Clinical Features and Endolymphatic Hydrops in Patients With MRI Evidence of Hydrops

2018 ◽  
Vol 128 (4) ◽  
pp. 286-292 ◽  
Author(s):  
Suming Shi ◽  
Ping Guo ◽  
Wenquan Li ◽  
Wuqing Wang
Keyword(s):  
Diagnostic Criteria ◽  
Clinical Features ◽  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Endolymphatic Hydrops ◽  
Low Frequency ◽  
Clinical Severity ◽  
Mri Findings ◽  
Vestibular Symptoms ◽  
Magnetic Resonance Imaging Mri

Objectives: The purpose of this study was to investigate the correlation between grades of endolymphatic hydrops (ELH) and clinical characteristics and determine the detailed clinical characteristics of Ménière’s disease (MD) patients with evidence of hydrops based on magnetic resonance imaging (MRI). Methods: One hundred ninety-eight MD patients (396 ears) with MRI evidence of hydrops were included. ELH grades were evaluated using the Nakashima grading standard. Correlations between the extent of ELH and clinical features were evaluated. Detailed clinical characteristics were analyzed to assess the clinical diagnostic criteria. Results: Of 198 patients, ELH was observed in 100% of cases on the clinically affected side and 8.6% of cases on the asymptomatic side. In addition, 98.5% of ELH was classified as moderate or significant grade. Low-frequency hearing loss was significantly correlated with the extent of both vestibular and cochlear hydrops, whereas the vertigo attack frequency showed no significant correlation with ELH grades. The disease duration of MD with bilateral ELH was longer than that with unilateral ELH. The clinical characteristics were variant and did not completely fit the proposed diagnostic criteria. Conclusions: MRI findings have relevance to the clinical severity, to a certain extent, but not vestibular symptoms. The proposed diagnostic criteria based on clinical characteristics may be partially effective; analysis of the detailed clinical characteristics of MD was meaningful. Diagnosis of MD based on both MRI and clinical symptoms could facilitate an early diagnosis.

Discrepancies in the interpretation of clinical symptoms and signs in the diagnosis of multiple sclerosis. A proposal for standardization

2005 ◽  
Vol 11 (2) ◽  
pp. 227-231 ◽  
Author(s):  
Bernard MJ Uitdehaag ◽  
Ludwig Kappos ◽  
Lars Bauer ◽  
Mark S Freedman ◽  
David Miller ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Demyelinating Disease ◽  
Clinical Symptoms ◽  
Clinical Findings ◽  
Large Trial ◽  
Mri Findings ◽  
Mcdonald Criteria ◽  
Magnetic Resonance Imaging Mri ◽  
Eligibility Assessment

The new McDonald diagnostic criteria for multiple sclerosis (MS) incorporate detailed criteria for the interpretation and classification of magnetic resonance imaging (MRI) findings, but, in contrast, provide no instructions for the interpretation of clinical findings. Because MS according to the McDonald criteria is one of the primary endpoints in a large trial enrolling patients after the first manifestation suggestive for a demyelinating disease (BENEFIT study), it was decided to organize a centralized eligibility assessment for this trial. During this eligibility assessment it was observed that there were marked inconsistencies in the decisions of participating neurologists with respect to the classification of clinical symptoms as being caused by one or more lesions provoking discussions in about one in every five patients. This paper describes these inconsistencies and their sources, and recommends a systematic approach that attempts to reduce the variability in interpreting clinical findings.

scholarly journals Comparison of the Usefulness of CBCT and MRI in TMD Patients According to Clinical Symptoms and Age

2020 ◽  
Vol 10 (10) ◽  
pp. 3599
Author(s):  
Kug Jin Jeon ◽  
Chena Lee ◽  
Yoon Joo Choi ◽  
Sang-Sun Han
Keyword(s):  
Clinical Symptoms ◽  
Mouth Opening ◽  
Temporomandibular Joint Disorders ◽  
Joint Effusion ◽  
Type I ◽  
Mri Findings ◽  
Type Iv ◽  
Temporomandibular Joints ◽  
Number Of Patients ◽  
Magnetic Resonance Imaging Mri

