Transient altered mental status and leptomeningeal enhancement associated with pembrolizumab: a case report

2021 ◽  
Author(s):  
Keng Lam ◽  
Sameer K. Kulkarni ◽  
Manya Khrlobyan ◽  
Pamela K. Cheng ◽  
Caroline L. Fong
Keyword(s):  
Case Report ◽  
Mental Status ◽  
Altered Mental Status ◽  
Leptomeningeal Enhancement

scholarly journals Altered mental status with mirror giant middle cerebral artery aneurysms: A case report

2021 ◽  
pp. 101154
Author(s):  
Kamil W. Nowicki ◽  
Jasmine L. Hect ◽  
Nallamai Muthiah ◽  
Arka N. Mallela ◽  
Benjamin M. Zussman
Keyword(s):  
Case Report ◽  
Middle Cerebral Artery ◽  
Mental Status ◽  
Cerebral Artery ◽  
Altered Mental Status ◽  
Middle Cerebral Artery Aneurysms

scholarly journals Intravascular large B-cell lymphoma presenting with altered mental status: A case report

2019 ◽  
Vol 10 (12) ◽  
pp. 402-408
Author(s):  
Christopher Robert D’Angelo ◽  
Kimberly Ku ◽  
Jessica Gulliver ◽  
Julie Chang
Keyword(s):  
Case Report ◽  
B Cell ◽  
Mental Status ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Altered Mental Status ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Posterior Reversible Encephalopathy Syndrome (PRES) in Palliative Medicine: Case Report and Discussion

2021 ◽  
pp. 104990912110304
Author(s):  
Jade Willey ◽  
Steven J. Baumrucker
Keyword(s):  
Case Report ◽  
Mental Status ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Palliative Medicine ◽  
Altered Mental Status ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy ◽  
Visual Disturbances

Posterior reversible encephalopathy syndrome (PRES) is associated with seizures, visual disturbances, headache, and altered mental status. Given its presentation, the diagnosis can be mistaken for other severe conditions. Palliative medicine consultants should be aware of PRES and be prepared to counsel families on the treatment and prognosis of this syndrome.

scholarly journals A SINGLE CASE REPORT ON HYPERAMMONEMIA INDUCED BY VALPROATE MONOTHERAPY WITHOUT HEPATIC DYSFUNCTION

2017 ◽  
Vol 9 (4) ◽  
pp. 218 ◽  
Author(s):  
C. Prarthana Saraswathi ◽  
J. Anu Rita ◽  
S. Nambi
Keyword(s):  
Case Report ◽  
Mental Status ◽  
Hepatic Dysfunction ◽  
Single Case ◽  
Bipolar Affective Disorder ◽  
Mood Stabilizer ◽  
Altered Mental Status ◽  
Plasma Ammonia ◽  
Manic Symptoms ◽  
Single Case Report

Valproate is a commonly used mood stabilizer. One of the important and rare side effects of valproate is hyperammonemia leading to delirium and hepatic encephalopathy. Valproate-induced delirium is commonly mistaken for worsening of manic symptoms or psychosis. We hereby report a case of bipolar affective disorder who was on a therapeutic dose of valproate monotherapy developed altered mental status where we found elevated levels of plasma ammonia which decreased after the discontinuation of valproate and with normal levels of serum valproate, LFT’s, EEG and imagings. This case report emphasises on the need to consider plasma ammonia levels in patients with altered mental status receiving valproate in addition to other investigations.

scholarly journals Confusional State in HaNDL Syndrome: Case Report and Literature Review

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Sarah Nelson
Keyword(s):  
Cerebrospinal Fluid ◽  
Case Report ◽  
Literature Review ◽  
Mental Status ◽  
Clinical Manifestation ◽  
English Language ◽  
Altered Mental Status ◽  
Confusional State ◽  
Limited Condition ◽  
Confusional States

The syndrome of transient headache and neurologic deficits with cerebrospinal fluid lymphocytosis (HaNDL syndrome) is a self-limited condition. Confusional states are uncommonly reported as a clinical manifestation of this syndrome. Here, I report a 76-year-old female who presented with headache, confusion, and agitation with a mild CSF lymphocytosis. Other workup to determine the cause of her altered mental status was otherwise negative. The literature available in the English language on HaNDL syndrome is reviewed, including its history, pathophysiology, possible associations with migraine and stroke, and previously reported cases of confusional states in this syndrome. While HaNDL syndrome has been a described entity since the 1980s, its pathophysiology has yet to be clearly defined.

