scholarly journals MOG antibody-associated encephalitis secondary to Covid-19: case report

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ervin Durovic ◽  
Corinna Bien ◽  
Christian G. Bien ◽  
Stefan Isenmann
Keyword(s):  
Clinical Presentation ◽  
Neuropsychological Testing ◽  
Brain Mri ◽  
Unique Case ◽  
Case Presentation ◽  
Csf Analysis ◽  
Atypical Clinical Presentation ◽  
Executive Deficits ◽  
Mog Antibodies ◽  
Persistent Headache

Abstract Background While Covid-19 predominantly affects the respiratory system, neurological manifestations including encephalitis occur in some patients, possibly affecting the course and outcome of the disease. Here, we describe a unique case of a young man with Covid-19 and transient MOG-positive encephalitis, with a benign course. Case presentation A 22-year-old male, with PCR confirmed Covid-19 infection was admitted because of persistent headache. The clinical examination was normal. Neuropsychological testing revealed distinct executive deficits. Brain MRI and cerebrospinal fluid (CSF) analysis were suggestive for encephalitis. Further laboratory examination revealed a serum MOG antibody titre. The headache improved with analgetic treatment and i.v. methylprednisolone. Consequently, the MOG antibody titer decreased and MRI lesions were resolving. The patient made a full recovery, with no signs of deterioration over the following months. Conclusions Covid-19 manifestations in the CNS include encephalitis with variable course and prognosis. This case highlights a possible association between inflammation due to COVID-19 and transient secondary autoimmunity with transient MOG antibodies and atypical clinical presentation.

A well-appearing infant with a sudden anisocoria

2020 ◽  
pp. edpract-2020-319993
Author(s):  
Alessia Giuseppina Servidio ◽  
Francesca Peri ◽  
Andrew Tenore ◽  
Laura Cesca ◽  
Laura Diplotti ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Brain Mri ◽  
Vital Signs ◽  
Sudden Onset ◽  
List Type ◽  
Case Presentation ◽  
Third Nerve Palsy ◽  
Age Limits ◽  
Unilateral Mydriasis ◽  
A Minor

Case presentationA 10-month-old boy was admitted to the emergency department due to a sudden onset of left unilateral mydriasis (figure 1). His medical history was unremarkable. A minor head trauma 2 days before was reported, without alarming signs or symptoms. His mother was putting him to sleep, after coming back from work, when she noticed a different pupil size and promptly went to the ED with her husband. The parents denied any use of medications, including nebulised therapy or direct contact with plants. The child was well appearing and his vital signs were within the standard age limits. His extraocular motility was normal as well as the rest of his neurological and physical examination. Parents’ behaviour was somehow remarkable. Even though the child was not suffering, the mother seemed very worried while the father was nervous and aggressive, repeatedly asking for a discharge.Figure 1Left unilateral mydriasis.­QuestionsWhat is the most likely diagnosis based on this clinical presentation?Local contact with a mydriatic substanceIntracerebral haemorrhageBrain tumourThird nerve palsyWhat would be the next step in the investigation to confirm this diagnosis?Brain CTBrain MRIFundus oculi examinationToxicological screening of urineHow is this condition managed, and what is the prognosis?Answers can be found on page XX

scholarly journals A Case of Trapezium Avascular Necrosis Treated Conservatively

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Evangelos Petsatodis ◽  
Konstantinos Ditsios ◽  
Panagiotis Konstantinou ◽  
Iosafat Pinto ◽  
Lazaros Kostretzis ◽  
...  
Keyword(s):  
Avascular Necrosis ◽  
Clinical Presentation ◽  
Wrist Joint ◽  
Early Stage ◽  
Proximal Pole ◽  
Mri Scan ◽  
Unique Case ◽  
Avascular Osteonecrosis ◽  
Case Presentation ◽  
History Of

Introduction. Avascular necrosis (AVN) of the bones of the wrist most commonly involves the lunate followed by the proximal pole of the scaphoid and the capitate. Trapezium avascular necrosis is extremely rare with only two cases reported in the literature, both of which were treated surgically. In this article, we report a unique case of trapezium avascular necrosis treated conservatively. Case Presentation. A 38-year-old man complaining of a 4-month history of mild pain on the base of his right thumb. MRI scan was performed. The clinical presentation and the imaging findings indicated avascular osteonecrosis of the trapezium. The patient was treated with immobilization of the wrist joint for a period of six weeks. Three months later, the patient was free of symptoms and the MRI scan revealed a normal trapezium. Conclusion. AVN of trapezium is extremely rare. Our case shows that immobilization of an early stage avascular necrosis of the trapezium might be a treatment option.