Recently, the number of patients who visit the hospital with symptoms of temporomandibular joint disorders (TMD) has been gradually increasing, and the need for special imaging such as cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI) is increasing for accurate diagnosis and treatment. The purpose of this study was to help the image guideline by comparing the usefulness of CBCT and MRI according to the clinical symptoms of TMD patients and further examining whether the usefulness varies with age. A total of 473 temporomandibular joints (TMJs) with clinical symptoms of TMD who underwent both CBCT and MRI examinations were retrospectively reviewed. Clinical symptoms included pain, sound and limited mouth opening. The CBCT findings included sclerosis, flattening, erosion and osteophyte, while the MRI findings were defined as disc deformity, disc derangement or joint effusion. Joints were divided according to the presence of CBCT and MRI findings as follows: type I (neither CBCT nor MRI findings), type II (only CBCT findings), type III (only MRI findings) and type IV (both CBCT and MRI findings). We assessed the usefulness of the two imaging modalities by comparing the frequency of those four groups according to clinical symptoms and age. In TMD patients with the clinical symptoms, MRI and CBCT are complementary, but if it is difficult to choose the first of these two modalities, MRI is more recommended, and the younger the patient, the more the MRI is recommended.

scholarly journals Preoperative Misdiagnosis of Malignant Mucosal Melanoma of the Nasal Septum by MRI

2020 ◽  
pp. 014556132096356
Author(s):  
Kyung Soo Kim ◽  
Hyun Jin Min
Keyword(s):  
Nasal Septum ◽  
Diagnostic Procedure ◽  
Clinical Symptoms ◽  
Vascular Tumor ◽  
Mucosal Melanoma ◽  
Malignant Neoplasms ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Endoscopic Findings ◽  
Magnetic Resonance Imaging Mri

Malignant sinonasal mucosal melanoma is a rare and aggressive neoplasm. As it shows nonspecific clinical symptoms, magnetic resonance imaging (MRI) is the most effective diagnostic tool. Before a mass is histopathologically confirmed, MRI is regarded as the optimal differential diagnostic procedure, especially in patients who present with a unilateral sinonasal cavity mass. However, we recently treated a patient who showed atypical MRI findings, resulting in a preoperative misdiagnosis of a vascular tumor. By pathologic examination, the patient was confirmed to have a malignant mucosal melanoma that originated from the nasal septum. This case demonstrates that unilateral nasal cavity masses that present with nonspecific symptoms, such as epistaxis, should be evaluated for possible malignant neoplasms, even if the mass has benign-looking characteristics in preoperative endoscopic findings and MRI images.

Magnetic resonance evidence of cortical onset of multiple sclerosis

2009 ◽  
Vol 15 (8) ◽  
pp. 933-941 ◽  
Author(s):  
M Calabrese ◽  
P Gallo
Keyword(s):  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Diagnostic Criteria ◽  
Clinical Symptoms ◽  
Final Diagnosis ◽  
Pathological Process ◽  
Clinical Onset ◽  
Normal Appearing White Matter ◽  
Central Nervous System Dysfunction ◽  
Magnetic Resonance Imaging Mri

Background Despite clinical symptoms and signs of central nervous system dysfunction, conventional magnetic resonance imaging (MRI) of the brain and spinal cord may appear normal in multiple sclerosis (MS) at clinical onset. Objective To demonstrate cortical pathology, namely the presence of cortical lesions (CLs) in patients with symptoms/signs suggestive of MS but having normal appearing white matter (WM) on MRI. Methods CLs were disclosed by double inversion recovery (DIR) MRI sequence. The final diagnosis of MS was achieved by the demonstration of the dissemination in space and time of WM lesions, and the absence of a better explanation of symptoms/signs, according to the established international diagnostic criteria. Results We describe four patients with MS, in which CLs were observed by DIR months/years before the MRI evidence of inflammatory lesions in the WM. Interpretation We suggest that, at least in some patients with MS, the pathological process underlying MS starts in the cortex. DIR sequence should be included in the MRI examination of suspected patients with MS with normal conventional MRI sequences at clinical onset. CLs should be evaluated for their inclusion in the MRI diagnostic criteria for MS.

