scholarly journals Steroid-Responsive Encephalopathy Associated with Autoimmune Thyroiditis Presenting as Confusion, Dysphasia, and Myoclonus

2012 ◽  
Vol 2012 ◽  
pp. 1-2 ◽  
Author(s):  
S. A. Ryan ◽  
C. Kennedy ◽  
H. J. Harrington
Keyword(s):  
Clinical Features ◽  
Autoimmune Thyroiditis ◽  
Complete Response ◽  
Altered Level ◽  
Hashimoto’S Encephalopathy ◽  
The Core ◽  
Immune Mediated ◽  
Level Of Consciousness ◽  
Laboratory Results ◽  
Core Features

Steroid response encephalopathy associated with autoimmune thyroiditis (SREAT), or Hashimoto’s encephalopathy, is a rare disorder believed to be immune-mediated. It is most often characterized by a subacute onset of confusion with altered level of consciousness, seizures, and myoclonus. We describe the case of a 48-year-old gentleman who presented with confusion and dysphasia. Specific clinical features and laboratory results led to a diagnosis of Hashimoto’s encephalopathy. This case highlights the core features of this condition and the potential for complete response to steroid therapy.

scholarly journals Hashimoto's Encephalopathy Masquerading as Rapidly Progressive Dementia and Extrapyramidal Failure

2022 ◽  
Author(s):  
Yasser Aladdin ◽  
Bader Shirah
Keyword(s):  
Autoimmune Thyroiditis ◽  
Delayed Diagnosis ◽  
Thyroid Antibodies ◽  
Cerebral Damage ◽  
Serological Testing ◽  
Progressive Dementia ◽  
Rare Presentation ◽  
Hashimoto’S Encephalopathy ◽  
Immune Mediated ◽  
Underlying Pathogenesis

AbstractHashimoto's encephalopathy is a rare immune-mediated disorder characterized by subacute encephalopathy with elevated thyroid antibodies. Hashimoto's encephalopathy is also known as steroid-responsive encephalopathy associated with autoimmune thyroiditis. We report a rare presentation of Hashimoto's encephalopathy presenting with acute neuropsychiatric disturbances, rapidly progressive dementia, seizures, and extrapyramidal failure. Neuroimaging revealed multifocal vasculitides of major cerebral vessels that support the autoimmune vasculitic theory as the underlying pathogenesis for Hashimoto's encephalopathy. Unfortunately, permanent irreversible cerebral damage has already ensued before her presentation to our center, which rendered steroid therapy ineffective. Serological testing for Hashimoto's thyroiditis must be in the investigation of all rapidly progressive dementias as early diagnosis and timely management of autoimmune thyroiditis may salvage sizable and eloquent cerebral tissues. The rarity of the condition should not preclude the investigation of Hashimoto's disease even in the presence of normal levels of thyroid hormones. Delayed diagnosis may result in irreversibly catastrophic encephalopathy in patients who once presented with potentially curable dementia.

scholarly journals Hashimoto’s Encephalopathy: A Remediable Cause of Unexplained Encephalopathy

2021 ◽  
Vol 8 (1) ◽  
pp. 1-4
Author(s):  
Shafaq Saleem ◽  
Keyword(s):  
Immune Response ◽  
High Dose ◽  
Altered Level ◽  
Hashimoto’S Encephalopathy ◽  
Level Of Consciousness

Hashimoto’s encephalopathy is non-vasculitic autoimmune steroid responsive encephalopathy. It is an uncommon syndrome characterized by altered level of consciousness, confusion, seizures and myoclonus. Exact pathogenesis is yet to be determined though humoral hyper-immune response is favored mechanism rather than dysthyroidism. We present a case of Hashimoto’s encephalopathy in an eighty years old lady who presented with unexplained drowsiness. Extensive workup for the cause of drowsiness was carried outto find structural, metabolic, autoimmune or para-neoplastic etiology only to reveal high titers of anti-TPO antibodies. Patient responded remarkably to high dose steroids.

