scholarly journals A case of dyskinesia after levetiracetam administration

BMC Neurology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Soo Hwan Yim ◽  
Yun Ho Choi ◽  
Kyoung Heo ◽  
Kyoo ho Cho
Keyword(s):  
First Generation ◽  
Dopaminergic System ◽  
Case Reports ◽  
Medical Field ◽  
Unusual Manifestation ◽  
Case Presentation ◽  
Unusual Phenomenon ◽  
History Of ◽  
Clonic Seizures ◽  
Video Eeg

Abstract Background Antiepileptic drug (AED) induced dyskinesia is an unusual manifestation in the medical field. In the previous case reports describing first generation-AED related involuntary movements, the authors suggested that a plausible cause is pharmacokinetic interactions between two or more AEDs. To date, development of dyskinesia after levetiracetam (LEV) has not been reported. Case presentation A 28-year-old woman with a history of brain metastasis from spinal cord glioblastoma presented with several generalized tonic-clonic seizures without restored consciousness. LEV was administered intravenously. Thereafter no more clinical or electroencephalographic seizures were noted on video-EEG monitoring, while chorea movement was observed in her face and bilateral upper limbs. Discussion and conclusions To our knowledge, there is no case report of dyskinesia after administration of LEV. Considering the temporal relationship and absence of ictal video-EEG findings, we suggest that development of choreoathetosis was closely associated with the undesirable effects of LEV. We propose that dopaminergic system dysregulation and genetic susceptibility might underlie this unusual phenomenon after LEV treatment.

scholarly journals Spontaneous haemorrhage of an adrenal angiomyolipoma: case report

2019 ◽  
Vol 25 (1) ◽  
Author(s):  
Danielle Whiting ◽  
Ian Rudd ◽  
Amit Goel ◽  
Seshadri Sriprasad ◽  
Sanjeev Madaan
Keyword(s):  
Case Reports ◽  
Case Presentation ◽  
Open Adrenalectomy ◽  
Large Size ◽  
History Of ◽  
Loin Pain ◽  
Benign Tumours ◽  
Spontaneous Haemorrhage ◽  
Mesenchymal Tumours

Abstract Background Angiomyolipomas are rare mesenchymal tumours arising from the perivascular epithelioid cells consisting of variable amounts of adipose, thick-walled blood vessels and smooth muscle cells. These benign tumours commonly occur in the kidney with only a few case reports of adrenal angiomyolipomas which have the potential to reach a large size and haemorrhage. Case presentation A 45-year-old lady presented with a 3-week history of right loin pain, nausea and vomiting. A CT scan revealed a right adrenal angiomyolipoma measuring 6.3 × 6.8 cm with associated haemorrhage. The lesion was successfully treated with right open adrenalectomy, and histology confirmed the diagnosis of adrenal angiomyolipoma. The patient remained well with no evidence of recurrence at the 36-month follow-up. Conclusion Adrenal angiomyolipomas are rare benign tumours that have the ability to reach a large size and potential to bleed. Here, we report the second case of spontaneous haemorrhage in an adrenal angiomyolipoma, which was successfully treated with open adrenalectomy.

scholarly journals Clozapine-induced stuttering in the absence of known risk factors: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Florence Jaguga
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Side Effect ◽  
Case Reports ◽  
Extrapyramidal Symptoms ◽  
Prior History ◽  
Case Presentation ◽  
Rare Side Effect ◽  
History Of ◽  
Electrophysiological Findings

Abstract Background Stuttering is a rare side effect of clozapine. It has been shown to occur in the presence of one or more factors such as abnormal electrophysiological findings and seizures, extrapyramidal symptoms, brain pathology, and a family history of stuttering. Few case reports have documented the occurrence of clozapine-induced stuttering in the absence of these risk factors. Case presentation A 29-year-old African male on clozapine for treatment-resistant schizophrenia presented with stuttering at a dosage of 400 mg/day that resolved with dose reduction. Electroencephalogram findings were normal, and there was no clinical evidence of seizures. The patient had no prior history or family history of stuttering, had a normal neurological examination, and showed no signs of extrapyramidal symptoms. Conclusion Clinicians ought to be aware of stuttering as a side effect of clozapine, even in the absence of known risk factors. Further research should investigate the pathophysiology of clozapine-induced stuttering.

