Acute Disseminated Encephalomyelitis in a 2-Year-Old Patient Following COVID-19

2021 ◽  
Author(s):  
Amy Robinson ◽  
Louise Chapman ◽  
Wendy Watts
Keyword(s):  
Oral Prednisolone ◽  
Acute Disseminated Encephalomyelitis ◽  
Neurological Complications ◽  
High Signal ◽  
Resonance Imaging ◽  
Intermittent Fever ◽  
Intravenous Methylprednisolone ◽  
Ataxic Gait ◽  
Truncal Ataxia ◽  
The Brain

AbstractThis report presents the case of acute disseminated encephalomyelitis in a 2-year-old patient following a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test. She presented with ataxic gait, truncal ataxia, and reduced coordination following 10 days of intermittent fever and lethargy. She did not have any respiratory symptoms. Magnetic resonance imaging of the brain and spine showed widespread T2 high signal within the gray and white matters and within the spinal cord. She was treated with intravenous methylprednisolone followed by tapering oral prednisolone; this led to resolution of her neurological symptoms. This case highlights that neurological complications can occur secondary to SARS-CoV-2 infection.

scholarly journals Characteristic Brain Imaging Findings in a Patient with Joubert Syndrome and Segmental Glomerulosclerosis

2015 ◽  
Vol 22 (2) ◽  
pp. 53-57
Author(s):  
Ahmed H. Abduljabbar
Keyword(s):  
Brain Imaging ◽  
Autosomal Recessive ◽  
Joubert Syndrome ◽  
Recessive Trait ◽  
Autosomal Recessive Trait ◽  
Resonance Imaging ◽  
Truncal Ataxia ◽  
Bat Wing ◽  
The Brain ◽  
4Th Ventricle

Joubert syndrome is a rare disorder inherited as an autosomal recessive trait. It has distinctive clinical features and specific brain imaging fi ndings on magnetic resonance imaging. Patients present clinically with hyperpnea, apnea, ocular abnormalities, developmental delay and truncal ataxia. In this case report, we illustrate a patient with Joubert syndrome and chronic renal failure. Magmetic resonance imaging examination revealed the characteristic "molar tooth" appearance of the brain stem, "bat-wing" shaped 4th ventricle, cleft vermis and deep interpeduncular fossa consistent with the diagnosis.  

Severe acute disseminated encephalomyelitis complicating measles infection

2020 ◽  
Vol 13 (11) ◽  
pp. e237346
Author(s):  
Hamish Duncan Morrison ◽  
Clemency Clarke ◽  
Richard James ◽  
Nicola Giffin
Keyword(s):  
Measles Virus ◽  
Herd Immunity ◽  
Active Role ◽  
Acute Disseminated Encephalomyelitis ◽  
Neurological Complications ◽  
The Public ◽  
Fluid Analysis ◽  
Progressive Encephalopathy ◽  
Brain And Spinal Cord ◽  
The Brain

A 36-year-old man presented with an acute progressive encephalopathy, followed by tetraparesis and was diagnosed with acute disseminated encephalomyelitis (ADEM) complicating infection with measles virus. Despite demonstrating a typical rash and other early symptoms of measles infection, there was uncertainty around the initial diagnosis. Cerebrospinal fluid analysis and MRI of the brain and spinal cord were consistent with severe ADEM. He required treatment on intensive care but responded favourably to immunosuppressive therapy.This case highlights the importance of recognising acute measles infection, familiarity with the neurological complications and the potential for good outcome. Healthcare professionals must continue to play an active role in educating the public on the importance of maintaining herd immunity through universal immunisation.

scholarly journals A Case of Nivolumab-Induced Severe Mononeuropathy Multiplex and Rhabdomyolysis

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Katsuya Sakai ◽  
Hitoshi Mochizuki ◽  
Kosuke Mochida ◽  
Kazutaka Shiomi ◽  
Masahiro Amano ◽  
...  
Keyword(s):  
Nerve Conduction Study ◽  
Nerve Conduction ◽  
Immune Checkpoint Inhibitor ◽  
Checkpoint Inhibitor ◽  
Oral Prednisolone ◽  
Resonance Imaging ◽  
Intravenous Methylprednisolone ◽  
Limb Weakness ◽  
Muscle Impairment ◽  
Multiple Liver Metastases