scholarly journals Historical and Clinical Features of Psychogenic Tremor: a Review of 70 Cases

1999 ◽  
Vol 26 (3) ◽  
pp. 190-195 ◽  
Author(s):  
Yun J. Kim ◽  
Anthony S.-I. Pakiam ◽  
Anthony E. Lang
Keyword(s):  
Diagnostic Criteria ◽  
Clinical Features ◽  
Retrospective Review ◽  
Clinical Characteristics ◽  
Senior Author ◽  
Spontaneous Resolution ◽  
Accurate Diagnosis ◽  
Functional Symptoms ◽  
Characteristic Features ◽  
Symptoms And Signs

Objectives:To review the clinical characteristics and associated features found in patients with psychogenic tremor.Methods:Ten-year retrospective review of charts of all patients and videotapes of fifty-one patients diagnosed by the senior author as having psychogenic tremor.Results:Seventy patients fulfilled the diagnostic criteria for clinically definite psychogenic tremors. Psychogenic tremors usually started abruptly (73%), often with the maximal disability at onset (46%), and then took static (46%) or fluctuating (17%) courses. Psychogenic tremors usually started in one limb and spread rapidly to a generalized or mixed distribution. Spontaneous resolution and recurrence, easy distractibility together with entrainment and response to suggestion were characteristic features. Presence of functional symptoms and signs and refractoriness to conventional antitremor drugs were common.Conclusion:Psychogenic tremor is generally not a diagnosis of exclusion. The presence of characteristic features on history and especially clinical examination can permit an accurate diagnosis and avoid unnecessary investigations.

scholarly journals Dermatomal Somatosensory Evoked Potentials And Cortical Somatosensory Evoked Potentials Assessment In Congenital Scoliosis

2021 ◽  
Author(s):  
Zhenxing Zhang ◽  
Yi Wang ◽  
Tao Luo ◽  
Yang Yuan ◽  
Jingfeng Li
Keyword(s):  
Evoked Potentials ◽  
Somatosensory Evoked Potentials ◽  
Clinical Symptoms ◽  
Congenital Scoliosis ◽  
Mri Findings ◽  
Routine Clinical Examination ◽  
The Difference ◽  
Magnetic Resonance Imaging Mri ◽  
Spinal Cord Function ◽  
Baseline Examination

Abstract Background: The aim of this study was to assess the value of dermatomal somatosensory evoked potentials (DSEPs) and cortical somatosensory evoked potentials (SSEPs) in monitoring spinal cord function for patients with congenital scoliosis (CS). Methods: This study retrospectively analyzed the neurophysiological signals recorded in 62 patients from our orthopedic department who underwent MRI, CT and a specialist physical examination by a surgeon to confirm the diagnosis of CS. To observe the incidence of abnormal DSEPs and SSEPs in CS patients and to analyze the difference in sensitivity and reliability between the two in the examination of scoliosis patients. Results: All patients were evaluated with total spine magnetic resonance imaging (MRI). Only 23 patients (37.09%) showed intradural lesions in the MRI findings. Abnormal waveforms were observed in the DSEPs of 60 patients (96.8%) , 25 of which (40.3%) had abnormal waveforms in the tibial SSEPs, and the difference was statistically significant (P＜0.05). Of the 10 patients with clinical symptoms, 2 (20%) had abnormal tibial SSEPs waveforms , and 23 (44.2%) of 52 patients without clinical symptoms had abnormal tibial SSEPs waveforms. DSEPs are more sensitive to microscopic posterior column dysfunction in patients with CS that cannot be detected by either imaging or routine clinical examination. Conclusion: DSEPs provide evidence for the type of neurophysiological dysfunction in patients with congenital scoliosis. Preoperative DSEPs assessment is recommended as a baseline examination for intraoperative monitoring and comparison with the postoperative situation. DSEPs recording complements the information obtained from routine clinical and radiological evaluation.