Reconsidering NMIHBA Core Features: Macrocephaly Is Not a So Unusual Sign in PRUNE1-Related Encephalopathy

2020 ◽  
Author(s):  
Roberta Battini ◽  
Enrico Bertini ◽  
Roberta Milone ◽  
Chiara Aiello ◽  
Rosa Pasquariello ◽  
...  
Keyword(s):  
Nervous System ◽  
Differential Diagnosis ◽  
Clinical Features ◽  
Neurodevelopmental Disorder ◽  
Recurrent Mutation ◽  
Clinical Suspicion ◽  
Alexander Disease ◽  
Brain Anomalies ◽  
Progressive Encephalopathy ◽  
Core Features

Abstract PRUNE1-related disorders manifest as severe neurodevelopmental conditions associated with neurodegeneration, implying a differential diagnosis at birth with static encephalopathies, and later with those manifesting progressive brain damage with the involvement of both the central and the peripheral nervous system.Here we report on another patient with PRUNE1 (p.Asp106Asn) recurrent mutation, whose leukodystrophy, inferior olives hyperintensity, and macrocephaly led to the misleading clinical suspicion of Alexander disease. Clinical features, together with other recent descriptions, suggest avoiding the term “microcephaly” in defining this disorder that could be renamed “neurodevelopmental disorder with progressive encephalopathy, hypotonia, and variable brain anomalies” (NPEHBA).

Reduced Jumping to Conclusion Bias after Experimentally Induced Enhancement of Subjective Body Boundaries in Psychosis

2021 ◽  
Vol 54 (2) ◽  
pp. 92-97
Author(s):  
Naomi Lyons ◽  
Detlef E. Dietrich ◽  
Johannes Graser ◽  
Georg Juckel ◽  
Christian Koßmann ◽  
...  
Keyword(s):  
Sense Of Self ◽  
Psychotic Symptoms ◽  
Control Group ◽  
Implicit Measure ◽  
Relevant Factor ◽  
The Core ◽  
Significant Difference ◽  
Explicit Measure ◽  
Experimental Group ◽  
Core Features

<b><i>Introduction:</i></b> A disturbed sense of self is frequently discussed as an etiological factor for delusion symptoms in psychosis. Phenomenological approaches to psychopathology posit that lacking the sense that the self is localized within one’s bodily boundaries (disembodiment) is one of the core features of the disturbed self in psychosis. The present study examines this idea by experimentally manipulating the sense of bodily boundaries. <b><i>Methods:</i></b> Seventy-three patients with psychosis were randomly assigned to either a 10-min, guided self-massage in the experimental group (EG) to enhance the sense of bodily boundaries or a control group (CG), which massaged a fabric ring. Effects on an implicit measure (jumping to conclusion bias; JTC) and an explicit measure (Brief State Paranoia Checklist; BSPC) of delusion processes were assessed. The JTC measures the tendency to make a decision with little evidence available, and the BSPC explicitly measures the approval of paranoid beliefs. <b><i>Results:</i></b> Patients in the EG showed a lower JTC (<i>M</i> = 4.11 draws before decision) than the CG (<i>M</i> = 2.43; Cohen’s <i>d</i> = 0.64). No significant difference in the BSPC was observed. <b><i>Discussion/Conclusion:</i></b> Our results indicate that enhancing the sense of body boundaries through a self-massage can reduce an implicit bias associated with delusional ideation and correspondingly support the idea that disembodiment might be a relevant factor in the formation of psychotic symptoms.

scholarly journals The Dynamics of Musical Participation

2021 ◽  
pp. 102986492098831
Author(s):  
Andrea Schiavio ◽  
Pieter-Jan Maes ◽  
Dylan van der Schyff
Keyword(s):  
Dynamical System ◽  
Dynamical Systems ◽  
Systems Theory ◽  
Dynamical Systems Theory ◽  
Coordination Dynamics ◽  
Musical Experience ◽  
The Core ◽  
Interactive Dynamics ◽  
Interdisciplinary Scholarship ◽  
Core Features

