scholarly journals A case report of Morvan syndrome

2021 ◽  
Vol 2021 (8) ◽  
Author(s):  
Sokrat Xhaxho ◽  
Gentian Vyshka ◽  
Eti Muharremi ◽  
Jera Kruja
Keyword(s):  
Blood Pressure ◽  
Case Report ◽  
Clinical Picture ◽  
Pressure Fluctuations ◽  
High Dose ◽  
Left Forearm ◽  
Psychomotor Agitation ◽  
Profuse Sweating ◽  
Muscle Twitching ◽  
Electrophysiological Findings

ABSTRACT Authors describe the case of a 22-year-old Caucasian male who presented acutely with psychomotor agitation, insomnia and muscle twitching with painful cramps. Autonomic symptoms were as well present, with profuse sweating, blood pressure fluctuations and tachycardia. He presented a miliary rash in his left forearm as well as in the neck. Electromyography documented myokymic movements bilaterally at both gastrocnemii and pretibial muscles. Brain imaging had no abnormalities, and anti-LGI1 and anti-CASPR2 resulted positive; this data together with electrophysiological findings suggested a Morvan syndrome. High-dose steroid therapy and plasma exchange improved substantially the clinical picture of the patient.

scholarly journals Pheochromocytoma – An Unusual Presentation – A Case Report

1970 ◽  
Vol 28 (2) ◽  
pp. 113-116
Author(s):  
Indrajit Prasad ◽  
Zafar Ahmed Latif ◽  
Faruque Pathan ◽  
SM Ashrafuzzaman ◽  
Firoz Amin
Keyword(s):  
Blood Pressure ◽  
Case Report ◽  
Blood Sample ◽  
Blood Sugar ◽  
Severe Headache ◽  
Insulin Hypoglycemia ◽  
Intravenous Glucose ◽  
Profuse Sweating ◽  
To Come ◽  
Very High

This case report is of a 50yrs old man who got admitted inBIRDEM Hospital in a state of unconsciousness for 5 hours.He is a known case of hypertension and diabetes mellitusfor the last 12 years and was on insulin. Hypoglycemia wasdetected, treated with intravenous glucose and the patientregained consciousness. On further query he complainedof repeated episodes of nausea, palpitation and sweatingfor the last 12 years. The episodes were initially labeled ashypoglycemia but blood sugar was never found inhypoglycemic range. The patient was on multipleantihypertensive medications but blood pressure wasuncontrolled. All the investigations were normal including24hrs urinary VMA, serum adrenalin and noradrenalinexcept ultrasonography of whole abdomen which showed amass measuring 72x 76 mm in left suprarenal region. Onenight the patient again developed palpitation, chestdiscomfort, severe headache and profuse sweating. Bloodpressure was recorded 240/160 mmHg. Blood sample wasdrawn for adrenalin, noradrenalin, 24hrs urine collectionwas done for VMA and was found very high. The patientwas diagnosed as having left adrenal pheochromocytoma.After controlling blood pressure and other preoperativepreparations left adrenalectomy was done. Histopathologyrevealed phaeochromocytoma. Per and postoperativeperiods were quite eventful. Blood pressure was normalwithout any antihypertensive drug during discharge. Thepatient was discharged with the advice to come for followup after 1 month.DOI: 10.3329/jbcps.v28i2.5371J Bangladesh Coll Phys Surg 2010; 28: 113-116

scholarly journals Forced Diuresis and Expedient Blood Pressure Control in the Management of Quetiapine Induced Neuroleptic Malignant Syndrome: A Case Report

2018 ◽  
Vol 6 (7) ◽  
pp. 1267-1270 ◽  
Author(s):  
Neville Aquilina ◽  
Vincent Bugeja
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Case Report ◽  
Neuroleptic Malignant Syndrome ◽  
Isotonic Saline ◽  
Lewy Body Dementia ◽  
Concomitant Administration ◽  
High Rate ◽  
High Dose ◽  
Forced Diuresis

