Periodic Alternating Nystagmus

Horizontal jerk nystagmus is indicative of a disorder involving the vestibular system. Periodic alternating nystagmus is a form of spontaneous nystagmus with a specific pattern. It is identified by the presence of spontaneous nystagmus in the primary direction of gaze, which beats in one direction for 1 or 2 minutes, followed by a null period, and then reappearance of the nystagmus in the opposite direction for a similar length of time. It may be congenital or acquired, and may be seen in association with vestibular-cerebellar disease or loss of vision. Recent case reports indicate that some forms of periodic alternating nystagmus may respond favorably to baclofen therapy.

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Alexander's Law Revisited

Journal of the American Academy of Audiology ◽

10.3766/jaaa.19.8.6 ◽

2008 ◽

Vol 19 (08) ◽

pp. 630-638 ◽

Cited By ~ 3

Author(s):

Gary P. Jacobson ◽

Devin L. McCaslin ◽

David M. Kaylie

Keyword(s):

Eye Movement ◽

Vestibular System ◽

Case Reports ◽

Spontaneous Nystagmus ◽

Ocular Motility ◽

Vestibular Evoked Myogenic Potential ◽

Data Collection And Analysis ◽

Alexander’S Law ◽

Neuro Imaging ◽

Case Data

Background: It is a common occurrence in the balance function laboratory to evaluate patients in the post-acute period following unilateral vestibular system impairment. It is important to be able to differentiate spontaneous nystagmus (SN) emanating from peripheral vestibular system impairments from asymmetric gaze-evoked nystagmus (GEN) that originates from central ocular motility impairment. Purpose: To describe the three elements of Alexander's Law (AL) that have been used to define SN from unilateral peripheral impairment. Additionally, a fourth element is described (i.e., augmentation of spontaneous nystagmus from unilateral peripheral vestibular system impairment) that differentiates nystagmus of peripheral vestibular system origin from nystagmus that originates from a central eye movement disorder. Research Design: Case reports Study Sample: Case data were obtained from two patients both showing a nystagmus that followed AL. Intervention: None Data Collection And Analysis: Videonystagmography (VNG), rotational, vestibular evoked myogenic potential (VEMP), and neuro-imaging studies were presented for each patient. Results: The nystagmus in Case 1 occurred as a result of a unilateral, peripheral, vestibular system impairment. The nystagmus was direction-fixed and intensified in the vision-denied condition. The nystagmus in Case 2, by appearance identical to that in Case 1, was an asymmetric gaze-evoked nystagmus originating from a space-occupying lesion in the cerebello-pontine angle. Unlike Case 1, the nystagmus did not augment in the vision-denied condition. Conclusions: Although nystagmus following AL usually occurs in acute peripheral vestibular system impairment, it can occur in cases of central eye movement impairment. The key element is whether the SN that follows AL is attenuated or augmented in the vision-denied condition. The SN from a unilateral peripheral vestibular system impairment should augment in the vision denied condition. An asymmetric GEN will either not augment, decrease in magnitude, or disappear entirely, in the vision-denied condition.

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Peaked “T” Waves with Tranylcypromine (Parnate) Overdose

The International Journal of Psychiatry in Medicine ◽

10.2190/qa6e-7q65-5kwb-8pr2 ◽

1982 ◽

Vol 11 (2) ◽

pp. 155-160 ◽

Cited By ~ 5

Author(s):

Timothy E. Quill

Keyword(s):

Monoamine Oxidase ◽

Intracranial Hemorrhage ◽

Case Reports ◽

Monoamine Oxidase Inhibitors ◽

Toxic Effects ◽

Recent Case ◽

Clinical Use ◽

Ecg Changes ◽

T Waves

A case of tranylcypromine (Parnate) overdose is presented in which the main toxic effects were headache, obtundation, hypertension, and diffusely peaked T-waves on ECG. The latter effect, which occurred in the absence of hyperkalemia, has not been previously associated with monoamine oxidase inhibitors (MAOI). Recent case reports of tranylcypromine toxicity are briefly reviewed, confirming the potential for hypertension, hypotension, shock, hyperpyrexia, intracranial hemorrhage, agitation, hyperkinesis, coma and death in association with overdosage, or concommitant ingestion of sympathomimetic substances or other drugs. These ECG changes add to the worrisome list of potential toxicities in an era in which MAOI are finding increased clinical use.

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Iatrogenic meningitis

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20130145 ◽

2013 ◽

Vol 71 (9B) ◽

pp. 659-660 ◽

Cited By ~ 1

Author(s):

Eduardo Genaro Mutarelli ◽

Tarso Adoni

Keyword(s):

Aseptic Meningitis ◽

Case Reports ◽

Recent Case ◽

Medical Community ◽

Fungal Meningitis ◽

Hypersensitivity Mechanism ◽

Iatrogenic Meningitis

Iatrogenic meningitis can be caused by a number of mechanisms. The recent case reports of fungal meningitis after application of epidural methylprednisolone caused warning in the medical community. Cases were caused by contaminated lots of methylprednisolone from a single compounding pharmacy. Several medications can cause meninigitis by probable hypersensitivity mechanism. Neurologists should be alert to the recent description of the use of lamotrigine and development of aseptic meningitis.

