A Case of Syncope and Impaired Micturition

2018 ◽  
pp. 195-200
Author(s):  
Aaron E. Miller ◽  
Tracy M. DeAngelis ◽  
Michelle Fabian ◽  
Ilana Katz Sand

Panautonomic failure is manifested by a variety of symptoms indicating dysfunction of the sympathetic, parasympathetic, and enteric autonomic systems. An acute onset of this syndrome, in the absence of other systemic illness or neurological symptoms and signs, indicates autoimmune autonomic ganglionopathy (AAG), in which symptoms are causally related to the presence of antibodies to ganglionic nicotinic acetyl choline receptors. Differential diagnosis consists principally of toxic/metabolic disorders and other autoimmune illnesses, most notably Sjögren’s syndrome. Antibodies to ganglionic nicotinic acetyl choline receptors are present in 50–60% of cases, and, unlike in some other antibody-mediated disorders, symptom severity is related to the antibody level. Paroxysmal coughing spells are a feature of the illness in Japanese, but not Western, patients. Corticosteroids are generally ineffective when used alone, but may provide better response when used in combination with IVIg or plasma exchange. Other immunosuppressive medications are often required.

2021 ◽  
pp. 1-5
Author(s):  
Max A. Little

Parkinson’s disease is a complex and heterogeneous condition, and there are many gaps in the medical community’s scientific and practical understanding of the disease. Closing these gaps relies on objective data about symptoms and signs, collected over long durations. Smartphones contain sensor devices which can be used to remotely capture behavioral signals. From these signals, computational algorithms can distill metrics of symptom severity and progression. This brief review introduces the main concepts of the discipline, addressing the experimental, hardware and software logistics, and computational analysis. The article finishes with an exploration of future prospects for the technology.


2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Demetrio Larraín ◽  
Andrés Casanova ◽  
Iván Rojas

Ovarian torsion after hysterectomy is a rare event. The diagnosis of ovarian torsion is challenging because symptoms are nonspecific. We present a case of ovarian torsion 2 years after laparoscopic hysterectomy (LH). Furthermore, we performed a literature review about ovarian torsion after hysterectomy. This case shows that, in cases of acute onset pelvic pain in patients with history of hysterectomy, the adnexal torsion must be kept in mind in the differential diagnosis, especially in those women who had undergone LH.


2021 ◽  
Vol 11 (3) ◽  
pp. 301
Author(s):  
Fatima Ghandour ◽  
Alessio Squassina ◽  
Racha Karaky ◽  
Mona Diab-Assaf ◽  
Paola Fadda ◽  
...  

Brain tumors can present with various psychiatric symptoms, with or without neurological symptoms, an aspect that complicates the clinical picture. However, no systematic description of symptoms that should prompt a neurological investigation has been provided. This review aims to summarize available case reports describing patients with brain tumors showing psychiatric symptoms before brain tumor diagnosis, in order to provide a comprehensive description of these symptoms as well as their potential relationship with delay in the diagnosis. A systematic literature review on case reports of brain tumors and psychiatric symptoms from 1970 to 2020 was conducted on PubMed, Ovid, Psych Info, and MEDLINE. Exclusion criteria comprised tumors not included in the World Health Organization (WHO) Classification 4th edition and cases in which psychiatric symptoms were absent or followed the diagnosis. A total of 165 case reports were analyzed. In a subset of patients with brain tumors, psychiatric symptoms can be the only manifestation or precede focal neurological signs by months or even years. The appearance of focal or generalized neurological symptoms after, rather than along with, psychiatric symptoms was associated with a significant delay in the diagnosis in adults. A timely assessment of psychiatric symptoms might help to improve early diagnosis of brain tumors.


2021 ◽  
pp. 10.1212/CPJ.0000000000001090
Author(s):  
sara zarei ◽  
Phuong Vo ◽  
Christian Sam ◽  
Robert W Crow ◽  
Charles Stout ◽  
...  