BACKGROUND: This case report intends to highlight the importance of safeguarding renal function from rhabdomyolysis in neuroleptic malignant syndrome (NMS) by concomitant administration of parenteral fluids at a high rate together with high doses of parenteral loop diuretics (we utilised 6 mg bumetanide daily) and tailed over a few days, in order to preserve glomerular/renal medullary perfusion and nephron function.CASE REPORT: This case describes an elderly lady previously diagnosed with Lewy body dementia who had been started on low dose quetiapine a few days previously and presented with an acute 24 – 48 hour onset of fever, generalised stiffness, rapidly becoming uncommunicable and with high blood pressure. Haemoglobinuria was present prompting intravenous treatment with labetalol to address the BP, whereas rapid isotonic saline fluid infusions together with intravenous high dose bumetanide were instituted to safeguard the kidneys against damage due to nephron deposition, both from haemoglobinuria as well as possibly myoglobin from rhabdomyolysis. A working diagnosis of the neuroleptic malignant syndrome with secondary malignant hypertension was made, and the quetiapine withdrawn. Blood pressure was after that subsequently controlled on amlodipine, and the haemoglobinuria quickly settled within 24 hours, with large amounts of dilute urine being passed on account of the forced diuresis. The fact that renal function and creatinine kinase remained normal is testimony to how these expedient measures averted progression to both rhabdomyolysis and renal failure in this case, thereby ameliorating prognosis.CONCLUSION: The patient was kept on infused fluids with maintenance bumetanide alone, achieving a full clinical recovery within the following 3 days.

Case Report: Patient with POLG Mutation with the Clinical Picture of a Myocerebrohepatopathy Syndrome

2015 ◽  
Vol 46 (S 01) ◽  
Author(s):  
J. Spiegler ◽  
Y. Hellenbroich ◽  
U. Ahting ◽  
P. Freisinger
Keyword(s):  
Case Report ◽  
Clinical Picture ◽  
Polg Mutation

Pre-emptive Analgesia for Postoperative Pain Relief in Children – Role of Paracetamol

2009 ◽  
pp. 9-16
Author(s):  
Rubina Yasmin ◽  
AKM Akhtaruzzaman ◽  
Paresh Chandra Sarker ◽  
Neaz Ahmed ◽  
Ranadhir Kumar Kundu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Postoperative Pain ◽  
Diclofenac Sodium ◽  
Total Duration ◽  
Pain Scale ◽  
Prospective Clinical Study ◽  
High Dose ◽  
Induction Of Anaesthesia

This prospective clinical study was carried out in the Dept. of Anaesthesia, Analgesia and Intensive Care Medicine, BSMMU, Dhaka, during the period of May 2003 to July 2003. The study was done to emphasize the importance of giving analgesics preemptively instead of waiting for the child to complain of pain and to produce smooth recovery after surgery by decreasing immediate postoperative pain in children by a simple, safe acceptable drug. The children scheduled for tonsillectomy under general anaesthesia were recruited in this study. The analgesic efficiency of rectal paracetamol in two doses, 25 mg/kg bodywt.(Gr-P25) and 50 mg/kg. bodywt. (Gr-P50) were compared with Diclofenac Sodium suppository 1mg/ kg body weight (Gr-D) given half an hour before induction of anaesthesia. Pain scoring was done by TPPPS (Toddler Pre-schooler postoperative pain scale). Heart rate and blood pressure were stable in Gr-P50 and Gr-D. Time of first demand of analgesic was delayed in Gr-P50 and Gr-D. Total paracetamol consumption in 24 hours was less in Gr-P50(181±14.25) and Gr-D (212±25) than Gr-P25(318± 26.39). Total duration of analgesia in Gr- P50 (657±9.94) mins. and in Gr- D(502±10.63) mins. and in Gr-P25(288±23.17) mins. Pre-emptive high dose rectal paracetamol appears to be more effective than diclofenac sodium suppository for postoperative analgesia in children undergoing tonsillectomy. Journal of BSA, Vol. 18, No. 1 & 2, 2005 p.9-16

