Herpes zoster ophthalmicus following onabotulinumtoxinA administration for chronic migraine: A case report and literature review

Cephalalgia ◽  
2014 ◽  
Vol 35 (5) ◽  
pp. 443-448 ◽  
Author(s):  
Paul M Gadient ◽  
Jonathan H Smith ◽  
Stephen J Ryan
Keyword(s):  
Herpes Zoster ◽  
Literature Review ◽  
Chronic Migraine ◽  
Young Patients ◽  
Viral Reactivation ◽  
Herpes Zoster Ophthalmicus ◽  
Local Trauma ◽  
Physician Awareness ◽  
History Of ◽  
The Right

Background There is a growing body of literature documenting local herpes zoster outbreak following procedures. The mechanism underlying these outbreaks remains elusive. We present a case of zoster following onabotulinumtoxinA (BTX) for migraine and a literature review. Methods Chart and literature review. Case A 72-year-old woman with chronic migraine received BTX injections for 3 years without incident. She had a history of thoracic zoster with subsequent post-herpetic neuralgia. In August 2013, 48 hours after receiving BTX injections, she developed a painful rash in the right V1 distribution consistent with herpes zoster ophthalmicus. One week later the rash had resolved without treatment. Literature review We identified 65 (including 2 from Juel-Jenson) cases of zoster reactivation following minor procedures. These cases tend to be in young patients without specific risk factors. Outbreaks characteristically occur at the level of exposure to local trauma. Discussion Our review suggests that local trauma, regardless of the nature of stimuli, may be sufficient for zoster reactivation. We hypothesize that the stressors in these reported cases exert a local epigenetic influence on viral transcription, allowing for viral reactivation. Conclusion Zoster is a potential complication of BTX administration for chronic migraine in adults. Physician awareness can reduce the significant morbidity associated with this disease.

scholarly journals Acute Glaucoma Filtering Surgery Failure following Herpes Zoster Ophthalmicus Infection

2021 ◽  
pp. 324-329
Author(s):  
Stylianos A. Kandarakis ◽  
Andreas Diagourtas ◽  
Petros Petrou ◽  
Filippos Vingopoulos ◽  
Konstantinos Droutsas ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Herpes Zoster ◽  
Open Angle Glaucoma ◽  
Filtering Surgery ◽  
Herpes Zoster Ophthalmicus ◽  
History Of ◽  
The Right ◽  
Ophthalmic Branch ◽  
Acute Failure ◽  
Common Infection

Herein, we report a case of acute failure of a previously successful trabeculectomy, following an infection with herpes zoster ophthalmicus (HZO). HZO remains a common infection, especially among elderly and immunocompromised patients. There is a strong link between HZO infection, the incidence of secondary glaucoma, and the need for glaucoma filtering surgery. Though, to our knowledge, there are no cases reporting on the effect that a concomitant infection may have on a previously successful trabeculectomy. In our case, a 76-year-old immunocompetent male with primary open-angle glaucoma in both eyes and a history of a successful right eye trabeculectomy 1 year earlier presented with acute primary HZO involving the ophthalmic branch of the right trigeminal nerve. Appropriate topical and systemic treatment was immediately initiated. Three days later, the trabeculectomy bleb showed hyperemia and flattening and concomitant rise of intraocular pressure was noted. A week later, the cutaneous signs were improving yet the trabeculectomy had failed and high intraocular pressure was established, requiring both topical and systemic antiglaucoma medications. Our study suggests that a previously successful trabeculectomy may manifest signs of compromise and subsequent failure following a HZO infection.

scholarly journals Ocular manifestations in Herpes Zoster Ophthalmicus

1970 ◽  
Vol 3 (2) ◽  
pp. 165-171 ◽  
Author(s):  
LR Puri ◽  
GB Shrestha ◽  
DN Shah ◽  
M Chaudhary ◽  
A Thakar
Keyword(s):  
Herpes Zoster ◽  
Young Patients ◽  
Ocular Involvement ◽  
Post Herpetic Neuralgia ◽  
Visual Disability ◽  
Herpes Zoster Ophthalmicus ◽  
Cross Sectional ◽  
Ocular Manifestations ◽  
Visual Status ◽  
The Mean