scholarly journals Unilateral Posterior Polymorphous Corneal Dystrophy Presented as Anisometropic Astigmatism: 3 Case Reports

2017 ◽  
Vol 8 (1) ◽  
pp. 250-258
Author(s):  
Hyun Sun Jeon ◽  
Joon Young Hyon
Keyword(s):  
Refractive Error ◽  
Case Reports ◽  
Corneal Dystrophy ◽  
Visual Axis ◽  
Case Presentation ◽  
Visual Prognosis ◽  
Posterior Polymorphous Corneal Dystrophy ◽  
History Of ◽  
Contralateral Eye ◽  
Corrective Spectacle

Background: Posterior polymorphous corneal dystrophy (PPCD) is typically considered bilateral and asymptomatic. However, few case reports on patients with unilateral PPCD with asymmetric refractive error have mentioned anisometropic amblyopia development. In support of this, we report 3 cases of unilateral PPCD that presented as anisometropic astigmatism. Visual prognosis related to amblyopia development is discussed. Case Presentation: All 3 patients had a band lesion in the affected eye and a difference of at least 1.5 diopters in cylindrical refractive error between their eyes. The affected eye had a greater amount of astigmatism in all cases. Two patients (Cases 1 and 2) also had amblyopia in the affected eye. Case 1 was a 25-year-old male with a unilateral PPCD diagnosis and a band lesion involving the visual axis. Case 2 was an 11-year-old boy diagnosed with unilateral PPCD. The boy was treated with occlusion and atropine therapy over a 2-year period. Case 3 was a 4-year-old girl diagnosed with unilateral PPCD. The girl had a 30-month history of corrective spectacle use and had no amblyopia. In all cases, the corneal endothelial cell count was lower in the affected eye than in the unaffected contralateral eye. Conclusions: Practitioners should closely monitor patients with unilateral PPCD for astigmatic anisometropia and amblyopia development. Visual prognosis for patients with unilateral PPCD may be related to lesion position, age at diagnosis, astigmatism severity, and early-childhood corrective spectacle use.

scholarly journals Mixed cortico-medullary adrenal carcinoma in children: looks are deceptive!!

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Arti Khatri ◽  
Nidhi Mahajan ◽  
Niyaz Ahmed Khan ◽  
Natasha Gupta
Keyword(s):  
Past History ◽  
Case Reports ◽  
Final Diagnosis ◽  
Adrenal Carcinoma ◽  
Case Presentation ◽  
First Case ◽  
Contrast Enhanced ◽  
Paediatric Age ◽  
History Of ◽  
Enhanced Computed Tomography

Abstract Background Mixed cortico-medullary adrenal carcinoma (MCMAC) is an extremely rare entity with scarce literature on its cytomorphology. Case presentation A 2-year-old girl presented with abdominal pain for 3 days and a past history of fever with significant weight loss. On examination, a non-tender left hypochondrial firm mass and an enlarged left supraclavicular node were found. Twenty-four-hour urinary levels of VMA were marginally high. Contrast-enhanced computed tomography of the abdomen showed a suprarenal heterogeneous mass encasing major vessels. Aspiration cytology of both mass and node showed similar features comprising a predominant population of singly scattered large cells with moderate cytoplasm, eccentric nucleus and prominent nucleolus in a necrotic background. Tumour cells expressed Synaptophysin and Melan-A. In view of increasing respiratory distress, debulking surgery was performed, and histopathology of the specimen revealed the presence of both malignant medullary and cortical components supported by immunohistochemistry making a final diagnosis of MCMAC. The patient succumbed to death in the postoperative period. The cytology slides were reviewed and were seen to show a dual cell population. Conclusion Coexistent malignant cortical and medullary tumour of the adrenal gland is the first case reported in the paediatric age group in the literature with only three previous case reports in adults.

