scholarly journals Parkinsonism and dysautonomia with anti-CV2/CRMP5 associated paraneoplastic neurological syndromes mimicking multiple system atrophy: a case report

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jia Song ◽  
Ying Zhang ◽  
Yue Lang ◽  
Yi-Heng Wang ◽  
Jie Shao ◽  
...  

Abstract Background Paraneoplastic neurological syndromes (PNSs) are broad-spectrum disorders that can affect any part of the nervous system varying in core symptoms. Onconeural antibodies, including Hu, Yo, Ri, anti-CV2, amphiphysin, Ma2, and Tr are well-characterized and commonly used for the diagnosis of definite PNS. Generally, anti-CV2 antibodies have usually been associated with cerebellar ataxia, chorea, peripheral and autonomic neuropathies, myelopathy, optic neuritis, and retinitis. However, Parkinsonism has not been reported as the core symptom in patients with anti-CV2 antibodies. Case presentation We report a patient with anti-CV2 antibody manifested as Parkinsonism and autonomic dysfunction, which may lead to the diagnosis of multiple system atrophy with predominant Parkinsonism (MSA-P). A lumbar puncture examination was undergone to find a positive anti-CV2 antibody in cerebrospinal fluid. PET-CT showed no tumor. Immunotherapy was adopted and the symptoms were relieved for 5 months. However, with no evidence of tumor, he died after 8 months. Conclusions Our findings indicate that PNS with anti-CV2 antibody can be shown as MSA-P mimic. Considering that MSA is a neurodegenerative disease with a poor prognosis, screening for other treatable or controllable factors like PNS presented in this case is necessary when encountering a rapid progressive MSA-mimic patient.

2020 ◽  
Author(s):  
Jason He ◽  
Ericka Wodka ◽  
Mark Tommerdahl ◽  
Richard Edden ◽  
Mark Mikkelsen ◽  
...  

Alterations of tactile processing have long been identified in autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorder (ADHD). However, the extent to which these alterations are disorder-specific, rather than disorder-general, and how they relate to the core symptoms of each disorder, remains unclear. We measured and compared tactile detection, discrimination and order judgment thresholds between a large sample of children with ASD, ADHD, ASD + ADHD combined and typically developing controls. The pattern of results suggested that while difficulties with tactile detection and order judgement were more common in children with ADHD, difficulties with tactile discrimination were more common in children with ASD. Strikingly, subsequent correlation analyses found that the disorder-specific alterations suggested by the group comparisons were also exclusively related to the core symptoms of each respective disorder. These results suggest that disorder-specific alterations of lower-level sensory processes exist and are specifically related to higher-level clinical symptoms of each disorder.


2020 ◽  
Author(s):  
yulin Shi ◽  
Xiaojuan Hu ◽  
Cui Ji ◽  
Longtao Cui ◽  
Jingbin Huang ◽  
...  

Abstract BackgroundFatigue is a kind of non-specific symptom, which is widely found in sub-health and various diseases. It is closely related to people's physical and mental health.Due to lack of objective evidence, it is often neglected in clinical diagnosis,especially in the early stage of disease.A large number of clinical practices and studies have shown that tongue and pulse image are reflection of overall state of the body.Establishing an objective evaluation method for diagnosis of disease fatigue and non-disease fatigue by combining clinical symptom and index and tongue and pulse data is of great significance for timely and effective clinical treatment.MethodsIn this study, 2362 physical examination subjects were divided into healthy control, the group of sub-health fatigue and disease fatigue ,used complex network technology to screen out the core symptoms and western medicine indexes of fatigue,respectively. Constructed the core symptom network and the core symptom-index network. At the same time, used canonical correlation analysis to get the associated relationship of tongue and pulse, and analyzed the characteristic of the tongue and pulse data.ResultsThere were some similarities between the core symptoms of sub-health fatigue and disease fatigue,as well as differences. Symptom-index associated analysis of disease fatigue showed that the core indexes in the group of disease fatigue group had a significant canonical correlation, with the canonical correlation coefficient was 0.42 (P < 0.05). There was no statistically significant correlation between the tongue and pulse data in sub-health fatigue group.ConclusionsThe complex network technology was suitable for the correlation analysis of symptoms and indexes in the fatigue population, and the tongue and pulse objective data had certain diagnostic contribution to the classification of fatigue population.Name of the registry: Chinese Clinical Trial RegistryTrial registration number: ChiCTR-IOR-15006502; ChiCTR1900026008Date of registration: Jun. 04th, 2015URL of trial registry record:http://www.chictr.org.cn/showprojen.aspx?proj=11119;http://www.chictr.org.cn/edit.aspx?pid=38828&htm=4 (This is a retrospective registration)