Background: Ocular complications of herpes zoster ophthalmicus (HZO) may lead to substantial visual disability, severe post-herpetic neuralgia and rarely fatal cerebral complications. Aim: To identify the pattern of ocular manifestation in herpes zoster ophthalmicus. Materials and methods: A cross-sectional descriptive study was under taken including the clinically diagnosed cases of HZO. All of them underwent a complete ophthalmological evaluation. Results: Sixty-eight cases of HZO were examined, of which 37 (54.4 %) were male and 31 (45.6%) female. The mean age was 48.7 ± 18.5 years. Most of the patients (64.7 %) were above the age of 40 years. 77.94 % of the patients had some form of ocular involvement. Pain (77.9 %) was the commonest ocular complaint. In young patients less than 35 years, HIV was the most common risk factor (19.3 %).Visual status was good in the majority (73.5 %) of patients at presentation. Lid and adnexal findings (45.8 %) were most common ocular involvement followed by conjunctivitis (41.1 %). Corneal complication was seen in 38.2 % of cases, uveitis in 19.1 % and post-herpetic neuralgia (PHN) and secondary glaucoma each in 5.8 %. Conclusion: Eyelid and ocular adnexal involvement is most commonly found in patients with herpes zoster ophthalmicus followed by corneal complication and uveitis. There needs to be awareness of ocular involvement, which can be sight threatening, among the HZO patients and other medical departments and an increased emphasis on regular ophthalmic examination. Key words: herpes virus, herpes zoster, conjunctivitis, keratitis DOI: http://dx.doi.org/10.3126/nepjoph.v3i2.5271 Nepal J Ophthalmol 2011; 3(2): 165-171

scholarly journals Herpes Zoster pada Anak – Laporan Kasus

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Thigita A. Pandaleke ◽  
Herry E. J. Pandaleke ◽  
Ratna I. Susanti ◽  
Julieta D. P. Dotulong
Keyword(s):  
Herpes Zoster ◽  
Physical Examination ◽  
Primary Infection ◽  
Giant Cells ◽  
Lumbar Region ◽  
Sensory Ganglia ◽  
Laboratory Findings ◽  
Varicella Zoster ◽  
History Of ◽  
The Right

Abstract: Herpes zoster (HZ) is an acute vesicular eruption caused by latent varicella zoster virus (VVZ) reactivation in sensory ganglia after primary infection. Its incidence increases with age and it is rarely found in children. We reported a case of 10-year-old male with blisters on the right side of his stomach and back 3 days ago. The patient was suffered from fever, common cold, and cough a week before, and had a history of varicella at 5 years old. Dermatologic status showed multiple vesicles on erythematous base at the anterior dan posterior sides of his right lumbar region. The Tzank test showed multinucletaed giant cells. Acyclovir resulted in significant improvement after 7- day therapy. Conclusion: Diagnosis of herpes zoster was based on anamnesis, physical examination, and laboratory findings. Antiviral drugs was aimed to reduce complications and viral shedding.Keywords: Herpes zoster, childAbstrak: Herpes zoster (HZ) merupakan erupsi vesikuler akut yang disebabkan oleh reaktivasi dari virus varisela zoster (VVZ) laten pada ganglia sensoris yang sebelumnya terpajan dengan infeksi primer varisela. Insiden HZ meningkat seiring pertambahan usia dan jarang ditemukan pada anak-anak. Kami melaporkan kasus seorang anak laki-laki, 10 tahun, dengan bintil-bintil berair di perut dan punggung sebelah kanan sejak 3 hari lalu. Riwayat demam, batuk dan pilek 1 minggu sebelum timbul lesi. Riwayat varisela pada usia 5 tahun. Status dermatologis ditemukan vesikel multipel berisi cairan jernih yang tersusun bergerombol di atas kulit yang eritema di regio lumbar dekstra anterior dan posterior. Tes Tzank memperlihatkan sel raksasa berinti banyak. Pasien diterapi dengan asiklovir oral selama 7 hari dan menunjukkan perbaikan yang bermakna. Simpulan: Anamnesis, pemeriksaan fisik, dan pemeriksaan penunjang kasus ini khas untuk herpes zoster. Pemberian obat antiviral bertujuan untuk mengurangi komplikasi dan menurunkan viral shedding.Kata kunci: herpes zoster, anak

scholarly journals A Rare Cause of Supraventricular Ectopic Beats and Angina in a Young Patient