Diagnostic confusion in paediatric respiratory pathology. Case report

ORL ro ◽  
2016 ◽  
Vol 1 (1) ◽  
pp. 48-50
Author(s):  
Adina A. Zamfir-Chiru-Anton ◽  
D.C. Gheorghe
Keyword(s):  
Case Report ◽  
Foreign Body ◽  
Clinical Picture ◽  
Foreign Body Aspiration ◽  
Effective Therapy ◽  
Partial Loss ◽  
Detailed History ◽  
Therapy Approach ◽  
Diagnostic Confusion ◽  
Respiratory Pathology

The authors present the case of a 4-year-old child admitted to the ENT Department with possible pulmonary foreign body aspiration. A detailed history revealed a clinical picture that seemed to depict an absence episode (with partial loss of conscience and cianosis) occured when eating, less the symptomes of a respiratory foreign body. Diagnosis needed full respiratory endoscopy and neurologic evaluation for correct assesment and effective therapy approach.

Descending Cervical-Sacral Pain after the Administration of Antivenom to the Scorpion Sting Poisoning: A Case Report

2020 ◽  
Vol 2 (2) ◽  
pp. 93-96
Author(s):  
Josué Saúl Almaraz Lira ◽  
Alfredo Luis Chávez Haro ◽  
Cristian Alfredo López López ◽  
Remedios del Pilar González Jiménez
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Case Report ◽  
Signs And Symptoms ◽  
Cervical Region ◽  
Scorpion Sting ◽  
Case Presentation ◽  
Sacral Region ◽  
Scorpion Stings

Introduction. Scorpion stings occur mainly in spring and summer, with an estimate of 1.2 million cases per year worldwide. About 300,000 poisonings occur within a year, primarily affecting children and adults older than 65 years. In 2019, Guanajuato (Mexico) ranked third in poisoning by scorpion sting with a total of 43,913 cases. The intoxication grades are three where the signs and symptoms are varied. There are two types of antivenom in the Mexican market, and we use Alacramyn® in our case. Case presentation. A 70-year-old female —with grade 1 scorpion sting poisoning, 30 minutes of evolution, with type 2 diabetes and high blood pressure— received two vials of antivenom according to current regulations. She presented transient vagal reaction and subsequent transient pain in the cervical region that radiates to the sacral region. At discharge, there are no data compatible with scorpion sting poisoning. Conclusions. Transient pain in the cervical region to the sacral region may be secondary to an anxiety crisis, hypersensitivity to IgG, or secondary reaction to administration in less time than recommended by the provider. The benefit was greater than the reactions that occurred.

High-dose Cholecalciferol Supplementation Reducing Morning Blood Pressure in Normotensive DM1 Patients

2020 ◽  
Vol 16 ◽  
Author(s):  
Natércia Neves Marques de Queiroz ◽  
Franciane Trindade Cunha de Melo ◽  
Fabrício de Souza Resende ◽  
Luísa Corrêa Janaú ◽  
Norberto Jorge Kzan de Souza Neto ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Vitamin D ◽  
Blood Pressure Monitoring ◽  
Vitamin D Supplementation ◽  
High Dose ◽  
Before And After ◽  
Patients With Diabetes ◽  
Morning Blood Pressure ◽  
Cholecalciferol Supplementation ◽  
Lipids Profile

Background: Vitamin D (VD) deficiency has been related to several endocrine metabolic and cardiovascular diseases. Effect of VD supplementation on blood pressure (BP) in patients with diabetes is controversial. Objective: The aim of this study was to evaluate high-dose vitamin D supplementation effects on blood pressure of normotensive type 1 diabetes mellitus (T1DM) patients by 24-hour ambulatory blood pressure monitoring (ABPM). Methods: We performed a clinical trial including 35 T1DM normotensive patients, who received doses of 4,000 or 10,000 IU/day of cholecalciferol for 12 weeks according to previous VD levels. They underwent 24-hour ABPM, along with glycated hemoglobin, creatine, lipids profile and PCRus dosage before and after VD supplementation. Results and discussion: We found an expressive reduction of systolic and diastolic morning blood pressures (117±14 vs 112±14, p<0,05; 74±9 vs 70±10 mmHg, p<0,05, respectively) with no changes in other pressoric markers. Besides, we noticed a relation between levels of VD after supplementation and diastolic morning blood pressure (r= -0,4; p<0.05). Conclusion: Our study suggests an association between supplementation of high doses of vitamin D and the reduction of morning blood pressure in normotensive T1DM patients.