scholarly journals Atypical Clinical Presentation of Laryngopharyngeal Reflux: A 5-Year Case Series

2021 ◽  
Vol 10 (11) ◽  
pp. 2439
Author(s):  
Jerome R. Lechien ◽  
Stéphane Hans ◽  
Francois Bobin ◽  
Christian Calvo-Henriquez ◽  
Sven Saussez ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Laryngopharyngeal Reflux ◽  
Case Series ◽  
Clinical Findings ◽  
Aerodigestive Tract ◽  
Common Disease ◽  
Upper Aerodigestive Tract ◽  
Suppurative Otitis Media ◽  
Adequate Treatment ◽  
Atypical Clinical Presentation

Background: Laryngopharyngeal reflux (LPR) is a common disease in otolaryngology characterized by an inflammatory reaction of the mucosa of the upper aerodigestive tract caused by digestive refluxate enzymes. LPR has been identified as the etiological or favoring factor of laryngeal, oral, sinonasal, or otological diseases. In this case series, we reported the atypical clinical presentation of LPR in patients presenting in our clinic with reflux. Methods: A retrospective medical chart review of 351 patients with LPR treated in the European Reflux Clinic in Brussels, Poitiers and Paris was performed. In order to be included, patients had to report an atypical clinical presentation of LPR, consisting of symptoms or findings that are not described in the reflux symptom score and reflux sign assessment. The LPR diagnosis was confirmed with a 24 h hypopharyngeal-esophageal impedance pH study, and patients were treated with a combination of diet, proton pump inhibitors, and alginates. The atypical symptoms or findings had to be resolved from pre- to posttreatment. Results: From 2017 to 2021, 21 patients with atypical LPR were treated in our center. The clinical presentation consisted of recurrent aphthosis or burning mouth (N = 9), recurrent burps and abdominal disorders (N = 2), posterior nasal obstruction (N = 2), recurrent acute suppurative otitis media (N = 2), severe vocal fold dysplasia (N = 2), and recurrent acute rhinopharyngitis (N = 1), tearing (N = 1), aspirations (N = 1), or tracheobronchitis (N = 1). Abnormal upper aerodigestive tract reflux events were identified in all of these patients. Atypical clinical findings resolved and did not recur after an adequate antireflux treatment. Conclusion: LPR may present with various clinical presentations, including mouth, eye, tracheobronchial, nasal, or laryngeal findings, which may all regress with adequate treatment. Future studies are needed to better specify the relationship between LPR and these atypical findings through analyses identifying gastroduodenal enzymes in the inflamed tissue.

Blindness paving the path to the diagnosis of metastatic prostate carcinoma: A unique case presentation

2021 ◽  
pp. 205141582110537
Author(s):  
Aadhar Jain ◽  
Anveshi Nayan ◽  
Sujata Patwardhan
Keyword(s):  
Vision Loss ◽  
Specific Antigen ◽  
Primary Source ◽  
Metastatic Lesion ◽  
Unique Case ◽  
Case Presentation ◽  
Intracranial Metastases ◽  
Appropriate Therapy ◽  
Brain Involvement ◽  
Metastatic Prostate Carcinoma

Background: Intracranial metastases from prostate adenocarcinoma are very unusual and typically occur late in the course of the disease, and initial presentation with symptomatic brain involvement, especially vision loss is very rare (with this being only the sixth such reported case to the best of our knowledge). The present case elucidates how a diagnosis was reached in such a scenario and the management provided. Case presentation: A 66-year-old gentleman presented with loss of vision and headache with no other ocular or neurological complaint. Computed tomography (CT) of his head revealed a destructive lesion involving the clivus and a space-occupying lesion (SOL) in occipito-parietal region. Detailed inquiry regarding the possible primary source of suspected the metastatic lesion revealed an increased frequency of urination, nocturia, and significant weight loss. His serum prostate-specific antigen (PSA) levels were raised. He was treated by surgical hormonal therapy and his visual symptoms improved. Conclusion: Awareness of such a presentation can lead to an accurate diagnosis. Initiation of appropriate therapy can successfully alleviate the neurologic deficits.