2018 ◽  
Vol 4 (2) ◽  
pp. 106-109
Author(s):  
Monica Jurcău ◽  
Mariana Floria ◽  
Bogdan Mazilu ◽  
Anca Ouatu ◽  
Daniela Maria Tanase
Keyword(s):  
Coronary Artery ◽  
Stress Test ◽  
Young Patients ◽  
Physical Exertion ◽  
Diagnostic Techniques ◽  
History Of ◽  
Ectopic Beats ◽  
Artery Disease ◽  
One Year ◽  
The Right

Abstract Introduction: We present the case of a young man with multiple atherosclerotic risk factors and a rare cause of angina and supraventricular ectopic beats. Case presentation: A 35-year-old man with one-year history of stable angina pectoris and supraventricular ectopic beats, without any medication, presented to the emergency room complaining of anterior chest pain that occurs at moderate physical exertion. The rest electrocardiogram, transthoracic echocardiography, and chest X-ray were normal; the exertion stress test was also normal, except for supraventricular ectopic beats (trigeminal rhythm). Due to the intermediate pre-test probability of coronary artery disease, he was evaluated using coronary computed tomography angiography. An anomalous origin of the right coronary artery from the left coronary sinus, with an inter-arterial course and without any atheroma plaques, was observed. During hospitalization the evolution was stable, without complications. The patient was further referred to a cardiac surgery clinic to evaluate the possibility of surgical treatment of this anomaly. Conclusions: Coronary artery anomalies are very rare; however, they present multiple implications in current practice. The most severe complication of this condition is represented by sudden death in young patients due to malignant ventricular arrhythmias. Imaging diagnostic techniques allow for a rapid, noninvasive diagnosis of this rare cause of angina.

scholarly journals Chronic subdural hematoma

2021 ◽  
pp. 1-7
Author(s):  
Blanca Piedra Herrera ◽  
Yanet Yanet Acosta Piedra
Keyword(s):  
Subdural Hematoma ◽  
Head Injuries ◽  
Young Patients ◽  
Chronic Subdural Hematoma ◽  
Complete Recovery ◽  
Computed Tomography Scan ◽  
History Of ◽  
Third Cranial Nerve Palsy ◽  
The Right ◽  
Tomography Scan

Chronic subdural hematoma (CSH) is a common neurosurgical pathology that is recognized as a consequence of minor head injuries that are usually diagnosed in senile patients, although it can occur in young patients without a history of trauma. The objective of this work is the presentation of a patient with a bilateral CSH, with unusual characteristics. Clinical case: a 46-year-old female patient with no history of head trauma or other concomitant pathology is presented, who consulted for a 15-day-old headache. Physical examination confirmed mydriasis, Hutchinson’s pupil, bilateral papilledema and exophoria of the right eye, third cranial nerve palsy, and trunk ataxia. She was cataloged with Glasgow 13. Early anti-cerebral edema treatment was performed and the manifestations largely disappeared. A computed tomography scan diagnosed a bilateral fronto temporal subdural hematoma with displacement of the midline structures to the left. She underwent emergency surgery and was discharged completely recovered three days later. Conclusion: HSC can present with different clinical forms, simulating expansive tumor processes, cerebrovascular attacks, dementias or neurological entities of another nature. The case management by clinicians and neurosurgeons was quick and effective, which explains that the patient had an early and complete recovery. In these cases, medical action is decisive in the success of the treatment.

scholarly journals Patients With Chronic Migraine Without History of Medication Overuse Are Characterized by a Peculiar White Matter Fiber Bundle Profile

2020 ◽  
Author(s):  
Gianluca Coppola ◽  
Antonio Di Renzo ◽  
Emanuele Tinelli ◽  
Barbara Petolicchio ◽  
Cherubino Di Lorenzo ◽  
...  
Keyword(s):  
White Matter ◽  
Chronic Migraine ◽  
Diffusion Tensor ◽  
Internal Capsule ◽  
Posterior Limb ◽  
History Of ◽  
The Right ◽  
Normal White Matter ◽  
Microstructural Integrity ◽  
The Brain