1988 ◽  
Vol 3 (1_suppl) ◽  
pp. S48-S56 ◽  
Author(s):  
Doris A. Allen

It is well recognized that children with "autistic features" constitute a very heterogeneous population. There is a growing consensus that the core symptoms seen in autism include deficits in: (1) social/affective/behavioral functions, (2) developmental language disorders with concomitant deficits in interpersonal communication, and (3) play/preferred activities/ preoccupations which have a repetitive or stereotypic quality. The definition of the boundaries of "autism" as opposed to other related pervasive developmental disorders is widely debated among clinicians and research investigators alike. In the present paper, it is argued that autism is a cover term for a spectrum disorder with similarities and differences in the clinical presentation of preschool children. A model for subtyping the autistic spectrum disorders is suggested. (J Child Neurol 1988;3(Suppl):S48-S56).


2004 ◽  
Vol 34 (8) ◽  
pp. 1561-1569 ◽  
Author(s):  
GÜNTHER KNOBLICH ◽  
FRANK STOTTMEISTER ◽  
TILO KIRCHER

Background. The present study investigated whether a failure of self-monitoring contributes to core syndromes of schizophrenia.Method. Three groups of patients with a DSM-IV diagnosis of schizophrenia (n=27), with either prominent paranoid hallucinatory or disorganization syndrome, or without these symptoms, and a matched healthy control group (n=23) drew circles on a writing pad connected to a PC monitor. Subjects were instructed to continuously monitor the relationship between their hand movements and their visual consequences. They were asked to detect gain changes in the mapping. Self-monitoring ability and the ability to automatically correct movements were assessed.Results. Patients with either paranoid-hallucinatory syndrome or formal thought disorder were selectively impaired in their ability to detect a mismatch between a self-generated movement and its consequences, but not impaired in their ability to automatically compensate for the gain change.Conclusions. These results support the claim that a failure of self-monitoring may underlie the core symptoms of schizophrenia.


2016 ◽  
Vol 24 (1) ◽  
pp. 52-65 ◽  
Author(s):  
Hervé Caci ◽  
David Cohen ◽  
Olivier Bonnot ◽  
Bernard Kabuth ◽  
Jean-Phillipe Raynaud ◽  
...  

Objective: The objective of this study is to retrospectively describe the pathway toward ADHD diagnosis and treatment, and identify potential areas for improvement. Method: Parent-reported questionnaires were collected by a national sample of ADHD specialists. Results: In total, 473 complete questionnaires were analyzed. Initial onset of ADHD symptoms was reported at a mean age of 4.45 years. Mean age at diagnosis was 8.07 years, and half of the families had seen at least three health care professionals previously. Psychiatrists were most commonly consulted. A “combined” (89% boys) and inattentive (49% boys) profile was identified. Diagnosis was made 1 year later for the latter group. Two thirds of patients received pharmacological treatment. The delay in diagnosis was identified as the main source of concern for caregivers. Conclusion: The 4-year delay in diagnosis may represent a loss of opportunity. Training health care professionals in the core symptoms of ADHD may help reduce disparities and improve patient trajectory.


2021 ◽  
Vol 14 ◽  
pp. 175628642098532
Author(s):  
Michelle F. Devine ◽  
Naga Kothapalli ◽  
Mahmoud Elkhooly ◽  
Divyanshu Dubey

We provide an overview of the varied presentations of paraneoplastic neurological syndromes. We also review the onconeural antibodies and their particular oncological and neurological associations. Recognition of these syndromes and their oncological associations is crucial, as early diagnosis and management has been associated with better patient outcomes. Specific management strategies and prognosis vary widely depending on the underlying etiology. An understanding of the relevant clinical details, imaging findings, and other diagnostic information can help tailor treatment approaches. We provide an outline of the diagnostic evaluation and treatment of various paraneoplastic neurological disorders, presenting with central and/or peripheral nervous system involvement. We briefly discuss neurologic immune checkpoint inhibitor-related adverse events, which can occasionally present with paraneoplastic neurological syndrome phenotypes.


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