We report an 81-year-old man with multiple liver metastases after tumorectomy for primary mediastinal malignant melanoma, who experienced limb weakness and sensory disturbance after nivolumab monotherapy. He was diagnosed with nivolumab-induced mononeuropathy multiplex and rhabdomyolysis based on serologic examination, muscle biopsy, magnetic resonance imaging of the limbs, and a nerve conduction study. A course of intravenous methylprednisolone (mPSL) was initiated at 1 g/day for 3 days. After that, oral prednisolone (PSL) was started at 1 mg/kg/day and gradually tapered. Limb muscle strength improved, but when PSL was reduced to 0.3 mg/kg/day, the weakness recurred, and a nerve conduction study showed exacerbation of mononeuropathy multiplex. The patient was again administered intravenous mPSL (0.5 g/day for 3 days) followed by oral PSL at 0.5 mg/kg/day, and his neurological symptoms improved. Nivolumab, an immune checkpoint inhibitor, is used for the treatment of advanced melanoma and other cancers and causes various immune-related adverse events (irAEs). However, neurological irAEs related to nivolumab are rare. Furthermore, there are no reports of simultaneous nerve and muscle impairment. Unexpected irAEs affecting various organs should be recognized and treated appropriately.

scholarly journals Imaging Techniques for Diagnosis of Thoracic Aortic Atherosclerosis

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Wouter W. Jansen Klomp ◽  
George J. Brandon Bravo Bruinsma ◽  
Arnoud W. van ’t Hof ◽  
Jan. G. Grandjean ◽  
Arno P. Nierich
Keyword(s):  
Magnetic Resonance Imaging ◽  
Imaging Techniques ◽  
Neurological Complications ◽  
Ascending Aorta ◽  
Aortic Atherosclerosis ◽  
Resonance Imaging ◽  
Advantages And Disadvantages ◽  
Manual Palpation ◽  
Valve Implantation ◽  
The Brain

The most severe complications after cardiac surgery are neurological complications including stroke which is often caused by emboli merging from atherosclerosis in the ascending aorta to the brain. Information about the thoracic aorta is crucial in reducing the embolization risk for both surgical open and closed chest procedures such as transaortic heart valve implantation. Several techniques are available to screen the ascending aorta, for example, transesophageal echocardiography (TEE), epiaortic ultrasound, TEE A-view method, manual palpation, computed tomography, and magnetic resonance imaging. This paper provides a description of the advantages and disadvantages of these imaging techniques.

scholarly journals Spontaneous Subarachnoid Haemorrhage in a Case with Covid-19 Infection - Effect or Association? A Case Report

2021 ◽  
Vol 10 (41) ◽  
pp. 3607-3609
Author(s):  
Sourya Acharya ◽  
Samarth Shukla ◽  
Pankaj Banode ◽  
Shefali Sharma ◽  
Abhijeet Wadekar
Keyword(s):  
Subarachnoid Haemorrhage ◽  
Severe Pneumonia ◽  
Haemorrhagic Stroke ◽  
Airway Disease ◽  
Acute Disseminated Encephalomyelitis ◽  
Neurological Complications ◽  
Multiple Organ ◽  
Chronic Obstructive ◽  
Acute Necrotizing Encephalopathy ◽  
The Brain

Covid-19 is a disease caused by the SARS-CoV-2 virus that usually causes mild flu-like illness in majority of the cases, but it can cause severe pneumonia and multiple organ dysfunction even death especially in elderly patients who also have comorbidities like hypertension, diabetes, chronic obstructive airway disease (COAD), asthma, and cardiac disease. The central and peripheral nervous systems are not spared, and neurological complications are frequently reported in severely ill patients who have comorbidities. The SARS-CoV-2 virus has the potential to invade the brain and it enters the brain via a haematogenous route or olfactory system through angiotensinconverting enzyme -2 receptors, present on endothelial cells of cerebral vessels. The most neurological manifestations, seen in Covid-19 infection are altered sensorium (agitation, delirium, and coma), ischemic or haemorrhagic stroke, acute disseminated encephalomyelitis or acute necrotizing encephalopathy, headaches, Guillain-Barré syndrome. Here is a case of a 70-year-old hypertensive female who presented to us with complaints of fever, headache and vomiting of 3 days duration and after investigations, a diagnosis of Covid -19 with hypertension and subarachnoid haemorrhage was made.