Apraxia screening predicts Alzheimer pathology in frontotemporal dementia

2018 ◽  
Vol 90 (5) ◽  
pp. 562-569 ◽  
Author(s):  
Matthias Pawlowski ◽  
Viktoria Joksch ◽  
Heinz Wiendl ◽  
Sven G Meuth ◽  
Thomas Duning ◽  
...  
Keyword(s):  
Frontotemporal Dementia ◽  
Clinical Presentation ◽  
Neuropsychological Testing ◽  
High Sensitivity ◽  
Clinical Syndrome ◽  
Test Results ◽  
Discriminative Power ◽  
Bedside Test ◽  
Neurodegenerative Dementias ◽  
Alzheimer Pathology

ObjectivesFrontotemporal dementia (FTD) is a heterogeneous clinical syndrome linked to diverse types of underlying neuropathology. Diagnosis is mainly based on clinical presentation and accurate prediction of underlying neuropathology remains difficult.MethodsWe present a large cohort of patients with FTD spectrum diseases (n=84). All patients were thoroughly characterised by cerebrospinal fluid (CSF) Alzheimer’s disease (AD) biomarkers, neuroimaging, neuropsychological testing and standardised apraxia screening.ResultsA potential AD pathology was found in 43% of patients with FTD. CSF AD biomarker levels positively correlated with AD-typical apraxia scores in patients with FTD. The discriminative power of apraxia test results indicative of AD pathology was high (sensitivity: 90%, specificity: 66%).ConclusionsApraxia is common in neurodegenerative dementias but under-represented in clinical workup and diagnostic criteria. Standardised apraxia screening may serve as bedside test to objectify an AD-typical apraxia profile as an early and robust sign of AD pathology in patients with FTD.

Keratosis lichenoides chronica with an atypical clinical presentation and variable histopathological features

2016 ◽  
Vol 14 (11) ◽  
pp. 1136-1139 ◽  
Author(s):  
Alessia Barisani ◽  
Francesco Savoia ◽  
Paola Sgubbi ◽  
Massimino Negosanti ◽  
Salvatore Domenico Infusino ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Histopathological Features ◽  
Atypical Clinical Presentation

scholarly journals Perforated Meckel’s Diverticulitis in a Patient with Unknown Intestinal Malrotation: Clinical Pitfall

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Marie Burgard ◽  
Floryn Cherbanyk ◽  
François Pugin ◽  
Bernhard Egger
Keyword(s):  
Acute Appendicitis ◽  
Clinical Presentation ◽  
Final Diagnosis ◽  
Intestinal Malrotation ◽  
Radiological Imaging ◽  
Atypical Clinical Presentation ◽  
Lower Abdominal Quadrant ◽  
Meckel’S Diverticulitis ◽  
The Right ◽  
Abdominal Quadrant

Symptomatic Meckel’s diverticulum is rare in adults. The most frequent complications are intestinal obstruction and diverticulitis. Diagnosis of Meckel’s diverticulitis can be challenging due to nonspecific clinical manifestation of pain in the right lower abdominal quadrant, mimicking acute appendicitis. If associated with congenital malformation, such as intestinal malrotation, the anomalous anatomy makes the diagnosis even more challenging. In such cases, radiological imaging is essential to guide further management. We present a case of Meckel’s diverticulitis in which physicians were initially misguided because of the atypical clinical presentation. Yet, anamnestic details directed to a potential underlying malformation, leading to supplementary radiological examination and the final diagnosis.

scholarly journals Malakoplakia in a colonic tubular adenoma: a unique case presentation

2018 ◽  
Vol 67 (6) ◽  
pp. 365-369
Author(s):  
Akash Gupta ◽  
Abdalla Saad Abdalla Al-Zawi ◽  
Asghar Naqvi ◽  
Samih Salama ◽  
Salem Alawami ◽  
...  
Keyword(s):  
Tubular Adenoma ◽  
Unique Case ◽  
Case Presentation
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