scholarly journals Functional positional eye and eyelid movements

2020 ◽  
Vol 267 (11) ◽  
pp. 3425-3428
Author(s):  
Mohamed Mabrouk Mustafa ◽  
Harry Akram ◽  
Manuel Oliva-Domínguez ◽  
Diego Kaski
Keyword(s):  
Clinical Features ◽  
Neurological Examination ◽  
Neurological Disorders ◽  
Case Series ◽  
Positional Vertigo ◽  
Accurate Interpretation ◽  
Upbeat Nystagmus ◽  
Functional Movements

Abstract Background Positional manoeuvres are an important part of the neurological examination, particularly in patients with vertigo where the presence and characteristics of provoked nystagmus can help differentiate central from peripheral neurological disorders. Methods Case series of functional positional eye and eyelid movements. Results We report four patients with functional eye and eyelid movements provoked during positional manoeuvres. The range of abnormalities observed included positional convergence spasm, brief functional saccadic oscillations, and excessive positional blinking mimicking upbeat nystagmus. The functional movements described were present on a background of pre-existing peripheral or central nystagmus, or positional vertigo. Conclusion Functional positional eye and eyelid movements may co-exist with organic nystagmus that renders an accurate interpretation of the manoeuvre more challenging. A thorough understanding of the clinical features that differentiate these two categories of eye/eyelid movements makes the analysis easier, thus preventing misdiagnosis and avoiding unnecessary investigations.

Clinical Features of Recurrent or Persistent Benign Paroxysmal Positional Vertigo

2012 ◽  
Vol 147 (5) ◽  
pp. 919-924 ◽  
Author(s):  
Seong Jun Choi ◽  
Jong Bin Lee ◽  
Hye Jin Lim ◽  
Hun Yi Park ◽  
Keehyun Park ◽  
...  
Keyword(s):  
Clinical Features ◽  
Benign Paroxysmal Positional Vertigo ◽  
Case Series ◽  
Semicircular Canals ◽  
University Hospital ◽  
Positional Vertigo ◽  
Epley Maneuver ◽  
Clinical Records ◽  
Secondary Causes ◽  
Paroxysmal Positional Vertigo

Objectives To identify clinical features and causes of recurrent or persistent benign paroxysmal positional vertigo (BPPV) and to analyze the effectiveness of frequently repeated canalith repositioning procedures (CRPs). Study Design Case series with chart review. Setting Academic university hospital. Methods The authors retrospectively reviewed the clinical records of 120 patients who were diagnosed with BPPV at the Dizziness Clinic in Ajou University Hospital, Korea, between 2004 and 2008. “Persistent” and “recurrent” BPPV were respectively defined as BPPV continuing more than 2 weeks and recurring BPPV in the same canals after at least 2 weeks of a symptom-free interval following previous successful treatments. The authors treated patients with frequently repeated CRPs such as the modified Epley maneuver or a barbecue rotation every 2 or 3 days in the outpatient clinic. Results Among 120 patients with BPPV, 93 (77.5%) were typical, 15 (12.5%) were persistent, and 12 (10.0%) were recurrent. Although the most common cause was idiopathic in both recurrent and persistent BPPV, secondary causes, including trauma, were much more common in recurrent and persistent BPPV than in typical BPPV. Typical and recurrent BPPV developed most commonly in the posterior semicircular canals. Persistent BPPV was most commonly detected in the lateral semicircular canals. After frequently repeated CRPs, 91.7% and 86.7% of the patients with recurrent or persistent BPPV, respectively, had resolution of nystagmus and vertigo. Conclusion Recurrent and persistent BPPV are not rare diseases and occur with a higher incidence than expected, especially in patients with secondary causes. However, they can be successfully treated with frequently repeated CRPs.

scholarly journals Clinical features and predictors of severity in COVID-19 patients with critical illness in Singapore

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ser Hon Puah ◽  
◽  
Barnaby Edward Young ◽  
Po Ying Chia ◽  
Vui Kian Ho ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Clinical Features ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Case Series ◽  
Plateau Pressure ◽  
Apache Ii Score ◽  
Multivariable Logistic Regression Model ◽  
Reactive Protein ◽  
Ventilatory Management

AbstractWe aim to describe a case series of critically and non-critically ill COVID-19 patients in Singapore. This was a multicentered prospective study with clinical and laboratory details. Details for fifty uncomplicated COVID-19 patients and ten who required mechanical ventilation were collected. We compared clinical features between the groups, assessed predictors of intubation, and described ventilatory management in ICU patients. Ventilated patients were significantly older, reported more dyspnea, had elevated C-reactive protein and lactate dehydrogenase. A multivariable logistic regression model identified respiratory rate (aOR 2.83, 95% CI 1.24–6.47) and neutrophil count (aOR 2.39, 95% CI 1.34–4.26) on admission as independent predictors of intubation with area under receiver operating characteristic curve of 0.928 (95% CI 0.828–0.979). Median APACHE II score was 19 (IQR 17–22) and PaO2/FiO2 ratio before intubation was 104 (IQR 89–129). Median peak FiO2 was 0.75 (IQR 0.6–1.0), positive end-expiratory pressure 12 (IQR 10–14) and plateau pressure 22 (IQR 18–26) in the first 24 h of ventilation. Median duration of ventilation was 6.5 days (IQR 5.5–13). There were no fatalities. Most COVID-19 patients in Singapore who required mechanical ventilation because of ARDS were extubated with no mortality.

