A neurologist’s rhombencephalitis after comirnaty vaccination. A change of perspective

AbstractRhombencephalitis is an orphan disease of multiple causes that may manifest with facial palsy, limb ataxia and reduced consciousness. Up to now it is described after COVID-19 infection and in this (personal) case was found up to 8 weeks after Comirnaty vaccination. So far, we do not fully understand the pathophysiological characteristics of encephalitis associated with SARS-CoV-2. In rare cases, vaccination may cause an immunological reaction and delayed inflammation, the consequences of which we have not yet deciphered. Rhombencephalitis should be considered as a rare potential mRNA-associated vaccination side effect.

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Rhabdomyolysis in a Hospitalized 16-Year-Old Boy: A Rarely Reported Underlying Cause

Case Reports in Pediatrics ◽

10.1155/2016/7873813 ◽

2016 ◽

Vol 2016 ◽

pp. 1-2 ◽

Cited By ~ 4

Author(s):

Rishika Singh ◽

Dilip R. Patel ◽

Sherry Pejka

Keyword(s):

United States ◽

Acute Kidney Injury ◽

Side Effect ◽

Kidney Injury ◽

The United States ◽

Multiple Factors ◽

Case Diagnosis ◽

Multiple Causes

Rhabdomyolysis can occur because of multiple causes and account for 7% of all cases of acute kidney injury annually in the United States. Identification of specific cause can be difficult in many cases where multiple factors could potentially cause rhabdomyolysis. We present a case of 16-year-old male who had seizures and was given levetiracetam that resulted in rhabdomyolysis. This side effect has been rarely reported previously and like in our case diagnosis may be delayed.

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Facial Palsy As a Side Effect of Vemurafenib Treatment in Patients With Metastatic Melanoma

Journal of Clinical Oncology ◽

10.1200/jco.2012.45.7028 ◽

2013 ◽

Vol 31 (12) ◽

pp. e215-e217 ◽

Cited By ~ 24

Author(s):

Oliver Klein ◽

Antoni Ribas ◽

Bartosz Chmielowski ◽

Grant Walker ◽

Arthur Clements ◽

...

Keyword(s):

Metastatic Melanoma ◽

Facial Palsy ◽

Side Effect

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The Modified National Institutes of Health Stroke Scale: its Time has Come

International Journal of Stroke ◽

10.1111/j.1747-4949.2009.00294.x ◽

2009 ◽

Vol 4 (4) ◽

pp. 267-273 ◽

Cited By ~ 75

Author(s):

B. C. Meyer ◽

P. D. Lyden

Keyword(s):

Clinical Trials ◽

Foreign Language ◽

Facial Palsy ◽

National Institutes Of Health ◽

Poor Agreement ◽

Web Based ◽

Limb Ataxia ◽

Level Of Consciousness ◽

Diverse Groups ◽

The Ideal

The National Institutes of Health Stroke Scale (NIHSS) is a well known, reliable and valid stroke deficit scale. The NIHSS is simple, quick, and has shown significant reliability in diverse groups, settings, and languages. The NIHSS also contains items with poor reliability and redundancy. Recent investigations (include assessing a new training DVD, analyzing web-based or videotape certifications, and testing foreign language versions) have further detailed reliability issues. Items recurrently shown to have poor reliability include Level of Consciousness, Facial Palsy, Limb Ataxia, and Dysarthria. The modified NIHSS (mNIHSS) minimizes redundancy and eliminates poorly reliable items. The mNIHSS shows greater reliability in multiple settings and cohorts, including scores abstracted from records, when used via telemedicine, and when used in clinical trials. In a validation of the mNIHSS against the NIHSS, the number of elements with excellent agreement increased from 54% to 71%, while poor agreement decreased from 12% to 5%. Overall, 45% of NIHSS items had less than excellent reliability vs. only 29% for the mNIHSS. The mNIHSS is not the ideal stroke scale, but it is a significant improvement over the NIHSS. The mNIHSS has shown reliability at bedside, with record abstraction, with telemedicine, and in clinical trials. Since the mNIHSS is more reliable, it may allow for improved practitioner communication, improved medical care, and refinement of trial enrollments. The mNIHSS should now serve as the primary stroke clinical deficit scale for clinical and research aims. When it comes to the mNIHSS, its time has come!

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Ethical Challenges: Less About Moral Wrongdoing and More About Communication Breakdown

Perspectives on Gerontology ◽

10.1044/gero20.3.72 ◽

2015 ◽

Vol 20 (3) ◽

pp. 72-84 ◽

Cited By ~ 2

Author(s):

Paula Leslie ◽

Mary Casper

Keyword(s):

Ethical Challenges ◽

Speech Language Pathology ◽

Thickened Liquids ◽

Communication Breakdown ◽

Professional Duty ◽

Language Pathology ◽

The Law ◽

Personal Case

“My patient refuses thickened liquids, should I discharge them from my caseload?” A version of this question appears at least weekly on the American Speech-Language-Hearing Association's Community pages. People talk of respecting the patient's right to be non-compliant with speech-language pathology recommendations. We challenge use of the word “respect” and calling a patient “non-compliant” in the same sentence: does use of the latter term preclude the former? In this article we will share our reflections on why we are interested in these so called “ethical challenges” from a personal case level to what our professional duty requires of us. Our proposal is that the problems that we encounter are less to do with ethical or moral puzzles and usually due to inadequate communication. We will outline resources that clinicians may use to support their work from what seems to be a straightforward case to those that are mired in complexity. And we will tackle fears and facts regarding litigation and the law.

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