scholarly journals Neurocysticercosis in Children with Seizures: A Cross-Sectional Study

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Murli Manohar Gupta ◽  
Nagendra Chaudhary ◽  
Santosh Pathak ◽  
Nikhil Agrawal ◽  
Jaydev Yadav ◽  
...  
Keyword(s):  
Ct Scan ◽  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Middle Income ◽  
Focal Seizures ◽  
Magnetic Resonance Imaging Mri ◽  
Considerable Morbidity

Background. Neurocysticercosis (NCC), a common cause of seizures in children from low and middle income countries (LMICs), if not diagnosed and treated early enough may lead to considerable morbidity and mortality. There is a lack of data on the prevalence of NCC and its clinical characteristics among those with seizure in South-Western Nepal. Aims and Objectives. To study the prevalence and clinical characteristics of NCC in children with seizures. Material and Methods. All children admitted to Universal College of Medical Sciences, a tertiary hospital in South-Western Nepal with seizures during 2014–16, were tested for NCC. NCC was diagnosed by neuroimaging [computerized tomography (CT) scan or magnetic resonance imaging (MRI)]. We used logistic regression to test the association between NCC with participants’ characteristics and clinical symptoms. Results. Among 4962 in-patient children, 168 (104 boys and 64 girls) had seizures (138 with generalized tonic clonic seizures (GTCS) and 30 with focal seizures). 43% of children with seizures had CT scan confirmed NCC. The prevalence of NCC in the oldest children (13–16 years) was significantly greater (57.1% versus 15.6%) compared to the youngest (0–4 years) one (p<0.001). Among 72 children with NCC, the proportions of children with vesicular, calcified, and colloidal stages were 76% (n=35), 18% (n=13), and 6% (n=2), respectively. Children with focal seizures had 13% more NCC compared to those with GTCS but the result was statistically not significant. The adjusted odds of having NCC among 5–8 years, 9–12 years, and 13–16 years children were 6.6 (1.78–24.60), 11.06 (2.74–44.60), and 14.47 (3.13–66.96), respectively, compared to 0–4-year-old children. Reoccurrence of seizures within the first 3 months of taking antiepileptic drug in those with NCC was approximately 3 times higher compared to those without NCC (11% versus 4%, p=0.084). Conclusions. This study shows that NCC contributes significantly to higher prevalence of seizures in children in South-Western region of Nepal.

Depression in General Practice:

1985 ◽  
Vol 147 (2) ◽  
pp. 119-126 ◽  
Author(s):  
L. I. Sireling ◽  
P. Freeling ◽  
E. S. Paykel ◽  
B. M. Rao ◽  
S. P. Patel
Keyword(s):  
General Practice ◽  
Depressive Symptoms ◽  
Diagnostic Criteria ◽  
Clinical Features ◽  
Clinical Characteristics ◽  
Severe Depression ◽  
Endogenous Depression

SummaryGeneral practice (GP) depressives prescribed an antidepressant were compared with those given other treatment, and with antidepressant-treated psychiatric out-patient depressives. GP depressives were considerably less severely ill than out-patients, with fewer depressive symptoms and shorter illness, as well as less primary and less endogenous depression. The two groups of GP depressives differed less, but those receiving other treatment tended to have less severe depression than those receiving antidepressants and were less likely to satisfy diagnostic criteria for depression. Depressives in GP differ considerably in clinical characteristics from psychiatric out-patient depressives, and clinical features influence the GP's decision to treat with antidepressants.

scholarly journals Hydropic Ear Disease: Correlation Between Audiovestibular Symptoms, Endolymphatic Hydrops and Blood-Labyrinth Barrier Impairment