ABSTRACTPurposeof review: Acute bilateral blindness has an extensive differential diagnosis that requires a careful history and physical exam to narrow down. In this paper we discuss the pathophysiology and radiographic findings of each possible diagnosis for acute bilateral blindness.Recent findings:Visual pathology with respect to bilateral blindness can be broadly broken down into three anatomic categories: media (i.e. the anterior and posterior chamber of the eye), retina, and neural visual pathway. Possible causes of rapid onset bilateral blindness include bilateral occipital infarcts, endogenous bacterial endophthalmitis, orbital cellulitis, orbital compartment syndrome, cavernous sinus thrombophlebitis, thyroid disease and bilateral non-arteritic ischemic optic neuropathy.Summary:In this case we present a patient with acute onset of bilateral blindness, in addition to bilateral ophthalmoplegia, proptosis, and orbital chemosis. We believe this rare case of acute bilateral blindness is thought provoking and aids in the understanding of the differential diagnosis and underlying pathophysiology of visual loss.


2018 ◽  
Vol 52 (8) ◽  
pp. 653-657 ◽  
Author(s):  
Maria Passhak ◽  
Yaaqov Amsalem ◽  
Eugene Vlodavsky ◽  
Inna Varaganov ◽  
Gil Bar-Sela

The current case presents a patient with a tumor emboli stroke as a presenting symptom of a liposarcoma metastasis to the heart that was treated successfully with endovascular mechanical retrieval, followed by subsequent cardiac surgery. The patient is still alive, under chemotherapy treatment, 3 years following the interventions. This scenario should be considered as a part of the differential diagnosis of oncology patients presenting with new central neurological symptoms. This active approach can be an effective treatment if the patient is fit and there is no evidence of widespread disease.


2018 ◽  
Vol 57 (14) ◽  
pp. 2057-2060 ◽  
Author(s):  
Tatsuya Ueno ◽  
Ryoya Kimura ◽  
Tomoya Kon ◽  
Rie Haga ◽  
Haruo Nishijima ◽  
...  

2008 ◽  
Vol 12 (1) ◽  
pp. 38-42 ◽  
Author(s):  
Susan M. Poelman ◽  
Khue Nguyen

Background: Pancreatic panniculitis is a rare entity, occurring in less than 2% of patients with pancreatic disorders. Skin manifestations may precede the diagnosis of a pancreatic disease by many months. When treatable, correction of the underlying pancreatic disorder may lead to prompt resolution of the panniculitis. Objective: We present the case of a 74-year-old-man with a history of chronic pancreatitis who presented with an acute onset of tender, nonulcerating nodules. The clinical and histologic features of pancreatic panniculitis are discussed, with a brief review of the differential diagnosis and clinical approach to panniculitis. Conclusions: Pancreatic panniculitis is a recognizable clinical entity with characteristic histologic features that may resolve with treatment of the underlying pancreatic disorder. The algorithm-based clinical approach to panniculitis presented in this study is a practical tool designed to guide clinicians in ordering investigations and determining the appropriate management for patients presenting with subcutaneous nodules.


2020 ◽  
Author(s):  
Safir Soukaina

Background: Acute myocarditis and acute myocardial infarction have frequently similar clinical presentations and poses an important clinical challenge in the differential diagnosis. In both cases, the electrocardiographic ST-T changes and an increase in troponins can be noted. Differential diagnosis may be very challenging and requires invasive assessment of coronary arteries and other investigations especially cardiac magnetic resonance. Case Presentation: In this report, we report a rare case of acute myocarditis misdiagnosed to an acute myocardial infarction in a patient presented to the emergency department for an acute onset of chest pain with ST-segment elevation on electrocardiogram for which he received urgent fibrinolysis. The confirmation of acute myocarditis was confirmed posteriori after a normal coronary angiogram using cardiac Magnetic Resonance Imaging cMRI. Conclusions: Clinical signs as long with Electrocardiogram may mimick a ST elevation myocardial infarction in the presence of an authentic acute myocarditis,Hence, cardiac magnetic resonance could present an intersting tools to make the difference even in acute phase.


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