temporal lobes particularly on fluid-attenuated inversion recovery (FLAIR) or diffusion-weighted images. These findings suggest that complicated paraneoplastic neurological syndromes occur in non-SCLC as well as SCLC and that unidentified antineuronal autoantibodies may underlie the pathophysiology.
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ranking = 1
keywords = encephalitis
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2/10. Localization of antibody in the central nervous system of a patient with paraneoplastic encephalomyeloneuritis.

    We report a patient with severe paraneoplastic encephalomyeloneuritis, occult small-cell carcinoma of the lung, and high titers of circulating antineuronal antibody who died shortly after developing limbic encephalitis. The antibody was of IgG class and reacted specifically with nuclei and cytoplasm of all neurons in the pattern typical for encephalomyelitis and subacute sensory neuropathy associated with small-cell carcinoma (type II, anti-Hu). At autopsy, perivascular inflammatory infiltrates were prominent. All samples of serum, CSF, and postmortem peritoneal and pleural fluid contained high titers of antibody. Direct immunofluorescence of frozen tissue revealed IgG bound to most remaining neurons in multiple brain regions in a pattern similar to indirect immunofluorescence of normal brain tissue. IgG was also bound to tumor. Attempts to elute antibody from tissue decreased background staining but did not remove neuronal immunofluorescence. These results indicate that antibody can access and bind specifically to neuronal antigens in the brain during the course of paraneoplastic disease.
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ranking = 1
keywords = encephalitis
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3/10. The Ramsay Hunt syndrome: a dynamic demonstration of applied anatomy.

    The clinical features of herpes zoster of the geniculate ganglion were reviewed and related to the functional anatomy of the seventh cranial nerve. An illustrative case highlights many of the features of the syndrome that was first described by Ramsay Hunt. The significance of facial palsy is discussed in the light of its distribution.
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ranking = 7.5185850080075
keywords = herpes zoster, zoster, herpes
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4/10. Encephalomyeloneuritis with mediastinal germ cell tumor. A paraneoplastic condition?

    An unusual case of encephalomyeloneuritis associated with germ cell tumor with mature and immature teratoma arising int he mediastinum is presented. There was an unusually long interval from the onset of neurologic symptoms to the development of malignancy. The histopathology, characterized by limbic encephalitis, brain stem encephalitis, cortical cerebellar degeneration and myeloneuritis, was similar to that of paraneoplastic encephalomyeloneuritis previously described in the literature. Virological and immunological studies failed to demonstrate any causative agents or autoantibodies reacting with brain tissue. The causal relationship between the malignant neoplasm and encephalomyeloneuritis thus seems to be very complex.
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ranking = 2
keywords = encephalitis
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5/10. Radial keratoneuritis as a presenting sign in acanthamoeba keratitis.

    Three myopic patients who wore soft contact lenses developed unilateral acanthamoeba keratitis that presented with unusual infiltrates that appeared to be located along the corneal nerves. These infiltrates were found in the midstroma, beginning paracentrally, and extending to the limbus in a radial pattern. The epithelium overlying these infiltrates was intact. In two patients, the central epithelium had a stippled, almost dendritiform appearance leading to the misdiagnosis of herpes simplex keratitis. Cultures from corneal scrapings of two patients and cultures of a corneal biopsy from one patient, which included an area of presumed neural involvement, grew Acanthamoebae. All three patients used homemade saline solutions (salt tablets dissolved in distilled water). In one patient, Acanthamoebae were found in the contact lens case solution. In our recent experience, Acanthamoebae have also been found in the distilled water bottle and the saline solution made from distilled water and salt tablets in two additional patients with A. keratitis. Distilled water, which is not sterile, has proven to be one potentially avoidable source of A. keratitis in contact lens wearers.
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ranking = 0.2277967525333
keywords = herpes
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6/10. Genital herpes: the newest venereal disease. Report of a case associated with aseptic meningitis.