2021 ◽  
Vol 8 ◽  
Author(s):  
Lisa M. H. de Pont ◽  
Josephine M. van Steekelenburg ◽  
Thijs O. Verhagen ◽  
Maartje Houben ◽  
Jelle J. Goeman ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Clinical Features ◽  
Disease Duration ◽  
Endolymphatic Hydrops ◽  
Region Of Interest ◽  
Cross Sectional Study ◽  
Mri Findings ◽  
Cross Sectional ◽  
High Frequency Hearing Loss ◽  
Drop Attacks

Research Objective: To investigate the correlation between clinical features and MRI-confirmed endolymphatic hydrops (EH) and blood-labyrinth barrier (BLB) impairment.Study Design: Retrospective cross-sectional study.Setting: Vertigo referral center (Haga Teaching Hospital, The Hague, the Netherlands).Methods: We retrospectively analyzed all patients that underwent 4 h-delayed Gd-enhanced 3D FLAIR MRI at our institution from February 2017 to March 2019. Perilymphatic enhancement and the degree of cochlear and vestibular hydrops were assessed. The signal intensity ratio (SIR) was calculated by region of interest analysis. Correlations between MRI findings and clinical features were evaluated.Results: Two hundred and fifteen patients with MRI-proven endolymphatic hydrops (EH) were included (179 unilateral, 36 bilateral) with a mean age of 55.9 yrs and median disease duration of 4.3 yrs. Hydrops grade is significantly correlated with disease duration (P &lt; 0.001), the severity of low- and high-frequency hearing loss (both P &lt; 0.001), and the incidence of drop attacks (P = 0.001). Visually increased perilymphatic enhancement was present in 157 (87.7%) subjects with unilateral EH. SIR increases in correlation with hydrops grade (P &lt; 0.001), but is not significantly correlated with the low or high Fletcher index (P = 0.344 and P = 0.178 respectively). No significant differences were found between the degree of EH or BLB impairment and vertigo, tinnitus or aural fullness.Conclusion: The degree of EH positively correlates with disease duration, hearing loss and the incidence of drop attacks. The BLB is impaired in association with EH grade, but without clear contribution to the severity of audiovestibular symptoms.

scholarly journals Role of Diagnostic Imaging in Chronic Recurrent Multifocal Osteomyelitis (CRMO) in Children: An Observational Study

Children ◽  
2021 ◽  
Vol 8 (9) ◽  
pp. 792
Author(s):  
Michał Kopeć ◽  
Magdalena Brąszewska ◽  
Mariusz Jarosz ◽  
Katarzyna Dylewska ◽  
Andrzej Kurylak
Keyword(s):  
Observational Study ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Chronic Recurrent Multifocal Osteomyelitis ◽  
Conventional Radiography ◽  
Cortical Layer ◽  
Mri Findings ◽  
Multifocal Osteomyelitis ◽  
Magnetic Resonance Imaging Mri

The aim of this single-center observational study was to analyze the applicability of various imaging studies to the diagnosis and further evaluation of patients with chronic recurrent multifocal osteomyelitis (CRMO). The analysis included the data of 10 patients with CRMO treated between 2016 and 2021. The mean ages of the patients at the first manifestation of CRMO and ultimate diagnosis were 10 years and 7 months and 11 years and 10 months, respectively. Conventional radiography demonstrated focal loss of bone density in only 30% of the patients. Computed tomography showed disseminated foci with non-homogeneous osteolytic/osteosclerotic structure, with a massive loss of cortical layer and strong periosteal reaction. On magnetic resonance imaging (MRI), most patients presented with multifocal hypodense areas on T1-weighted images, with the enhancement of signal on T-weighted and STIR sequences. The duration of follow-up varied between 3 months and 3 years. In 40% of the patients, both clinical symptoms and the abnormalities seen on MRI resolved completely, whereas another 50% showed partial regression of clinical and radiological manifestations. MRI findings, co-existing with characteristic clinical manifestations, play a pivotal role in establishing the ultimate diagnosis of CRMO. MRI can also be used to monitor the outcomes of treatment in CRMO patients.

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