scholarly journals Super refractory seizures with autoimmune encephalitis and ventilator associated pneumonia: a case report

2021 ◽  
Vol 10 (3) ◽  
pp. 297
Author(s):  
A. Priya Shiva ◽  
Aswathy M. Shaji ◽  
Mohammed Fardan ◽  
K. Arun Chander Yadav
Keyword(s):  
Case Report ◽  
Early Recognition ◽  
Neuropsychiatric Symptoms ◽  
Autoimmune Encephalitis ◽  
Refractory Status Epilepticus ◽  
High Grade Fever ◽  
Altered Sensorium ◽  
Immune Mediated ◽  
Initiation Of Therapy

Autoimmune encephalitis is an immune-mediated syndrome with sub-acute to chronic presentations, such as memory impairment, altered sensorium, behavioral abnormality, psychosis, and seizures. Treatment as such must not be procrastinated due to pending laboratory workup, as early recognition and initiation of therapy prevents long term neurological sequelae. This is a case report of an 11-year-old male who presented with neuropsychiatric symptoms, altered sensorium and high-grade fever which evolved into refractory status epilepticus and autonomic dysfunction. While his MRI had positive findings of encephalitis, he tested negative for infectious diseases and antibody panels.  

Anti-GAD autoimmune encephalitis resembling long term chronic dissociative amnesia case report

2021 ◽  
Vol 429 ◽  
pp. 118814
Author(s):  
Wolfgang Trillo Alvarez ◽  
Joshua Medina Suárez ◽  
Claudio Ibañez Escalante ◽  
Joaquin Molina Acosta ◽  
Juan Valdivia Pino ◽  
...  
Keyword(s):  
Case Report ◽  
Autoimmune Encephalitis ◽  
Dissociative Amnesia

scholarly journals Rheumatoid arthritis onset after COVID-19 infection: a case report

2021 ◽  
Vol 9 (12) ◽  
pp. 3713
Author(s):  
Thafar S. A. Safar ◽  
Karmen B. Katay ◽  
Reem H. Khamis
Keyword(s):  
Rheumatoid Arthritis ◽  
Case Report ◽  
Pathological Condition ◽  
Primary Health Care Centre ◽  
Short Term ◽  
Health Care Centre ◽  
Immune Mediated ◽  
Small Hand ◽  
History Of

At the end of 2019, coronavirus disease (COVID-19) outbreak is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV2). Worldwide researchers and physician try to explore the mechanisms of damage induced by virus, they focus on the short-term and long-term immune-mediated consequences induced by the virus infection. Every day discover a new pathological condition induced by virus and new symptoms and disease may occur after recovery from disease. Our case report is 41 years old, Indian lady who presented to our primary health care centre complaining of multiple small hand joints pain, both elbows and knees pain with swelling of them and prolonged morning stiffness, diagnosed seropositive rheumatoid arthritis (RA) (arthritis, positive rheumatoid factor (RF), and X-ray changes) after 1 month recovery from COVID-19 infection. She did not have any joint pain and she had negative RF before COVID-19 infection with no family history of RA.

scholarly journals Local Anesthetic Systemic Toxicity following Peribulbar Block: A Case Report

2020 ◽  
Vol 3 (2) ◽  
pp. 67-68
Author(s):  
Abdul Nasser ◽  
Faheem Raja
Keyword(s):  
Case Report ◽  
Cataract Surgery ◽  
Local Anesthetic ◽  
Lipid Emulsion ◽  
Early Recognition ◽  
Systemic Toxicity ◽  
Peribulbar Block ◽  
Local Anesthetic Systemic Toxicity ◽  
Symptoms And Signs

ABSTRACT Cataract surgery is performed routinely under regional orbital blocks including retrobulbar and peribulbar blocks. Several complications have been reported while performing these blocks, the most significant of which is the local anesthetic systemic toxicity (LAST). The symptoms and signs present in a varied spectrum, but every such case requires early recognition and immediate resuscitation to avoid long-term morbidity and even death. Lipid emulsion therapy forms the mainstay of treatment. We present a case of a 49-year-old man who planned to undergo cataract surgery under the peribulbar block, who developed LAST and was successfully treated with 20% lipid emulsion without any adverse sequelae. How to cite this article Nasser A, Raja F. Local Anesthetic Systemic Toxicity following Peribulbar Block: A Case Report. J Med Acad 2020;3(2):67–68.

scholarly journals Multisystem Inflammatory Syndrome in Children and Adolescents Associated with COVID-19: Review

2020 ◽  
Vol 07 (04) ◽  
pp. 13-15 ◽  
Author(s):  
BS Mahapatra ◽  
Keyword(s):  
Early Recognition ◽  
Artery Aneurysm ◽  
Multidisciplinary Care ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Immune Mediated ◽  
Life Threatening ◽  
Adolescent And Young Adults ◽  
Inflammatory Syndrome

