scholarly journals Anti-LGI1 Antibody Encephalitis Mimicking Jumping Stump Syndrome

2020 ◽  
Vol 38 (1) ◽  
pp. 46-49
Author(s):  
Min-Hee Woo ◽  
Jung-Won Choi ◽  
Darda Chung ◽  
Jung-Won Shin
Keyword(s):  
Movement Disorder ◽  
Cognitive Dysfunction ◽  
Peripheral Nerves ◽  
Involuntary Movement ◽  
History Of

Jumping stump syndrome is considered to be a peripherally induced movement disorder due to damage to peripheral nerves leading to dystonia or myoclonus. Anti-leucine-rich glioma-inactivated 1 antibody (anti-LGI 1 Ab) encephalitis is clinically characterized with progressive cognitive dysfunction and seizure including facial brachial dystonic seizure. We report a case of a woman with a history of intractable involuntary movement on amputated forearm diagnosed as anti-LGI 1 Ab encephalitis, mimicking symptoms of jumping stump syndrome.

scholarly journals P.059 Brachial plexus enhancement in acute flaccid myelitis: A novel radiographic finding

2019 ◽  
Vol 46 (s1) ◽  
pp. S30
Author(s):  
SC Hammond ◽  
M Almomen ◽  
A Mineyko ◽  
A Pauranik
Keyword(s):  
Spinal Cord ◽  
Peripheral Nerves ◽  
Grey Matter ◽  
Pediatric Patients ◽  
Radiographic Finding ◽  
Mri Imaging ◽  
Full Spectrum ◽  
Acute Flaccid Myelitis ◽  
History Of ◽  
The Brain

Background: Acute flaccid myelitis (AFM) is a condition which causes acute paralysis in pediatric patients. Although awareness of AFM is increasing, the pathophysiology and full spectrum of clinical, biochemical, and radiographic features remain to be fully elucidated. Methods: We report a 5 year-old, previously healthy, male patient who presented with acute right upper extremity weakness following a two day history of fever, cough, and fatigue. The patient underwent extensive inflammatory and infectious workup in addition to MRI imaging of the brain, spinal cord, and bilateral brachial plexuses. Results: Infectious and inflammatory workup did not identify a causative agent. The patient was seen to have bilateral asymmetric (R>L) thickening and enhancement of the anterior horn cells of his cervical (C3-C7) spine, consistent with the spinal grey matter lesions previously described in patients with AFM. Enhancement of the corresponding anterior nerve rootlets and bilateral brachial plexuses was also seen. Conclusions: Patients with acute flaccid myelitis may demonstrate grey matter enhancement extending beyond the spinal cord to the peripheral nerves and plexuses, a radiographic finding which has not previously been published.

Heterotopic Ossification of Peripheral Nerve (“Neuritis Ossificans”): Report of Two Cases

Neurosurgery ◽  
2002 ◽  
Vol 51 (1) ◽  
pp. 244-246 ◽  
Author(s):  
David H. George ◽  
Bernd W. Scheithauer ◽  
Robert J. Spinner ◽  
Ueli Buchler ◽  
Timothy E. Cronin ◽  
...  
Keyword(s):  
Heterotopic Ossification ◽  
Peripheral Nerves ◽  
Clinical Presentation ◽  
Myositis Ossificans ◽  
Tibial Nerve ◽  
Nerve Sparing ◽  
Experienced Pain ◽  
Local Trauma ◽  
History Of ◽  
Bone Deposition

Abstract OBJECTIVE AND IMPORTANCE Heterotopic ossification (“neuritis ossificans”) is among the least frequently encountered reactive lesions in peripheral nerves. Only two cases have been described previously, one in the median nerve of a 34-year-old man, and the other in the ulnar nerve of an adult woman. The architecture of this lesion is distinctly zonal. Consisting of a central fibroblastic core, an intervening zone of osteoid production, and a peripheral layer of ossification, the pattern is remarkably similar to that of myositis ossificans. This similarity and the occurrence of the process in superficial nerves have led to speculation that trauma plays a role in its pathogenesis; this hypothesis remains unproved. We describe two additional cases of neuritis ossificans. CLINICAL PRESENTATION One patient, a 41-year-old man, experienced pain and numbness in the left leg for several months but had no history of local trauma. A mass was detected in the saphenous nerve. The second patient, a 16-year-old boy, noted subacute onset of pain in the popliteal fossa and decreased sensation in the distribution of the lateral sural cutaneous nerve. A mass was found within the tibial nerve at the knee level. INTERVENTION In each patient, resection of the mass required sacrifice of a segment of the nerve. CONCLUSION In each patient, the mass was composed of fibrovascular tissue with osteoid and bone deposition arranged in a zonal pattern. The ossifying process was intraneural but encased rather than directly involving nerve fascicles. These exceptionally intact examples of neuritis ossificans underscore its resemblance to myositis ossificans. Nerve-sparing resection of such masses is not always possible.