Abstract Background: We investigated intracerebral fiber bundles using a tract-based spatial statistics (TBSS) analysis of diffusion tensor imaging (DTI) datato investigate microstructural integrity in patients with episodic (MO) and chronic migraine (CM).Methods: We performed DTI in 19 patients with MO within interictal periods, 18 patients with CM without any history of drug abuse, and 18 healthy controls (HCs) using a 3T magnetic resonance imaging scanner. We calculated diffusion metrics, including fractional anisotropy (FA), axial diffusion (AD), radial diffusion (RD), and mean diffusion (MD).Results: TBSS revealed no significant differences in the FA, MD, RD, and AD maps between the MO and HC groups. In comparison to the HC group, theCM group exhibited widespread increased RD (bilateral superior [SCR] and posterior corona radiata [PCR], bilateral genu of the corpus callosum [CC], bilateral posterior limb of internal capsule [IC], bilateral superior longitudinal fasciculus [LF]) and MD values (tracts of the right SCR and PCR, right superior LF, and right splenium of the CC). In comparison to theMO group, theCM group showed decreased FA (bilateral SCR and PCR, bilateral body of CC, right superior LF, right forceps minor) and increased MD values (bilateral SCR and right PCR, right body of CC, right superior LF, right splenium of CC, and right posterior limb of IC). Conclusion: Our results suggest that chronic migraine can be associated withthe widespread disruption of normal white matter integrity in the brain.

scholarly journals Hemangioma of the uvula: the most frequent vascular tumor with a rare localization - Case report with literature review

2016 ◽  
Vol 22 (4) ◽  
pp. 212-216
Author(s):  
Alexandra Maiorean ◽  
Mariana Aschie ◽  
Anca Mitroi ◽  
Georgeta Camelia Cozaru ◽  
I. Poinareanu ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Literature Review ◽  
Head And Neck ◽  
Potential Risk ◽  
Vascular Tumor ◽  
Vascular Origin ◽  
Local Trauma ◽  
History Of

Abstract Hemangioma is the most common tumor of the vascular origin, benign, frequently observed in children, and with preference for head and neck, but rarely having a uvular origin. In this organ, it presents potential risk of local trauma, hemorrhage and it may produce great discomfort for the patient. In this article we present the cases of two patients (34 year-old and 44-year old) with uvular hemangiomas; patient 1 was admitted for dysphagia, salivation and choking and patient 2 was admitted for the swelling of the uvula, dysphagia, salivation and difficulty in speaking. They both presented a history of this symptoms, with acute episodes of dysphagia. They did not report bleeding, pain or fever. Hemangiomas were histopathologically confirmed, thus raising the awareness that hemangiomas are included in the differential diagnosis when a patient presents an elongated, swollen uvula or uvular masses.

scholarly journals Juvenile Osteochondritis Dissecans of the Knee. About A Case

2017 ◽  
Vol 5 (1_suppl) ◽  
pp. 2325967117S0002
Author(s):  
Ignacio Astore ◽  
Juan Ignacio Agotegaray ◽  
Ignacio Comba ◽  
Luciana Bisiach
Keyword(s):  
Osteochondritis Dissecans ◽  
Femoral Condyle ◽  
Young Patients ◽  
Body Burden ◽  
Acute Onset ◽  
Type Iv ◽  
Juvenile Osteochondritis Dissecans ◽  
Osteosynthesis Material ◽  
History Of ◽  
The Right