Multisystem Inflammatory Syndrome in Children (MIS-C) is a newly recognized multiorgan disease seen in children, adolescent and young adults presumed to be a delayed immune mediated complication of Corona virus 2 (SARS-CoV-2) infection leading to severe acute respiratory syndrome. MIS-C can be associated with life threatening organ dysfunction requiring complex multidisciplinary care. Early recognition is important in order to prevent complication and serious sequalae. Because it is a post infective complication, in most of the cases RT-PCR comes negative though antibodies to COVID-19 are positive. Although SARS-CoV-2 in children are generally mild and nonfatal, there is increasing evidence of MIS-C. Clinical and laboratory features of MIS-C are similar to those of Kawasaki disease like syndrome and Toxic Shock Syndrome. Pathophysiology of MIS-C is still unclear and mainly due to formation of autoantibody and immune complex which activates inflammation. Most of the MIS-C associated with COVID-19, need treatment with ionotropic agents and anticoagulants. The long-term outcome of MIS-C like coronary artery aneurysm formation remain unknown and needs close follow up.

scholarly journals Cephalic tetanus manifesting as isolated facial nerve palsy- a case report from rural Armenia

2021 ◽  
Vol 15 (11) ◽  
pp. 1770-1773
Author(s):  
Armen Kishmiryan ◽  
Jeevan Gautam ◽  
Deeksha Acharya ◽  
Bishnu Mohan Singh ◽  
Armen Ohanyan ◽  
...  
Keyword(s):  
Case Report ◽  
Facial Nerve ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Early Recognition ◽  
Cranial Nerves ◽  
Tetanus Antitoxin ◽  
The Face ◽  
Cephalic Tetanus ◽  
Initiation Of Therapy

Cephalic tetanus is a rare clinical form of tetanus, clinically characterized by trismus and cranial nerve palsy involving one or more cranial nerves, facial nerve being the most common. We report a case of cephalic tetanus with left-sided lower motor facial nerve palsy in a 66-year-old non-immunized patient after an untreated laceration injury. The patient had dysphagia, spasm of the muscles of mastication, asymmetry of the left side of the face, cough, shortness of breath, and stiffness of neck muscles. The presentation was unique given that the facial nerve palsy appeared prior to the occurrence of trismus, which misled the initial diagnosis towards Bell's palsy. He was successfully treated with tetanus antitoxin without any adverse events. Although widespread use of tetanus vaccine has led to a dramatic decline in this fatal disease, sporadic disease occurrence is still possible, particularly in individuals without up-to-date vaccinations. In this case report we illustrate the importance of early recognition of cephalic tetanus prior to the development of the full clinical picture. The early initiation of therapy is the key to recovery from this deadly disease. Physicians are encouraged to include cephalic tetanus as a cause of facial nerve palsy in their differential. In particular, paying attention to cases manifesting early after head or neck injury.

scholarly journals I can’t count, but I can beat you playing cards: a case report on autoimmune encephalitis

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Laura Mori ◽  
William Campanella ◽  
Lucilla Vestito ◽  
Lucio Marinelli ◽  
Luana Benedetti ◽  
...  
Keyword(s):  
Case Report ◽  
Young Patient ◽  
Autoimmune Encephalitis ◽  
Speech Disorders ◽  
Prolonged Treatment ◽  
Inflammatory Disorder ◽  
Neuropsychological Dysfunction ◽  
Nmdar Encephalitis ◽  
Wide Range

Abstract Background Autoimmune encephalitis (AE) is a rare inflammatory disorder characterized by important psychiatric and neurologic symptoms. The literature documents high rates of neuropsychological dysfunction in N-methyl D-aspartate-receptor (NMDAr) encephalitis but papers don’t consider specifically calculation disturbances between the long-term deficits, although deficits in executive control and episodic memory were less likely to resolve. Case report Here we present a severe case of NMDAr encephalitis in a young patient without a relevant past medical history. Upon first examination he presented psycho-motor slowdown, speech disorders, severe cognitive deficits in all areas: concentration, attention, memory, language, dual task functions, increased latency in responses, severe dyscalculia. Upon first evaluation, the young patient underwent a battery of neuropsychological tests and he showed a dysexecutive syndrome with performances significantly low for age and education. Our patient hence underwent 1 month of intensive cognitive rehabilitation. After the rehabilitation treatment, he presented an amelioration in all domains except calculations. Conclusions In our patient the calculation disorder has proved to be the most relevant problem and the most difficult to treat. Clinicians should consider a careful approach to determine the prognosis of this syndrome because of the wide range of deficits, the need of prolonged treatment and the rate of long-term sequelae.

