scholarly journals Paradoxical Reaction to Alprazolam in an Elderly Woman with a History of Anxiety, Mood Disorders, and Hypothyroidism

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Daniel Kirkpatrick ◽  
Tyler Smith ◽  
Mitchell Kerfeld ◽  
Taylor Ramsdell ◽  
Hasnain Sadiq ◽  
...  
Keyword(s):  
Case Report ◽  
Elderly Woman ◽  
Temporal Relationship ◽  
Bilateral Mastectomy ◽  
Subjective Feeling ◽  
Paradoxical Reaction ◽  
Paradoxical Response ◽  
Appropriate Treatment ◽  
History Of ◽  
Motor Restlessness

With less than 1% of patients who use benzodiazepines being affected, paradoxical responses to benzodiazepines are rare. In this case report, we outline the course of an 80-year-old female who developed a paradoxical response to benzodiazepines. Significant medical and psychiatric history includes anxiety, mood disorder, hypothyroidism, bilateral mastectomy, goiter removal, and triple bypass. The patient presented with mental status changes, anxiety, motor restlessness, and paranoia. Over time, a temporal relationship between the severity of the patient’s motor agitation and intake of alprazolam was observed. As doses of alprazolam were decreased, her motor agitation became less severe. In addition to motor agitation, the patient also demonstrated increased aggressiveness, a subjective feeling of restlessness, and increased talkativeness. As her dose of alprazolam decreased, many of the patient’s symptoms were observed to decrease. This case report also discusses theories regarding the pathophysiology of paradoxical reactions to benzodiazepines, known risk factors, and appropriate treatment.

scholarly journals Posterior reversible encephalopathy syndrome: A case report

2015 ◽  
Vol 72 (8) ◽  
pp. 735-739
Author(s):  
Dejan Kostic ◽  
Biljana Brkic-Georgievski ◽  
Aleksandar Jovanovski ◽  
Smiljana Kostic ◽  
Drazen Ivetic ◽  
...  
Keyword(s):  
Case Report ◽  
White Matter ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Impaired Consciousness ◽  
Posterior Reversible Encephalopathy ◽  
Neurological Signs ◽  
Appropriate Treatment ◽  
History Of ◽  
Reversible Encephalopathy ◽  
The Brain

Posterior reversible encephalopathy syndrome (PRES) is characterized by the following symptoms: seizures, impaired consciousness and/or vision, vomiting, nausea, and focal neurological signs. Diagnostic imaging includes examination by magnetic resonance (MR) and computed tomography (CT), where brain edema is visualized bi-laterally and symmetrically, predominantly posteriorly, parietally, and occipitally. Case report. We presented a 73-year-old patient with the years-long medical history of hipertension and renal insufficiency, who developed PRES with the symptomatology of the rear cranium. CT and MR verified changes in the white matter involving all lobes on both sides of the brain. After a two-week treatment (antihypertensive, hypolipemic and rehydration therapy) clinical improvement with no complications occurred, with complete resolution of changes in the white matter observed on CT and MR. Conclusion. PRES is a reversible syndrome in which the symptoms withdraw after several days to several weeks if early diagnosis is made and appropriate treatment started without delay.

scholarly journals Olfactory Neuroblastoma: A Case Report and Review of the Literature

2005 ◽  
Vol 84 (3) ◽  
pp. 150-152 ◽  
Author(s):  
Shehzad Ghaffar ◽  
Iftikhar Salahuddin
Keyword(s):  
Case Report ◽  
Facial Pain ◽  
Elderly Woman ◽  
Malignant Tumors ◽  
Olfactory Neuroblastoma ◽  
Lateral Rhinotomy ◽  
Review Of The Literature ◽  
Postoperative Radiation ◽  
History Of

Malignant tumors of the nasal cavity are rare. We report the case of an elderly woman who consulted us with a 4-year history of progressive nasal obstruction, occasional epistaxis, facial pain, and watering of the eyes. A diagnosis of olfactory neuroblastoma was established by histopathology and confirmed by immunohistochemistry. On staging, the mass was classified as a Kadish stage B tumor. The mass was excised via a lateral rhinotomy approach, and the tumor was peeled away completely from the cribriform plate with endoscopes. The patient underwent postoperative radiation, and she was free of recurrence at follow-up 15 months later.