scholarly journals Primary Malignant Melanoma of the Urinary Bladder

2011 ◽  
Vol 2011 ◽  
pp. 1-2 ◽  
Author(s):  
Jalal Eddine El Ammari ◽  
Youness Ahallal ◽  
Mohammed Jamal El Fassi ◽  
Moulay Hassan Farih
Keyword(s):  
Malignant Melanoma ◽  
Urinary Bladder ◽  
Male Patient ◽  
Metastatic Disease ◽  
Transurethral Resection ◽  
Bladder Tumor ◽  
Case Reports ◽  
Primary Melanoma ◽  
Case Presentation ◽  
History Of

Introduction. Primary melanoma of the urinary bladder is very rare. As far as we know, 19 cases have been reported worldwide, usually as case reports.Case Presentation. We present a 71-year-old male patient presented with a 2-month history of hematuria. Ultrasonography revealed a 5-cm-size mass located in the bladder trigone. A transurethral resection of the bladder tumor (TURBT) revealed a malignant melanoma. Evaluation for metastatic disease was negative. The patient deceased five months later before radical treatment could be performed.Conclusion. This is one more reported case of primary melanoma of the urinary bladder. The previously reported cases of bladder melanoma are reviewed. Therapy and prognosis are discussed.

scholarly journals Resolution of Right Hemidiaphragm Paralysis following Cervical Foraminotomies

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Neal Singleton ◽  
Matthew Bowman ◽  
David Bartle
Keyword(s):  
Medical Condition ◽  
Case Reports ◽  
Asbestos Exposure ◽  
Previous History ◽  
Foraminal Stenosis ◽  
Phrenic Nerve Palsy ◽  
Case Presentation ◽  
Cervical Spine Surgery ◽  
History Of ◽  
Hemidiaphragm Paralysis

Introduction. Hemidiaphragm paralysis secondary to phrenic nerve palsy is a well-recognised medical condition. There are few case reports in the literature documenting resolution of hemidiaphragm paralysis following cervical spine surgery. This case report documents our experience with one such case. Case Presentation. A 64-year-old man was referred to the orthopaedic service with right hemidiaphragm paralysis. He had a previous history of asbestos exposure and polio and was initially seen and investigated by the respiratory physicians. He also reported intermittent neck pain and an MRI scan showed right-sided cervical foraminal stenosis. He underwent posterior right C3/4 and C4/5 foraminotomies, and by three months postoperatively, his hemidiaphragm paralysis had resolved and his shortness of breath had also improved. Conclusion. This report documents a unique case of resolution of hemidiaphragm paralysis following posterior unilateral cervical foraminotomies.

scholarly journals Fatal course of idiopathic chronic ulcerative enteritis with panenteritis and perforation: a case report and review of literature

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Chang-Yeon Jung ◽  
Jung-Min Bae
Keyword(s):  
Small Bowel ◽  
Case Reports ◽  
Abdominal Distension ◽  
Multiple Organ ◽  
Case Presentation ◽  
Entire Small Bowel ◽  
Free Air ◽  
Fatal Course ◽  
History Of ◽  
Transmural Inflammation

Abstract Background Idiopathic chronic ulcerative enteritis (ICUE) is a very rare disease with high mortality. Because of clinical rarity, several small case reports have been published and there is a lack of large sample study. Preoperative definite diagnosis is difficult. Although definite treatment for ICUE is radical surgical resection, surgical decision in operative field is difficult. Case presentation A 77-year-old man came to the emergency department with complaints of a 1-day history of abdominal pain and abdominal distension. Abdominal computed tomography revealed ileus and focal free air. Laparotomy revealed multiple small bowel tiny perforations in the ileum. The serosa surface in the whole small bowel had small multiple yellowish tiny discolored lesions. Despite the presence of multiple mucosal ulcers in entire small bowel, the ileum including perforation site was resected segmentally. Microscopically, mucosal ulcers in resected small bowel demonstrated transmural inflammation, no granuloma, and no lymphoid aggregates. These features were consistent with a diagnosis of ICUE with panenteritis and perforation. After surgery, the patient’s general condition gradually aggravated. Unfortunately, the patient died of multiple organ failure on post-operative day 14. Conclusion Surgically, the decision including resection range, anastomosis or enterotomy becomes difficult in ICUE with panenteritis. According to recent 40 year’s revised data, the post-operative mortality of ICUE is about 53.4%. Although ICUE is rare, its recognition is important for appropriate diagnosis and treatment. Retrospective multicenter case studies are required to determine proper treatment and improve prognosis.