scholarly journals LO57: Validation of the Ottawa 3DY in community seniors in the ED

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S47 ◽  
Author(s):  
C. Bédard ◽  
P. Voyer ◽  
D. Eagles ◽  
V. Boucher ◽  
M. Pelletier ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Dysfunction ◽  
Mental Status ◽  
Medical Condition ◽  
Previous History ◽  
Altered Mental Status ◽  
Initial Interview ◽  
Nursing Facility ◽  
Trained Research Assistant ◽  
History Of

Introduction: Cognitive dysfunction is getting more common in geriatric emergency department (ED) patients, as the number of seniors visiting our EDs is increasing. ED guidelines recommend a systematic mental status screening for seniors presenting to the ED. As the existing tools are not suitable for the busy ED environment, we need quicker and easier ways to assess altered mental status, such as the O3DY. The purpose of this study is to assess the effectiveness of the French version of the O3DY to screen for cognitive dysfunction in seniors presenting to the ED. Methods: This is a planned sub-study of the INDEED project, which was conducted between February and May 2016 in 4 hospitals across the province of Québec. Inclusion criteria were: patients aged ≥65, with an 8-hour ED stay, admitted on a care unit, independent or semi-independent in their activities of daily living. Exclusion criteria were: patient living in a long-term nursing facility, with an unstable medical condition, pre-existing psychiatric condition or severe dementia, a delirium within the 8-hour exposure to the ED. A trained research assistant collected the following data upon initial interview: socio-demographic information, cognitive assessment (TICS-m), functional assessment (OARS) and delirium screening (CAM). The O3DY was also administered at initial interview and during patient follow-ups, as well as the CAM. Results: This study population was composed of 305 participants, of which 47.7% were men. Mean age was 76 years old (SD: 10.8). Nine of these participants had a previous history of dementia. 151 of these participants (47,04%) had a negative O3DY and 154 (47,98%) a positive O3DY at the initial encounter. When compared to the CAM, the O3DY presents a sensitivity of 85.0% (95% CI [62.1, 96.8]) and a specificity of 57.7% (95% CI [51.8, 63.6]) for prevalent delirium. When compared to the TICS, the O3DY presents a sensitivity of 76.7% (95% CI [66.4, 85.2]) and a specificity of 68.1% (95% CI [61.3, 74.3]) for cognitive impairment. The combined measure presents a sensitivity of 76.7% (95% CI [66.6, 84.9]) and a specificity of 68.4% (95% CI [61.7, 74.5]). Conclusion: A negative result to the O3DY indicates the absence of prevalent delirium or undetected cognitive impairment. The O3DY could be a useful tool for the triage nurses in the ED.

scholarly journals Westphal Variant of Huntington's Disease

2017 ◽  
Vol 17 (01) ◽  
pp. 028-030
Author(s):  
L. Cabarcas-Castro ◽  
J. Ramón-Gómez ◽  
A. Zarante-Bahamón ◽  
O. Bernal-Pacheco ◽  
E. Espinosa-García ◽  
...  
Keyword(s):  
Family History ◽  
Huntington's Disease ◽  
Movement Disorder ◽  
Huntington’S Disease ◽  
Neurodegenerative Disorder ◽  
Cag Repeats ◽  
Molecular Evidence ◽  
Exon 1 ◽  
History Of

AbstractA Westphal variant of Huntington's disease (HD) is an infrequent presentation of this inherited neurodegenerative disorder. Here, we describe a 14-year-old girl who developed symptoms at the age of 7, with molecular evidence of abnormally expanded Cytosine-Adenine-Guanine (CAG) repeats in exon 1 of the Huntingtin gene. We briefly review the classical features of this variant highlighting the importance of suspecting HD in a child with parkinsonism and a family history of movement disorder or dementia.