In this paper we argue that our comprehension of musical participation—the complex network of interactive dynamics involved in collaborative musical experience—can benefit from an analysis inspired by the existing frameworks of dynamical systems theory and coordination dynamics. These approaches can offer novel theoretical tools to help music researchers describe a number of central aspects of joint musical experience in greater detail, such as prediction, adaptivity, social cohesion, reciprocity, and reward. While most musicians involved in collective forms of musicking already have some familiarity with these terms and their associated experiences, we currently lack an analytical vocabulary to approach them in a more targeted way. To fill this gap, we adopt insights from these frameworks to suggest that musical participation may be advantageously characterized as an open, non-equilibrium, dynamical system. In particular, we suggest that research informed by dynamical systems theory might stimulate new interdisciplinary scholarship at the crossroads of musicology, psychology, philosophy, and cognitive (neuro)science, pointing toward new understandings of the core features of musical participation.

Direct ophthalmoscopy for the acute physicia – papilloedema and other abnormalities of the optic nerve head

2002 ◽  
Vol 1 (2) ◽  
pp. 60-63
Author(s):  
B Edmunds ◽  
◽  
P J Francis ◽  
Keyword(s):  
Optic Nerve ◽  
Optic Nerve Head ◽  
Visual Disturbance ◽  
Medical Setting ◽  
Altered Level ◽  
Level Of Consciousness ◽  
Systemic Disorder ◽  
Systemic Examination ◽  
Direct Ophthalmoscopy

Direct ophthalmoscopy is an essential part of the full systemic examination. However, the technique is challenging and time-consuming. In the acute medical setting therefore, it is advisable for the physician to identify the subgroup of patients in whom examination of the fundus is most likely to be helpful. Ophthalmoscopy should be performed where papilloedema is suspected, in those with an altered level of consciousness or other focal neurology, those with an unknown systemic disorder, and those complaining of visual disturbance.

scholarly journals Altered Mental Status and Cyanosis in a Pediatric Patient with Methemoglobinemia

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Phillip M. Grenz ◽  
Robert N. Ray Jr. ◽  
Olivia A. Hardy ◽  
Andrew L. Koons ◽  
Kenneth D. Katz ◽  
...  
Keyword(s):  
Mental Status ◽  
Clinical Manifestations ◽  
Altered Mental Status ◽  
Pediatric Emergency ◽  
Abrupt Onset ◽  
Altered Level ◽  
Sustained Improvement ◽  
Oxygen Dissociation ◽  
Nail Polish ◽  
Level Of Consciousness

Methemoglobinemia results from increased amounts of oxidized hemoglobin in the blood with an ensuing change in oxygen dissociation curve and lack of oxygen delivery to tissue. A previously well, male toddler was brought to the Pediatric Emergency Department (PED) by Emergency Medical Services (EMS) with abrupt onset of altered mental status and cyanosis after a suspected ingestion of “Rush” nail polish remover. He was quickly diagnosed with methemoglobinemia by both clinical presentation and chocolate-colored blood appearance. He emergently received intravenous (IV) methylene blue (MB) with immediate and sustained improvement requiring no further doses. Though inhalation of nitrites and subsequent methemoglobinemia is frequently reported in adolescents, we were unable to find any cases in the literature detailing ingestion of this product and the resulting clinical manifestations. Our objective with this report is to describe a rare case of a toddler with an accidental ingestion of “Rush” nail polish remover, a nitrite compound. Our patient presented to the PED with abrupt onset of altered level of consciousness, hypotension, and cyanosis resulting from acquired methemoglobinemia. This case report demonstrates the importance of emergency clinicians being able to make clinical judgements and decisions based on the history and physical exam when methemoglobinemia is suspected.

Jewish Body Politics

2018 ◽  
Author(s):  
Eliyahu Stern
Keyword(s):  
United States ◽  
Minority Rights ◽  
The United States ◽  
Body Politics ◽  
Eastern European ◽  
The Core ◽  
Two Sides ◽  
Core Features

The idea of a Jewish body provides the background to understand the major Jewish migrations, the core features of modern Jewish politics, the transformation of Judaism as a religion and the role played by Jews in the Minority Rights Movement. Eastern European Jews’ immigration to the United States or Palestine as two sides of the same coin.

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