Introduction: Juvenile osteochondritis dissecans is a pathology that affects the superficial articular cartilage and subchondral bone in patients with open physes. Treatment of this disease is based on patient’s age and the stage of the disease. Methods: 16-year-old patient, athlete, with a history of knee pain on the right side of acute onset, without traumatic history. A physical examination shows pain in the external compartment of the knee. MRI shows a stable lesion that involves the external femoral condyle, over a posterior area of 16 mm by 20mm. Crutches are indicate for walking without body burden. Symptoms continue for six months and there are no changes in MRI. It is decided to do a stabilization with a Herbert type screw. After the surgery, pain persists and in x-ray controls, osteointegration is not observed. Osteosynthesis material is extracted and mosaicplasty is performed. We used Guhl’s intraoperative classification. Results: In this case, for a young patient with Guhl’s lesion type III, the reduction with a Herbert type screw was indicated, as the lesion was stable, of a significant size and congruent. Lesion progressed to type IV in 6 months. Thus, mosaicplasty was performed, obtaining a good functional result according to the physical exam, with a complete range of flexion and extension. A second-look arthroscopic assessment was carried out 2 months after surgery, showing osteointegration and stability of the allogenic graft. Conclusion: The variable of stability of the fragment is very important when determining the treatment. Most of the stable lesions can be successfully treated with a conservative treatment. Also, it has been demonstrated that young patients have a higher rate of healing. Instead, unstable lesions require surgical treatment.

scholarly journals Multicentric Giant Cell Tumor of Bone: Synchronous and Metachronous Presentation

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Reiner Wirbel ◽  
Frank Blümler ◽  
Dirk Lommel ◽  
Guido Syré ◽  
Veit Krenn
Keyword(s):  
Magnetic Resonance ◽  
Literature Review ◽  
Giant Cell Tumor ◽  
Giant Cell ◽  
Proximal Femur ◽  
Proximal Humerus ◽  
Distal Tibia ◽  
Cell Tumor ◽  
History Of ◽  
The Right

A 27-year-old man treated 2.5 years ago for synchronous multicentric giant cell tumor of bone located at the right proximal humerus and the right 5th finger presented now with complaints of pain in his right hip and wrist of two-month duration. Radiology and magnetic resonance revealed multicentric giant cell tumor lesions of the right proximal femur, the left ileum, the right distal radius, and the left distal tibia. The patient has an eighteen-year history of a healed osteosarcoma of the right tibia that was treated with chemotherapy, resection, and allograft reconstruction. A literature review establishes this as the first reported case of a patient with synchronous and metachronous multicentric giant cell tumor who also has a history of osteosarcoma.

scholarly journals TP10.1.3SARS-Cov-2 and Colitis: A Case Series

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Jessica Banks ◽  
Dheepa Nair ◽  
Richard Guy
Keyword(s):  
Young Patients ◽  
Case Series ◽  
Gi Tract ◽  
Ischaemic Colitis ◽  
Emergency General Surgery ◽  
Medical Comorbidities ◽  
Gi Symptoms ◽  
Nasal Swabs ◽  
History Of ◽  
The Right

Abstract Background Up to a third of patients with COVID-19 infection present with gastrointestinal (GI) symptoms. The Sars-Cov-2 virus enters enterocytes through a novel mechanism via ACE- 2 receptors, which are expressed throughout the GI tract, especially in the mid-gut. Small bowel and colonic inflammation and alteration of the gut microbiome (“altered inflammasome”) have been observed. Aims We report a cluster of cases during the first and second wave UK pandemics involving young patients with unexplained segmental CT-proven colitis. Methods All patients diagnosed with CT proven colitis with no history of IBD, ischaemic colitis or significant medical comorbidities were included. Results Fifteen patients (median age 33 years; 8 females) were admitted under Emergency General Surgery between Mar 2020 & Jan 2021. All patients were previously well with no history of IBD, ischaemic colitis or significant medical comorbidities. Thirteen patients underwent CT imaging, showing evidence of colitis in 12, with changes affecting the right colon predominating. Campylobacter jejuni was identified in 4 of 7 stool cultures but only 1 patient had a positive PCR nasal swab and another had COVID antibodies detected in serum. Endoscopic and histological appearances of those undergoing colonoscopy were non-specific. Conclusion These cases may represent Covid-19 involvement of the gut. Nasal swabs are not validated for use in the GI tract and detection of SARS-Cov-2 virus requires faecal or mucosal sampling. Disruption of the microbiome permits emergence of pathogenic species such as Campylobacter. More work is required in this important area to further define and elucidate COVID-19 GI involvement.

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