scholarly journals Kawasaki disease manifesting as bilateral facial nerve palsy and meningitis: a case report and literature review

2019 ◽  
Vol 47 (8) ◽  
pp. 4014-4018 ◽  
Author(s):  
Bo Zhang ◽  
Yunpeng Hao ◽  
Yanfeng Zhang ◽  
Nuo Yang ◽  
Hang Li ◽  
...  
Keyword(s):  
Case Report ◽  
Kawasaki Disease ◽  
Facial Nerve ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Brain Magnetic Resonance Imaging ◽  
Neurological Complications ◽  
Appropriate Treatment ◽  
History Of ◽  
The Right

Background Kawasaki disease (KD) is an acute multisystem vasculitic syndrome that predominantly affects infants and young children. Neurological complications are rare in patients with KD and the diagnosis is challenging. We report a case of KD that manifested as bilateral facial nerve palsy and meningitis. Case report A 6-month-old boy presented with a 10-day history of fever. Four days before admission, the patient developed a rash, conjunctival injection, perioral and perianal excoriation, and bilateral facial nerve palsy. Brain magnetic resonance imaging was normal. Echocardiography showed dilated coronary arteries and coronary artery aneurysms. A cerebrospinal fluid examination showed an elevated leukocyte count. A diagnosis of KD was made, and the patient was treated with gamma globulin and aspirin. The patient’s fever subsided on the following day and the right-sided facial nerve palsy was relieved 1 month later. An 18-month follow-up showed that the left-sided facial nerve palsy persisted and the patient’s condition remained stable. Conclusion KD manifesting as bilateral facial nerve palsy and meningitis is extremely rare. Clinicians should be aware of this condition, and early diagnosis and appropriate treatment should be emphasized.

scholarly journals Lingual thyroid causing dysphonia: case report

2004 ◽  
Vol 122 (2) ◽  
pp. 67-69 ◽  
Author(s):  
Alfio José Tincani ◽  
Antonio Santos Martins ◽  
André Del Negro ◽  
Priscila Pereira Costa Araújo ◽  
Gilson Barretto
Keyword(s):  
Case Report ◽  
Thyroid Gland ◽  
Upper Airway ◽  
Surgical Excision ◽  
Clinical Findings ◽  
Ectopic Thyroid ◽  
Lingual Thyroid ◽  
Recurrent Hemorrhage ◽  
Appropriate Treatment ◽  
History Of

CONTEXT: Lingual thyroid gland is a rare clinical entity that is caused by the failure of the thyroid gland to descend to a normal cervical location during embryogenesis. The occurrence of an ectopic thyroid gland located at the base of the tongue may cause problems for the patient, with symptoms of dysphagia, dysphonia, upper airway obstruction or even hemorrhage at any time from infancy through adulthood. CASE REPORT: We report on a case of lingual thyroid gland in a 41-year-old female patient. The embryology and diagnosis of ectopic thyroid are discussed and its management is outlined. Features of the diagnostic and therapeutic evaluation are described with attention to the clinical findings, laboratory tests, thyroid scan and computed tomography imaging studies employed in the confirmation of diagnosis and planning of appropriate treatment. The history of the condition is reviewed and a treatment strategy is outlined. Surgical excision of the gland is reserved for cases of gland enlargement that result in compromised airways (dysphagia or dysphonia) or recurrent hemorrhage.

scholarly journals Vestibular neuronitis of idiopathi origin: a case report

2021 ◽  
Vol 9 (4) ◽  
pp. 1219
Author(s):  
Savitha Kola ◽  
Akhila Janga ◽  
Kartheek Allam
Keyword(s):  
Case Report ◽  
Large Population ◽  
Complete Analysis ◽  
Vestibular Loss ◽  
Appropriate Treatment ◽  
Chief Complaints ◽  
History Of ◽  
Vestibular Neuronitis ◽  
Periodic Evaluation ◽  
Mild Headache