    A case of genital herpes associated with aseptic meningitis is presented. The current concepts regarding epidemiology and pathogenesis, with special attention to involvement of the central nervous system, are discussed. The various clinical and laboratory aspects of the disease are briefly discussed. A review of the literature revealed only forty-four cases of proved herpetic infection of the cerebrospinal fluid in patients other than neonates. The concept of genital herpes as a new and serious public health problem is presented. With the present state of our knowledge and technology, genital herpetic infections will be a major problem for some time to come.
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ranking = 1.3667805151998
keywords = herpes
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7/10. Plexus neuropathy following vaccination against tick-borne encephalitis and tetanus due to a sports related altered immune state.

    A 45-year-old female patient who was practising sports on a competition level, developed a plexus neuropathy subsequent to a vaccination against tick-borne encephalitis (TBE) followed by an inoculation of tetanus toxoid six days later. After the TBE vaccination she continued to exercise intensely until symptoms of a neuritis were noticed. Pronounced endurance exercise has been described to alter the composition and function of the immune system. In our patient a decrease of T-helper cells and a significant lowered CD4/CD8 ratio could be detected. The possible link between an altered immune state and post-vaccinal neuropathy is discussed.
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ranking = 5
keywords = encephalitis
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8/10. Paraneoplastic encephalo-myelo-ganglionitis: cellular binding sites of the antineuronal antibody.

    The cellular binding sites of an antineuronal antibody were characterized in an autopsy case of the paraneoplastic encephalo-myelo-ganglionitis. A 61 year-old woman developed a subacute sensorimotor polyneuropathy and, later, multiple involvement of cranial nerves, disturbance of consciousness, and generalized seizure. An autopsy revealed a small cell lung carcinoma and neuropathological changes that included disseminated encephalitis, spinal anterior horn lesions, severe loss of dorsal root ganglion neurons, and secondary degeneration and loss of the nerve fibers in the spinal posterior column and peripheral nerves. The serum IgG from the patient contained antineuronal antibody(s) including an antibody to 35- to 37-kDa neuronal antigens called anti-Hu as demonstrated in Western blot. In immunohistochemical studies, the serum IgG immunostained neurons of the brains, spinal cords, and dorsal root ganglia of humans or rats. Confocal laser-scanning microscopy revealed binding of the patient's IgG in the neuronal nuclei and cytoplasm, but not in the nucleoli. In immunoelectron microscopic studies, immunolabelling with the IgG was found diffusely in the karyoplasm, excluding nucleoli, and in the cytoplasmic matrix between the cisternae of the reticulums, golgi apparatus, and mitochondria. Encephalo-myeloganglionitis is a clinicopathological entity frequently associated with the presence of neoplasm and antineuronal antibody, however, the role of the antibody in the pathogenesis remains to be elucidated.
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ranking = 1
keywords = encephalitis
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9/10. herpes zoster brachial plexus neuritis.

    This is the first report of brachial plexus inflammation associated with clinical herpes zoster paresis. A 78-year-old female with a 3-week history of herpes zoster of the C4, C5, and C6 dermatomes developed left upper arm monoplegia. She died from an acute myocardial infarction. Post-mortem provided a rare opportunity to study the neuropathology of herpes zoster motor involvement. histology of the brachial plexus showed extensive lymphocytic infiltration, myelin breakdown, and preservation of axons without vasculitis. The cervical spinal cord showed perivascular lymphocytic cuffing and no anterior horn necrosis. We suggest, the brachial plexus inflammation was a distal extension of a dorsal ganglionitis. brachial plexus neuritis may be a direct cause of reversible upper limb paresis in herpes zoster. We demonstrate the motor neuropathy is an inflammatory demyelinative process consistent with the recovery observed in a number of patients. We postulate post-herpetic neuralgia may be related to an ongoing inflammatory process.
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ranking = 38.439607000328
keywords = herpes zoster, zoster, herpes
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10/10. Progressive encephalomyelitis with rigidity.

    Two cases of encephalomyelitis are described in which the major clinical manifestation was muscular rigidity and stimulus-sensitive muscular spasms. It is suggested, from pathological evidence, that this rigidity was of spinal origin, and that this disorder is a rare but recognizable entity. Comparison is made with previously reported cases of rigidity of spinal origin, including encephalitis lethargica, and with 'subacute myoclonic spinal neuronitis' and the 'stiff man syndrome.'
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ranking = 1
keywords = encephalitis
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