scholarly journals 714. Invasive Fungal Infection Caused by Curvularia Species in a Patient with Intranasal Drug Use: A Case Report

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S456-S457
Author(s):  
Bakri Kulla ◽  
Jason Pham ◽  
McKenna Johnson
Keyword(s):  
Case Report ◽  
Head And Neck ◽  
Mental Status ◽  
Sphenoid Sinus ◽  
Altered Mental Status ◽  
The United States ◽  
Fungal Sinusitis ◽  
Invasive Fungal Sinusitis ◽  
History Of ◽  
Curvularia Species

Abstract Background Invasive fungal infections (IFIs) are uncommon infections that account for approximately 27.2/100,000 cases per year in the United States. One form of IFI is chronic invasive fungal sinusitis (CIFS). If untreated, invasion into neighboring structures may cause altered mental status, seizures, strokes, proptosis, and intracranial complications. Case Report An afebrile 43-year-old female with a history of polysubstance abuse presented to the ED due to altered mental status, left sided facial droop, right sided hemiparesis, and slurred speech. The patient was somnolent but arousable to stimuli and appeared acutely ill. The patient’s mother reported a history of cocaine abuse, which was confirmed on urine toxicology. A CT head and neck with contrast revealed subacute basal ganglia lacunar infarcts and a left sphenoid opacity with scattered hyperintensities and erosive changes [Figure 2]. One month prior, she had been diagnosed with a left superior pole kidney mass and a left-sided enlarged periaortic lymph node containing multiple noncaseating granulomas and GMS stains positive for fungal hyphae [Figure 1]. The patient underwent nasal endoscopy with tissue biopsy. Tissue showed necrotizing invasive fungal sinusitis with granuloma formation and foreign-body giant cell reaction. Fungal speciation of the tissue culture showed Curvularia species was placed on IV voriconazole. While the infection stabilized, her neurologic deficits did not significantly improve. She was discharged to inpatient rehabilitation. Figure 1. Coronal and axial view of left upper pole kidney mass with perinephric fat stranding. Figure 2. MRI brain CTA Head and Neck with contrast in axial plane showing multifocal infarcts likely represent complications of fungal basilar meningitis secondary to the left sphenoid sinus disease. Imaging also shows irregular erosive change at the anterior aspect of the sella turcica, through the planum sphenoidale, and bony defect of the sphenoid sinus. Methods Results Conclusion Intranasal use of cocaine causes vasoconstriction to elicit sinonasal tissue ischemia. With extended use, chronic mucosal inflammation can occur that can result in sinonasal osteocartilaginous necrosis and potential for infection. CIFS is infrequently diagnosed and its indolent nature with progression over weeks or months can make diagnosis and treatment difficult. The most frequent fungal species identified are the Aspergillus species, but Curvularia species have been found as well. CT and MRI scanning can be suggestive, but are not sufficiently specific or sensitive. The main forms of interventional modalities include surgical debridement and antifungal therapy to maximize survival Disclosures All Authors: No reported disclosures

scholarly journals Altered mental status and low anion gap in a patient with sickle cell anemia: a case report

2012 ◽  
Vol 6 (1) ◽  
Author(s):  
Siddharth A Wartak ◽  
Reshma A Mehendale ◽  
Benjamin Freda ◽  
Ashish Verma ◽  
David N Rose
Keyword(s):  
Case Report ◽  
Sickle Cell ◽  
Mental Status ◽  
Sickle Cell Anemia ◽  
Altered Mental Status ◽  
Anion Gap

A SUDDEN AND TEMPORARY EPISODE OF ALTERED MENTAL STATUS: A CASE REPORT

2005 ◽  
Vol 53 (2) ◽  
pp. 350-351
Author(s):  
Benedetta Boari ◽  
Massimo Gallerani ◽  
Roberto Manfredini
Keyword(s):  
Case Report ◽  
Mental Status ◽  
Altered Mental Status
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