Vestibular Neuronitis is a neuronal condition characterized by spontaneous and unilateral vestibular loss suddenly with preserved hearing and no signs of brain stem dysfunction. According to large population studies, it is the sixth cause of vertigo with an incidence of 8%. Here is the case report of VN which was observed in a super speciality hospital. A 42 years old male patient was admitted in a private super speciality hospital with the chief complaints of history of vomiting 4 episodes, neck pain, mild headache and gaint imbalance since 5 days. Complete analysis of diagnostic reports was done and appropriate treatment given. This case emphasizes the importance of periodic evaluation and reporting of vestibular neuritis cases accumulating clinical knowledge. In this particular type of cases it is difficult to identify the etiology and pathophysiology, hence it is vitally important to conduct such studies. 

scholarly journals Acute Oxalate Nephropathy Due to Bilimbi Poisoning: A Case Report

2016 ◽  
Vol 4 (1) ◽  
pp. 33-35
Author(s):  
Rajat Das Gupta ◽  
Debashis Datta ◽  
Debashis Datta ◽  
Suranjan Kumar.
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Case Report ◽  
Oxalic Acid ◽  
Calcium Oxalate ◽  
Elderly Woman ◽  
Biochemical Study ◽  
Calcium Oxalate Crystals ◽  
History Of ◽  
Oxalate Nephropathy

Background: The concentrated juice made from Averrhoa bilimbi is rich in oxalic acid. It can cause acute oxalate nephropathy by blocking the tubules with calcium oxalate crystals. Case: An elderly woman was admitted to the hospital with a history of swelling of the legs, facial puffiness, and abdominal distention. Her biochemical study revealed features of acute renal failure. She gave history of taking half liter of bilimbi juice. Renal biopsy confirmed it was a case of acute oxalic nephropathy, which made it the second case of acute oxalic nephropathy due to ingestion of bilimbi juice ever reported from Bangladesh. Conclusion: It is not safe to consume high oxalate-containing fruits in large quantities.

scholarly journals Lateral Medullary Syndrome (Wallenberg's Syndrome) - A Case Report

1970 ◽  
Vol 5 (1) ◽  
pp. 35-36 ◽  
Author(s):  
R Saha ◽  
S Alam ◽  
MA Hossain
Keyword(s):  
Case Report ◽  
Ischaemic Stroke ◽  
Posterior Inferior Cerebellar Artery ◽  
Sudden Onset ◽  
Appropriate Treatment ◽  
Cerebellar Artery ◽  
Lateral Medullary Syndrome ◽  
Great Vessels ◽  
History Of ◽  
The Brain

The Lateral medullary syndrome is not a very common stroke. Sometimes it is under diagnosed. Mr. Ibrahim Mollah, 50 years old male person, non diabetic, non hypertensive but smoker presented with the history of sudden onset of dysphagia, dysarthria and ataxia of the gait. He is clinically and radiologically diagnosed as a case of Lateral medullary syndrome (Ischaemic stroke). With treatment this patient improved significantly. It is commonly caused by occlusion of the cranial segment of the vertebral artery or the posterior inferior cerebellar artery. The occlusion may be due to thrombosis or embolism. The emboli are coming from the heart or the great vessels. We can diagnose Lateral medullary syndrome with expert clinical eye and CT/MRI of the brain. It should be managed with appropriate treatment and physiotherapy. DOI: 10.3329/fmcj.v5i1.6813Faridpur Med. Coll. J. 2010;5(1):35-36

scholarly journals Impairment-Based Examination and Disability Management of an Elderly Woman With Sacroiliac Region Pain

2002 ◽  
Vol 82 (8) ◽  
pp. 812-821 ◽  
Author(s):  
Joseph J Godges ◽  
Denisa R Varnum ◽  
Kelly M Sanders
Keyword(s):  
Elderly Patient ◽  
Case Report ◽  
Elderly Woman ◽  
Groin Pain ◽  
Low Back ◽  
Case Description ◽  
Initial Symptoms ◽  
Left Buttock ◽  
History Of ◽  
Sacroiliac Region