scholarly journals Challenging Presentations of Seven Cases of Gastrointestinal Basidiobolomycosis in Sudan: Clinical Features, Histology, Imaging, and Recommendations

2020 ◽  
Vol 12 (04) ◽  
pp. 281-284
Author(s):  
Sawsan A. Mohammed ◽  
Azza A. Abdelsatir ◽  
Mohamed Abdellatif ◽  
Suliman Hussein Suliman ◽  
Omer Mohammed Ibrahim Elbasheer ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Fungal Infection ◽  
Clinical Features ◽  
Subcutaneous Tissue ◽  
Case Series ◽  
First Case

AbstractsBasidiobolomycosis is a fungal infection caused by Basidiobolus ranarum which affects the skin and subcutaneous tissue and rarely the gastrointestinal tract. We report seven cases of gastrointestinal basidiobolomycosis with interesting clinical, radiological, and histological presentations. To our knowledge, this is the first case series of abdominal basidiobolomycosis to be reported from Sudan.

scholarly journals Persistent Upbeat Positional Nystagmus in a Patient with Bilateral Posterior Canal Benign Paroxysmal Positional Vertigo

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Akihide Ichimura ◽  
Shigeto Itani
Keyword(s):  
Supine Position ◽  
Benign Paroxysmal Positional Vertigo ◽  
Semicircular Canals ◽  
Downbeat Nystagmus ◽  
Positional Vertigo ◽  
Head Roll ◽  
The Right ◽  
Upbeat Nystagmus ◽  
Torsional Nystagmus ◽  
Paroxysmal Positional Vertigo

Here, we report a patient with persistent positional upbeat nystagmus in a straight supine position with no evident abnormal central nervous system findings. A 43-year-old woman with rotatory positional vertigo and nausea visited our clinic 7 days after the onset. Initially, we observed persistent upbeat nystagmus in straight supine position with a latency of 2 s during the supine head roll test. However, an upbeat nystagmus disappeared on turning from straight to the left ear-down supine position, and while turning from the left to right ear-down position, an induced slight torsional nystagmus towards the right for >22 s was observed. In the Dix–Hallpike test, the left head-hanging position provoked torsional nystagmus towards the right for 50 s. In prone seated position, downbeat nystagmus with torsional component towards the left was observed for 45 s. Neurological examination and brain computed tomography revealed no abnormal findings. We speculated that persistent positional upbeat nystagmus in this patient was the result of canalolithiasis of benign paroxysmal positional vertigo of bilateral posterior semicircular canals.

scholarly journals Clinical features of cats with aqueous tear deficiency: a retrospective case series of 10 patients (17 eyes)

2018 ◽  
Vol 21 (10) ◽  
pp. 944-950 ◽  
Author(s):  
Lisa K Uhl ◽  
Akihiko Saito ◽  
Hiroko Iwashita ◽  
David J Maggs ◽  
Jonathan P Mochel ◽  
...  
Keyword(s):  
Clinical Features ◽  
Ocular Surface ◽  
Clinical Signs ◽  
Case Series ◽  
Reference Interval ◽  
Clinical Findings ◽  
Response To Therapy ◽  
Ocular Surface Disease ◽  
Retrospective Case ◽  
Schirmer Tear Test

Objectives The aim of this study was to describe the clinical findings, diagnostic test results and response to therapy of cats with Schirmer tear test 1 (STT-1) values below the reference interval. Methods The medical records of three institutions were searched for cats with ocular surface disease and STT-1 values <9 mm/min, confirmed at two or more separate visits. Results Ten cats (17 eyes) were included. The mean ± SD (range) age and STT-1 values in affected eye(s) were 6.1 ± 5.7 (0.2–16) years and 2.4 ± 3.1 (0–8) mm/min, respectively. Concurrent ocular surface disease was bilateral in 5/10 cats. Clinical signs included conjunctivitis (14/17 eyes), corneal ulceration (6/17 eyes), non-ulcerative keratitis (4/17 eyes), symblepharon (4/17 eyes), eosinophilic keratitis (3/17 eyes), corneal sequestrum (3/17 eyes), corneal fibrosis (2/17 eyes) and meibomitis (2/17 eyes). Management included: topically applied lacrimomimetics, antiviral drugs, corticosteroids or immunomodulatory drugs; orally administered famciclovir; or surgical procedures, in various combinations. Response to therapy (defined as an increase in STT-1 value of ⩾5 mm/min) was transient (seen at a single reassessment) in 65% of eyes and sustained (seen at ⩾2 consecutive reassessments) in 18% of eyes. Conclusions and relevance Clinical features seen in cats with low STT-1 values are described, although the association between aqueous deficiency and the reported ocular changes is unknown at this time. We encourage clinicians to assess the tear film in cats with ocular surface disease, and initiate therapy with lacrimomimetics if STT-1 values are repeatedly below normal. Such information will further define aqueous tear deficiency in cats, providing a better understanding of disease prevalence, pathogenesis and treatment.