Methylprednisolone on circulating eicosanoids and vasomotor tone after endotoxin

1986 ◽  
Vol 61 (1) ◽  
pp. 185-191 ◽  
Author(s):  
C. A. Hales ◽  
R. D. Brandstetter ◽  
C. F. Neely ◽  
M. B. Peterson ◽  
D. Kong ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Vascular Resistance ◽  
Systemic Blood Pressure ◽  
Physiological Effect ◽  
High Dose ◽  
Systemic Blood ◽  
Eicosanoid Production ◽  
Circulating Levels

Acute pulmonary and systemic vasomotor changes induced by endotoxin in dogs have been related, at least in part, to the production of eicosanoids such as the vasoconstrictor thromboxane and the vasodilator prostacyclin. Steroids in high doses, in vitro, inhibit activation of phospholipase A2 and prevent fatty acid release from cell membranes to enter the arachidonic acid cascade. We, therefore, administered methylprednisolone (40 mg/kg) to dogs to see if eicosanoid production and the ensuing vasomotor changes could be prevented after administration of 150 micrograms/kg of endotoxin. The stable metabolites of thromboxane B2 (TxB2) and 6-ketoprostaglandin F1 alpha (6-keto-PGF1 alpha) were measured by radioimmunoassay. Methylprednisolone by itself did not alter circulating eicosanoids but when given 2.5 h before endotoxin not only failed to inhibit endotoxin-induced eicosanoid production but actually resulted in higher circulating levels of 6-keto-PGF1 alpha (P less than 0.05) compared with animals receiving endotoxin alone. Indomethacin prevented the steroid-enhanced concentrations of 6-keto-PGF1 alpha after endotoxin and prevented the greater fall (P less than 0.05) in systemic blood pressure and systemic vascular resistance with steroid plus endotoxin than occurred with endotoxin alone. Administration of methylprednisolone immediately before endotoxin resulted in enhanced levels (P less than 0.05) of both TxB2 and 6-keto-PGF1 alpha but with a fall in systemic blood pressure and vascular resistance similar to the animals pretreated by 2.5 h. In contrast to the early steroid group in which all of the hypotensive effect was due to eicosanoids, in the latter group steroids had an additional nonspecific effect. Thus, in vivo, high-dose steroids did not prevent endotoxin-induced increases in eicosanoids but actually increased circulating levels of TxB2 and 6-keto-PGF1 alpha with a physiological effect favoring vasodilation.

scholarly journals Asymptomatic mediastinal extra-adrenal paraganglioma as a cause of sudden death: a case Report

2019 ◽  
Vol 14 (1) ◽  
pp. 564-567
Author(s):  
Qiancheng Xu ◽  
Yingya Cao ◽  
Hongzhen Yin ◽  
Rongrong Wu ◽  
Tao Yu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Case Report ◽  
Respiratory Failure ◽  
Pressure Drop ◽  
Thoracic Cavity ◽  
Severe Hypotension ◽  
Life Threatening ◽  
History Of ◽  
Posterior Mediastinal ◽  
Extra Adrenal Paraganglioma

AbstractA 23-year-old female patient was referred for treatment of a posterior mediastinal tumour. There was no history of hypertension or headache and no other complaints. The patient’s blood pressure increased to 210/125 mmHg after surgically manipulating the tumour, subsequently reversing to severe hypotension (25/15 mmHg) immediately after the tumour was removed. The life-threatening and irreversible blood pressure drop was difficult to treat with fluid and vasopressors, and the patient ultimately died of cardio-respiratory failure. Asymptomatic paraganglioma can be non-functional but can also be fatal. For any lump in the thoracic cavity, paraganglioma should be ruled out.

Sign in / Sign up

Export Citation Format

Share Document