Abstract Background and Purpose. The purpose of this case report is to describe the use of a cluster of sacroiliac tests in conjunction with an impairment-based model of examination, diagnosis, and management of sacroiliac region pain. Case Description. The patient was a 74-year-old woman with an 18-month history of low back, left buttock, and groin pain following a misstep. The initial symptoms were intermittent. The symptoms became constant and limited her walking tolerance to 5 minutes, which affected her ability to care for her grandchildren. She was examined using a cluster of sacroiliac tests that examined: (1) innominate active mobility, (2) innominate positional symmetry, and (3) sacroiliac ligament tenderness. Outcomes. Following 4 treatments for identified impairments, the patient had unlimited walking tolerance and she resumed an active caregiving role for her grandchildren. Discussion. This case illustrates the use of an impairment-based model for examination and management of an elderly patient with what appeared to be sacroiliac joint dysfunction.

scholarly journals Vaginal hysterectomy combined with transvaginal natural orifice transluminal endoscopic surgery bilateral adnexectomy: a case report

2020 ◽  
Vol 48 (12) ◽  
pp. 030006052098126
Author(s):  
Hanlin Yang ◽  
Mengyue Yang ◽  
Aduah Ransford ◽  
Dan Zi
Keyword(s):  
Elderly Patient ◽  
Case Report ◽  
Drug Treatment ◽  
Endoscopic Surgery ◽  
Vaginal Hysterectomy ◽  
Elderly Woman ◽  
Instructional Video ◽  
Natural Orifice ◽  
Current Case ◽  
History Of

This current case report describes an elderly woman with pyometra that underwent successful vaginal hysterectomy and transvaginal natural orifice transluminal endoscopic surgery (vNOTES) bilateral adnexectomy after conservative anti-inflammatory drug treatment. The patient had a history of transvaginal delivery so this approach was considered the most appropriate. To the best of our knowledge, this is the first report to investigate the use of vaginal hysterectomy and vNOTES bilateral adnexectomy in an elderly patient with pyometra. The necessary steps to the procedure are shown in a narrated instructional video.

scholarly journals Isolated tuberculous epididymal mass mimicking testicular malignancy: an interesting case report and lessons learnt

2021 ◽  
Author(s):  
Tejaswini Manne ◽  
Solomon Nazareth ◽  
Pavithra Vittalraj ◽  
Sandhya Sundaram ◽  
Sriram Krishnamoorthy ◽  
...  
Keyword(s):  
Case Report ◽  
Pulmonary Tuberculosis ◽  
Previous History ◽  
Interesting Case ◽  
Histopathological Diagnosis ◽  
Recent Onset ◽  
Appropriate Treatment ◽  
History Of ◽  
The Right ◽  
High Index Of Suspicion

Tuberculous epididymal mass is a condition that presents as a painless scrotal swelling. It resembles a testicular mass and is more often diagnosed after orchidectomy. About 22% of all genitourinary tuberculosis show epididymal involvement and 22% of epididymal tuberculosis are bilateral. This report reiterates the need for an increased awareness amongst the treating urologists that would enable an earlier diagnosis, appropriate treatment and may avert the need for orchidectomy in most cases. A 35-year-old diabetic male presented with rapidly enlarging right testicle associated with recent onset of pain over the testis. He also had fever and chills. At the age of 18, he was treated for pulmonary tuberculosis. The right testicle was enlarged, irregular and mildly tender. The right epididymis was also irregular and nodular, blended with the right testicle and indistinguishable from it. A clinical diagnosis of testicular tumour was made. Tumour markers were normal and he underwent high orchidectomy. Histopathological diagnosis confirmed right epididymal tuberculosis. This case report mainly highlights the need for a high index of suspicion amongst the treating physicians. A previous history of treatment for pulmonary tuberculosis should alert the physician to think in lines of tuberculous pathology in epididymis too. A prompt diagnosis and early, appropriate treatment would largely prevent removal of testicles in most cases.

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