scholarly journals A rare presentation of Austrian syndrome with septic arthritis in an immunocompetent female

2019 ◽  
Vol 71 (1) ◽  
Author(s):  
Ayman Battisha ◽  
Bader Madoukh ◽  
Ahmed Altibi ◽  
Omar Sheikh
Keyword(s):  
Septic Arthritis ◽  
Case Reports ◽  
Chronic Alcoholism ◽  
Immunocompetent Patient ◽  
Rare Presentation ◽  
Case Presentation ◽  
First Case ◽  
Viral Influenza ◽  
History Of ◽  
High Index Of Suspicion

Abstract Background Austrian syndrome, which is also known as Osler’s triad, is a rare aggressive pathology consisting of pneumonia, endocarditis, and meningitis caused by Streptococcus pneumoniae and carries drastic complications. Case presentation A case of a 68-year-old female with a past medical history of hypertension and had a recent viral influenza is presented. She developed bacterial pneumonia, endocarditis with mitral and aortic vegetations and perforation, meningitis, and right sternoclavicular septic arthritis. Two prior case reports have described sternoclavicular septic arthritis as part of Austrian syndrome. Our case is the third case; however, it is the first case to have this tetrad in an immunocompetent patient with no risk factors, i.e., males, chronic alcoholism, immunosuppression, and splenectomy. Conclusions Clinicians should maintain a high index of suspicion for the possibility of sternoclavicular joint septic arthritis as a complication of Austrian syndrome in immunocompetent patients.

scholarly journals Pretibial myxedema in a euthyroid patient: a case report

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Rediet Ambachew ◽  
Tizita Yosef ◽  
Aklilu M. Gebremariam ◽  
Lishan Demere ◽  
Theodros Aberra ◽  
...  
Keyword(s):  
Case Reports ◽  
Skin Lesions ◽  
Thyroid Function Tests ◽  
Thyroid Disorder ◽  
Rare Presentation ◽  
Case Presentation ◽  
Normal Thyroid Function ◽  
History Of ◽  
Euthyroid Patient ◽  
Pretibial Myxedema

Abstract Background Pretibial myxedema also known as localized myxedema, thyroid dermopathy, or infiltrative dermopathy and rarely as localized mucinosis is an infrequent manifestation of Graves’ disease. It can appear before, during, or after the thyrotoxic state. Euthyroid pretibial myxedema is a rare presentation with few case reports in the literature. This case highlights the importance of considering pretibial myxedema when characteristic skin lesions are observed in a euthyroid patient. Case presentation A 72-year old male Ethiopian patient with a very rare presentation of biopsy-proven pretibial myxedema in a euthyroid state without history of thyroid disease and absence of thyroid autoimmune markers. Resolution of skin lesion was achieved after topical corticosteroid application. Conclusion Absence of history of thyroid disorder and normal thyroid function tests should not exclude the diagnosis of pretibial myxedema.

scholarly journals Halo Nevi Are Not Trivial: About 2 Young Patients of Regressed Primary Melanoma That Simulates Halo Nevi

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
S. De Schrijver ◽  
I. Theate ◽  
O. Vanhooteghem
Keyword(s):  
Literature Search ◽  
Case Reports ◽  
Young Patients ◽  
Primary Melanoma ◽  
Rare Condition ◽  
Warning Signs ◽  
Spontaneous Bleeding ◽  
Case Presentation ◽  
Detailed History ◽  
History Of

Background. Halo nevi are often considered benign, and the possibility of malignancy is not always clear to practitioners. We present two case reports suggesting that a halo nevus appearance can be seen in melanoma, even in young adults. A literature search for halo nevi revealing melanoma shows that this is a very rare condition. Case presentation. This report of two young patients indicates the importance of obtaining a detailed history to detect warning signs such as itching, pain, spontaneous bleeding, and previous alterations according to the patient, including a previously totally black colour in an already fully regressed melanoma. Conclusions. The risk of a halo nevus being malignant is higher if there is only one unique halo nevus and no personal or familial history of vitiligo. We postulate that a regressing atypical nevus or a regressing melanoma may be induced by an immunologic reaction as halo nevus type of clinical picture.

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