scholarly journals Case of Severe Seronegative Autoimmune Rhombencephalitis Successfully Treated with Rituximab

2021 ◽  
Vol 16 (1) ◽  
pp. 31-33
Author(s):  
Farah Zarka ◽  
Tarik Slaoui ◽  
Jean-Paul Makhzoum
Keyword(s):  
Maintenance Dose ◽  
Neuropsychiatric Symptoms ◽  
Autoimmune Encephalitis ◽  
Neurological Deficits ◽  
First Line ◽  
Efficient Treatment ◽  
Neurological Sequelae ◽  
Noticeable Improvement

ABSTRACTPrompt treatment of autoimmune encephalitis can prevent long-term neurological sequelae. However, the data and evidence for the treatment of autoantibody negative encephalitis are limited, particularly so for rhombencephalitis. We report the case of a seronegative autoimmune rhombencephalitis successfully treated with rituximab.A 21-year-old woman was transferred to our center for progressive neuropsychiatric symptoms and neurological deficits progressing into a Locked-in state despite first-line immunotherapy with corticosteroids and immunoglobulins. She was started on a rituximab induction protocol with noticeable improvement within days. The patient then received a maintenance dose and during a follow-up after 9 months was still in remission, suggesting that rituximab can be an efficient treatment for severe refractory seronegative rhombencephalitis RÉSUMÉUn traitement rapide de l’encéphalite auto-immune peut prévenir les séquelles neurologiques à long terme. Cependant, les données et les preuves concernant le traitement de l’encéphalite séronégative sont limitées, en particulier pour la rhombencéphalite. Nous faisons état d’un cas de rhombencéphalite auto-immune séronégative traitée avec succès par le rituximab. Une femme de 21 ans a été transférée dans notre centre pour des symptômes neuropsychiatriques progressifs et des déficits neurologiques progressant vers un état de blocage malgré une immunothérapie de première intention avec des corticostéroïdes et des immunoglobulines. Un protocole d’induction au rituximab a été entrepris et on a constaté une amélioration notable en quelques jours. La patiente a ensuite reçu une dose d’entretien et, après neuf mois de suivi, elle était toujours en rémission, ce qui permet de penser que le rituximab peut s’avérer un traitement efficace pour les rhombencéphalites séronégatives réfractaires graves.

Isolated Dislocation of Fourth Carpometacarpal Joint: Case Report

2017 ◽  
Vol 22 (01) ◽  
pp. 118-121 ◽  
Author(s):  
K.P. Venkatesh ◽  
B. Sunil ◽  
N.V. Ankith ◽  
Anupama B.R.
Keyword(s):  
Case Report ◽  
Early Recognition ◽  
Lateral Radiograph ◽  
Carpometacarpal Joint ◽  
Long Term Outcomes ◽  
Anatomical Reduction ◽  
First Case ◽  
Precise Diagnosis

We present a case of dislocation of the fourth carpometacarpal joint without associated fractures. This is the first case to be reported in the literature. Carpal injuries are uncommon; it is even rare for isolated carpometacarpal dislocation to occur without associated fractures. The injury is difficult to diagnose because of the swelling of the hand and may be missed on several occasions. A lateral radiograph of the wrist has been found to be mandatory to its precise diagnosis if suspected. Early recognition and anatomical reduction are essential in achieving good long-term outcomes.

A critical analysis of helminth immunotherapy in multiple sclerosis

2020 ◽  
Vol 26 (12) ◽  
pp. 1448-1458 ◽  
Author(s):  
Marc Charabati ◽  
Sarah J Donkers ◽  
Megan C Kirkland ◽  
Lisa C Osborne
Keyword(s):  
Multiple Sclerosis ◽  
Helminth Infection ◽  
Inflammatory Diseases ◽  
Autoimmune Encephalitis ◽  
Mammalian Host ◽  
Industrialized Countries ◽  
Experimental Autoimmune Encephalitis ◽  
Immune Mediated ◽  
Experimental Autoimmune

Helminthic worms are ancestral members of the intestinal ecosystem that have been largely eradicated from the general population in industrialized countries. Immunomodulatory mechanisms induced by some helminths mediate a “truce” between the mammalian host and the colonizing worm, thus allowing for long-term persistence in the absence of immune-mediated collateral tissue damage. This concept and the geographic discrepancy between global burdens of chronic inflammatory diseases and helminth infection have sparked interest in the potential of using helminthic worms as a therapeutic intervention to limit the progression of autoimmune diseases such as multiple sclerosis (MS). Here, we present and evaluate the evidence for this hypothesis in the pre-clinical animal model of MS, experimental autoimmune encephalitis, in helminth-infected MS patients and in clinical trials of administered helminth immunotherapy (HIT).

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