scholarly journals Neurological disorders associated with gluten sensitivity

2017 ◽  
Vol 89 (2) ◽  
pp. 99-102
Author(s):  
D A Degterev ◽  
I V Damulin ◽  
A I Parfenov
Keyword(s):  
Clinical Features ◽  
Neurological Disorders ◽  
Gluten Free Diet ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Gluten Ataxia

The review considers the pathogenetic, clinical, and therapeutic aspects of neurological disorders associated with gluten sensitivity. Gluten ataxia and polyneuropathy are most common. The clinical features of neurological disorders in patients with gluten sensitivity and the effects of a gluten-free diet are described.

scholarly journals Familial adult myoclonic epilepsy (FAME): clinical features, molecular characteristics, pathophysiological aspects and diagnostic work-up

2021 ◽  
Vol 33 (4) ◽  
pp. 311-318
Author(s):  
Lorenz Peters ◽  
Christel Depienne ◽  
Stephan Klebe
Keyword(s):  
Clinical Features ◽  
Neurological Disorders ◽  
Genetic Disorder ◽  
Repeat Expansion ◽  
Myoclonic Epilepsy ◽  
Molecular Characteristics ◽  
Autosomal Dominant Disorder ◽  
Repeat Expansions ◽  
Diagnostic Work ◽  
Work Up

Abstract Familial adult myoclonic epilepsy (FAME) is a rare autosomal dominant disorder characterized by myoclonus and seizures. The genetic variant underlying FAME is an intronic repeat expansion composed of two different pentamers: an expanded TTTTA, which is the motif originally present at the locus, and an insertion of TTTCA repeats, which is usually located at the 3′ end and likely corresponds to the pathogenic part of the expansion. This repeat expansion has been identified so far in six genes located on different chromosomes, which remarkably encode proteins with distinct cellular localizations and functions. Although the exact pathophysiological mechanisms remain to be clarified, it is likely that FAME repeat expansions lead to disease independently of the gene where they occur. We herein review the clinical and molecular characteristics of this singular genetic disorder, which interestingly shares clinical features with other more common neurological disorders whose etiology remains mainly unsolved.

scholarly journals Ingestion and Pharyngeal Trauma Causing Secondary Retropharyngeal Abscess in Five Adult Patients

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Sudhir B. Sharma ◽  
Paul Hong
Keyword(s):  
Emergency Medicine ◽  
Foreign Body ◽  
Clinical Features ◽  
Case Series ◽  
Adult Patients ◽  
Retropharyngeal Abscess ◽  
Emergency Medicine Physician ◽  
Medicine Physician ◽  
Local Trauma ◽  
Pertinent Information

Retropharyngeal abscess most commonly occurs in children. When present in adults the clinical features may not be typical, and associated immunosuppression or local trauma can be part of the presentation. We present a case series of five adult patients who developed foreign body ingestion trauma associated retropharyngeal abscess. The unusual pearls of each case, along with their outcomes, are discussed. Pertinent information for the emergency medicine physician regarding retropharyngeal abscess is presented as well.

NEAR FATAL AMITRAZ: A NOT SO UNCOMMON POISONING

2021 ◽  
pp. 42-43
Author(s):  
Rohan J Desai ◽  
Prasad Ugargol
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Clinical Features ◽  
Case Series ◽  
Agricultural Product ◽  
Common Symptom ◽  
Retrospective Case ◽  
Case Series Study ◽  
Cns Depression ◽  
Series Study

Background: Amitraz is a pharmaceutical, veterinary, and agricultural product which is used worldwide to control ectoparasites in animals. Its widespread use has led to increased cases of poisoning in rural parts of India. Aim: To study the clinical features, complications, laboratory abnormalities and outcome of the patients with acute amitraz intoxication. Methodology: The study is a retrospective case series study conducted in HSK hospital between the period of Feb 2019 and May 2020. Results: A total of 11 patients were analysed and results revealed CNS depression and vomiting in 8 of those patients with 1 patient with respiratory failure requiring mechanical ventilation. Conclusion: Amitraz poisoning appears to be severe with CNS depression being the most common symptom. But most patients stabilise and recover quickly. Patients should be monitored for respiratory failure as it is a dreadful complication. Treatment is symptomatic as no antidote is available.

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