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A Recent Case Reports on Unfamiliar Kikuchi-Fujimoto Disease

10.36648/2471-299x.5.1.77 ◽

2019 ◽

Vol 05 (01) ◽

Author(s):

Jasleen Kaur ◽

Atif Khurshid Wani ◽

Bijay Kumar Yadav ◽

Bhuban Subedi

Keyword(s):

Case Reports ◽

Recent Case

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Benzathine Penicillin G in the Treatment of Neurosyphilis

Drug Intelligence & Clinical Pharmacy ◽

10.1177/106002808201600303 ◽

1982 ◽

Vol 16 (3) ◽

pp. 205-210 ◽

Cited By ~ 8

Author(s):

Paul G. Cuddy

Keyword(s):

Case Reports ◽

Diagnosis And Treatment ◽

Recent Case ◽

Penicillin G ◽

Controlled Trials ◽

Benzathine Penicillin ◽

Benzathine Penicillin G

The definition, pathogenesis, incidence, diagnosis, and treatment of neurosyphilis are discussed. Controlled trials of benzathine penicillin in the treatment of neurosyphilis are reviewed, as are recent case reports of benzathine penicillin failures. Although few well-controlled studies exist to document conclusively the efficacy of benzathine penicillin in the treatment of neurosyphilis, its use is recommended in selected situations.

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Hard knocks: Concussion injuries in tennis

ITF Coaching & Sport Science Review ◽

10.52383/itfcoaching.v24i70.208 ◽

2016 ◽

Vol 24 (70) ◽

Author(s):

Alan Pearce ◽

Janet Young

Keyword(s):

Case Reports ◽

Recent Case

Concussions in tennis are rare, but they do occur. As recent case reports have highlighted, players who sustain concussions in tennis can be affected for much longer than expected. This article, written for the coach, outlines the signs of concussion, concussion awareness in tennis, and the coach’s role in mitigating risk and managing concussions in their players.

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Silver nasal sprays: Misleading Internet marketing

Ear Nose & Throat Journal ◽

10.1177/014556130808700414 ◽

2008 ◽

Vol 87 (4) ◽

pp. 217-220 ◽

Cited By ~ 4

Author(s):

Michael T. Gaslin ◽

Cory Rubin ◽

Edmund A. Pribitkin

Keyword(s):

Natural Products ◽

Web Sites ◽

Case Reports ◽

Health Benefits ◽

Internet Marketing ◽

Recent Case ◽

The Internet ◽

Internet Search ◽

Nasal Sprays

Long-term use of silver-containing products is associated with a permanent bluish-gray discoloration of the skin known as argyria, but they remain widely available despite several measures by the FDA to regulate them. Several recent case reports have described the occurrence of argyria as a result of using these “natural” products. We used the five most common Internet search engines to find Web sites providing information on silver-containing nasal sprays. Of 49 Web sites analyzed, only 2 (4%) mentioned argyria as a possible complication, although 30 (61 %) did caution against long-term use. Eight sites (16%) made specific claims about the health benefits of the product. All 49 sites (100%) provided direct or indirect links to buy silver-containing nasal sprays. We conclude that information about silver-containing nasal sprays on the Internet is misleading and inaccurate. Therefore, otolaryngologists should be aware of the misinformation their patients may be receiving about these products.

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Vibrotactile stimulators and virtual 3-D audio countermeasures, training and motion sickness symptoms with a simulated graveyard spin illusion

Journal of Vestibular Research ◽

10.3233/ves-2008-185-605 ◽

2009 ◽

Vol 18 (5-6) ◽

pp. 287-294

Author(s):

Lawrence T. Guzy ◽

William B. Albery ◽

Chuck Goodyear

Keyword(s):

Motion Sickness ◽

Opposite Direction ◽

Vestibular System ◽

Random Perturbation ◽

Well Being ◽

Vibrotactile Stimulation ◽

Additional Training ◽

Post Test ◽

The Mean ◽

Experimental Trials

The vestibular system by itself is incapable of effectively compensating for the graveyard spin illusion. We examined two countermeasures, i.e., efficacy of vibrotactile stimulation around the waist and virtual 3-D audio presented independently and jointly for controlling a simulated graveyard spin. We also examined: a) additional training with these countermeasures to improve "intuitiveness;" b) included non-perturbation trials along with perturbation trials; and c) monitored changes in well-being as measured by a motion sickness scale from pre- to post-test and immediately following each trial. Ten volunteers received two training and two test sessions. The somatogyral illusion was generated by accelerating a chair for 24 s until it attained a peak rotation of 120°/s and then stopped. Over the ensuing 40 s the chair rotated in one of two random perturbation patterns or remained stationary. During this period, participants were required to eliminate all movements of the chair by turning a knob in the opposite direction of perceived rotation. For the control trials, participants relied solely on vestibular signals to cancel perceived movements. For the experimental trials, vibrotactile stimulation around the waist, virtual 3-D audio, or both were presented. The mean Cancellation Error (CE) for the control trials was 52°/s. The application of the countermeasures significantly reduced the CE. Additional training and testing did not improve intuitiveness. Perturbations to the chair resulted in a higher CE than no perturbations. Motion sickness symptoms showed no differences from pre- to post-test and very rarely reported after each trial.

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