Assessment of Tardive Dyskinesia in Psychiatric Outpatients Using a Standardized Rating Scale

1981 ◽  
Vol 15 (1) ◽  
pp. 33-37 ◽  
Author(s):  
J. M. Rey ◽  
G. E. Hunt ◽  
G. F. S. Johnson
Keyword(s):  
Tardive Dyskinesia ◽  
Neurological Disorders ◽  
Rating Scale ◽  
Involuntary Movement ◽  
Antidepressant Medication ◽  
Tricyclic Antidepressant ◽  
Neuroleptic Treatment ◽  
Psychiatric Outpatients ◽  
History Of ◽  
Australian Sample

Psychiatric outpatients were assessed for dyskinetic movements using the abnormal involuntary movement scale (AIMS). The prevalance of tardive dyskinesia in an Australian sample of 66 patients was 44% which is similar to reported prevalence in other countries. Although the prevalence was significantly higher in patients over 45 years of age and with more than a 5 year history of neuroleptic medication, there were no significant correlations between presence of dyskinesias and age, sex or duration of neuroleptic treatment. Organic factors such as neurological disorders, ECT or alcoholism were not related to dyskinetic movements, nor was the use of anticholinergic or tricyclic antidepressant medication. The AIMS is a reliable rating scale for dyskinetic movements and could be used more widely as a screening instrument for early detection of tardive dyskinesia.

Cognitive Function in Patients with Multiple Sclerosis: Impairment and Treatment

2004 ◽  
Vol 6 (1) ◽  
pp. 9-22 ◽  
Author(s):  
Stephen M. Rao
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Cognitive Dysfunction ◽  
Disease Duration ◽  
Cognitive Domains ◽  
Neuropsychological Dysfunction ◽  
Visuospatial Abilities ◽  
Assessment And Treatment ◽  
Neurologic Disability ◽  
History Of

Cognitive impairment is common in multiple sclerosis (MS), with up to 65% of patients exhibiting some type of neuropsychological dysfunction. The cognitive domains most affected by MS are learning and memory, attention, information processing, visuospatial abilities, and executive functioning. It is difficult to detect cognitive dysfunction in patients with MS during routine neurologic examinations because conventional measures of neurologic disability are not sensitive enough to detect cognitive impairment. Furthermore, cognitive dysfunction is only weakly correlated with the type of MS, disease duration, or physical disability. However, brain imaging studies show that a relatively strong correlation exists between cognitive dysfunction and overall lesion burden and brain atrophy in MS. This paper reviews the natural history of cognitive dysfunction, areas of cognition affected, the correlation between MRI measures and cognitive dysfunction, issues related to neuropsychological assessment, and treatment of cognitive impairment with disease-modifying MS drugs.

A Brief History of Local Anesthesia

2016 ◽  
Vol 7 (1) ◽  
pp. 29-32 ◽  
Author(s):  
John Nathan ◽  
Lynda Asadourian ◽  
Mark A Erlich
Keyword(s):  
Local Anesthesia ◽  
Peripheral Nerves ◽  
Pain Control ◽  
Cold Water ◽  
Herbal Remedies ◽  
Stimulant Effect ◽  
Local Pain ◽  
Hypodermic Syringe ◽  
History Of ◽  
Head Neck

ABSTRACT Mankind has, throughout its existence, been engaged in the quest to control the pain associated with disease and trauma. Evidence from over 4500 years ago demonstrates the Egyptians use of methods to compress peripheral nerves. Homer's Iliad relates the use of herbal remedies for pain control. Other early writings describe the use of electricity generated by the Torpedo ray for pain control as well as cold water and ice for pain reduction. These techniques, in their various incarnations, comprised the main armamentarium of local pain control until the early 1800's when the early framework for the hypodermic syringe emerged in America. Cocaine, noted for its stimulant effect as well as numbing properties, was first brought to Europe by Vespucci. The combination of a workable syringe and the purification of Cocaine by Niemann essentially gave birth to modern local anesthesia. Halsted would perform the first injections of cocaine via hypodermic syringe into a proximal nerve for distal pain control, introducing modern conduction local anesthesia. All that remained was the introduction of numerous blockers of nerve depolarization, combined with vasoconstrictors, to minimize systemic toxicity, and we arrive at the modern state of local anesthesia. How to cite this article Nathan J, Asadourian L, Erlich MA. A Brief History of Local Anesthesia. Int J Head Neck Surg 2016; 7(1):29-32.

Sign in / Sign up

Export Citation Format

Share Document