scholarly journals Posterior quadrantic dysplasia with localized hemimegalencephaly in a patient with giant congenital melanocytic nevus: First case report

2019 ◽  
Vol 32 (3) ◽  
pp. 210-214 ◽  
Author(s):  
Ishan Kumar ◽  
Priyanka Aggarwal ◽  
Tulika Rai ◽  
Vineeta Gupta
Keyword(s):  
Neurological Complications ◽  
Melanocytic Nevus ◽  
Congenital Melanocytic Nevus ◽  
Resonance Imaging ◽  
First Case ◽  
Malformation Of Cortical Development ◽  
Cell Migration And Proliferation ◽  
The Brain ◽  
Neurocutaneous Melanocytosis ◽  
Giant Congenital Melanocytic Nevus

Giant congenital melanocytic nevus (GCMN) is associated with neurocutaneous melanocytosis and various other neurological complications. Its association with migrational anomalies of the brain is extremely rare. Herein, we document the first case of GCMN in a one-day-old baby associated with localized hemimegalencephaly (HME) of the brain with extensive malformation of cortical development including polymicrogyria, pachygyria and sublobar dysplasia, limited to an enlarged quadrant of the brain. HME and GCMN are considered embryological anomalies of cell migration and proliferation. We discuss the unusual magnetic resonance imaging findings along with a brief review of the literature. To the best of our knowledge, our case is the first to report the association of GCMN with localized HME.

Сauses of Dizziness in Patients with Suspected Stroke

2018 ◽  
Vol 7 (3) ◽  
pp. 217-221
Author(s):  
E. V. Shevchenko ◽  
G. R. Ramazanov ◽  
S. S. Petrikov
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Demyelinating Disease ◽  
Heart Rhythm ◽  
Diagnostic Methods ◽  
Deficiency Anemia ◽  
Resonance Imaging ◽  
Peripheral Vestibulopathy ◽  
Suspected Stroke ◽  
The Brain

Background Acute dizziness may be the only symptom of stroke. Prevalence of this disease among patients with isolated dizziness differs significantly and depends on study design, inclusion criteria and diagnostic methods. In available investigations, we did not find any prospective studies where magnetic resonance imaging, positional maneuvers, and Halmagyi-Curthoys test had been used to clarify a pattern of diseases with isolated acute dizziness and suspected stroke.Aim of study To clarify the pattern of the causes of dizziness in patients with suspected acute stroke.Material and methods We examined 160 patients admitted to N.V. Sklifosovsky Research Institute for Emergency Medicine with suspected stroke and single or underlying complaint of dizziness. All patients were examined with assessment of neurological status, Dix-Hollpike and Pagnini-McClure maneuvers, HalmagyiCurthoys test, triplex scans of brachiocephalic arteries, transthoracic echocardiography, computed tomography (CT) and magnetic resonance imaging (MRI) of the brain with magnetic field strength 1.5 T. MRI of the brain was performed in patients without evidence of stroke by CT and in patients with stroke of undetermined etiology according to the TOAST classification.Results In 16 patients (10%), the cause of dizziness was a disease of the brain: ischemic stroke (n=14 (88%)), hemorrhage (n=1 (6%)), transient ischemic attack (TIA) of posterior circulation (n=1 (6%)). In 70.6% patients (n=113), the dizziness was associated with peripheral vestibulopathy: benign paroxysmal positional vertigo (n=85 (75%)), vestibular neuritis (n=19 (17%)), Meniere’s disease (n=7 (6%)), labyrinthitis (n=2 (1,3%)). In 6.9% patients (n=11), the cause of dizziness was hypertensive encephalopathy, 1.9% of patients (n=3) had heart rhythm disturbance, 9.4% of patients (n=15) had psychogenic dizziness, 0.6% of patients (n=1) had demyelinating disease, and 0.6% of patients (n=1) had hemic hypoxia associated with iron deficiency anemia.Conclusion In 70.6% patients with acute dizziness, admitted to hospital with a suspected stroke, peripheral vestibulopathy was revealed. Only 10% of patients had a stroke as a cause of dizziness.

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