Clinical case of a vasovagal syncope

Syncope is defined as a transient loss of consciousness due to cerebral hypoperfusion, characterized by a rapid onset, short duration, and spontaneous complete recovery of all vital functions without signs of neurological deficits. Syncope is a multidisciplinary medical problem common in clinical practice. As a rule, syncope occurs due to cardiovascular dysfunction of organic or functional origin, which either develops spontaneously or is induced by a trigger. Due to a various etiology differential diagnosis and prognostic evaluation is difficult. This clinical case demonstrates the features of differential diagnosis of vasovagal syncope in a patient with polymorbid pathology and the features of the choice of an adequate management, including recommendations for lifestyle modifications, specialized education regarding prodromal symptoms recognition methods and timely application of countermeasures.

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Evaluation and Management of Syncope

Clinical Scholars Review ◽

10.1891/1939-2095.2.2.65 ◽

2009 ◽

Vol 2 (2) ◽

pp. 65-77 ◽

Cited By ~ 4

Author(s):

Joanne L. Thanavaro

Keyword(s):

Risk Stratification ◽

Specific Treatment ◽

Complete Recovery ◽

Medical Problem ◽

Cerebral Hypoperfusion ◽

Loss Of Consciousness ◽

Life Threatening ◽

Transient Loss ◽

Life Threatening Event ◽

Postural Tone

Syncope is a transient loss of consciousness precipitated by cerebral hypoperfusion, which is associated with a brief absence of postural tone and usually followed by a complete recovery. This clinical condition is a common medical problem and may be attributed to a multitude of disease processes. Risk stratification identifies the safest setting for the initial evaluation as well as which patients are most likely to have a life-threatening event. Establishing the diagnosis of syncope is important so that specific treatment can be instituted to prevent future recurrences and eliminate the underlying predisposing disease. This article reviews the etiology, risk stratification, diagnosis, and therapeutic management of syncope.

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Delayed onset of Lhermitte's sign following head and/or neck injuries

Journal of Neurosurgery ◽

10.3171/jns.1984.60.3.0609 ◽

1984 ◽

Vol 60 (3) ◽

pp. 609-612 ◽

Cited By ~ 8

Author(s):

Richard C. Chan ◽

Paul Steinbok

Keyword(s):

Differential Diagnosis ◽

Full Range ◽

Complete Recovery ◽

Neurological Deficits ◽

Neck Injuries ◽

Neck Trauma ◽

Range Of Movement ◽

Content Type ◽

Delayed Onset ◽

Fine Print

✓ The authors report four patients who suffered the delayed onset of Lhermitte's sign following head and/or neck trauma with no significant neurological deficits. The average onset from the time of the injury was 2½ months. In all patients, there was a full range of movement of the cervical spine with no tenderness and no neurological deficits. Myelography was performed in three of the four patients and was normal. The duration of Lhermitte's sign ranged from 4 months to 1 year (mean 8 months). Complete recovery occurred in all cases. The pathogenesis, differential diagnosis, and management of patients with Lhermitte's sign are discussed.

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Clinical case: Complicated differential diagnosis between postsurgical and functional hypoparathyroidism.

Endocrine Abstracts ◽

10.1530/endoabs.70.ep74 ◽

2020 ◽

Author(s):

Elena Kovaleva ◽

Anna Eremkina ◽

Julia Krupinova ◽

Natalia Mokrysheva

Keyword(s):

Differential Diagnosis ◽

Clinical Case

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Hypoglycemic Hemiparesis Masquerading As Ischemic Stroke: When Guideline Fails

Current Drug Therapy ◽

10.2174/1574885515666191227155624 ◽

2020 ◽

Vol 15 (4) ◽

pp. 420-422

Author(s):

Dhruvkumar M. Patel ◽

Mukundkumar V. Patel ◽

Jayanti K. Gurumukhani ◽

Maitri M. Patel ◽

Himal J. Mahadevia ◽

...

Keyword(s):

Ischemic Stroke ◽

Thrombolytic Therapy ◽

Neurological Deficit ◽

Clinical Case ◽

Complete Recovery ◽

Acute Onset ◽

Diabetic Patients ◽

Focal Neurological Deficit ◽

Random Blood Sugar ◽

Resident Doctor

Background: Hypoglycemia may rarely present as hemiparesis and sometimes it is difficult to differentiate from ischemic stroke. When random blood sugar (RBS) value is between 50 and 80 mg % in patients presenting with focal neurological deficit, no guideline exists to consider the possibility of hypoglycemia before initiating thrombolytic therapy. Clinical Case: A 58-year-old male, who was a known case of diabetes and hypertension, was brought to the emergency room with acute onset of right hemiparesis and dysarthria of 90 minutes duration. His NIHSS Score was 9, blood pressure was 150/90 mm of Hg and RBS was 79 mg% on admission. His CT scan brain was normal and was considered for thrombolysis. Resident doctor not aware of previous sugar repeated RBS before thrombolysis which was surprisingly 60 mg% 60 minutes after the first RBS. Even though he was a candidate for thrombolysis, intravenous 25 % dextrose was administered considering the possibility of hypoglycemia. He made a complete recovery within 20 minutes and thrombolytic therapy was withheld. : In Diabetic patients with focal neurological deficit and RBS less than 80 mg% on admission, RBS should be rechecked and in appropriate cases should be challenged with IV dextrose considering the possibility of hypoglycemia before commencing thrombolytic therapy.

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Acute Disseminated Encephalomyelitis (ADEM): A Demyelinating Disease with Specific Morphological Features

International Journal of Surgical Pathology ◽

10.1177/1066896921993562 ◽

2021 ◽

pp. 106689692199356

Author(s):

Fleur Cordier ◽

Lars Velthof ◽

David Creytens ◽

Jo Van Dorpe

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Differential Diagnosis ◽

Clinical Case ◽

Demyelinating Disease ◽

Acute Disseminated Encephalomyelitis ◽

Demyelinating Diseases ◽

Demyelinating Disorder ◽

Immune Mediated ◽

The Central Nervous System

Acute disseminated encephalomyelitis (ADEM) is a rare immune-mediated inflammatory and demyelinating disorder of the central nervous system. Its characteristic perivenular demyelination and inflammation aid in the differential diagnosis with other inflammatory demyelinating diseases. Here, we present a clinical case of ADEM, summarize its histological hallmarks, and discuss pitfalls concerning the most important neuropathological differential diagnoses.

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Congenital optic disc coloboma

Russian ophthalmology of children ◽

10.25276/2307-6658-2021-1-33-39 ◽

2021 ◽

pp. 33-39

Author(s):

A.O. Nazarenko ◽

◽

E.E. Sidorenko ◽

D.V. Miguel ◽

A.S. Smartsev ◽

...

Keyword(s):

Differential Diagnosis ◽

Optic Nerve ◽

Clinical Picture ◽

Clinical Case ◽

Charge Syndrome ◽

Diagnostic Methods ◽

Newly Diagnosed ◽

Optic Nerve Atrophy ◽

Optic Disc Coloboma ◽

Optic Nerve Coloboma

A clinical case of observation of a 3-year-old child with a newly diagnosed optic nerve coloboma and multiple malformations is considered. The clinical picture and diagnostic methods necessary for the diagnosis are reflected. On the example of this child, the differential diagnosis with Charge syndrome is considered. Key words: coloboma, optic nerve coloboma, partial optic nerve atrophy, astigmatism, Charge syndrome.

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Clinical case of recurrent vomiting in a child: diagnostic search from functional gastrointestinal disorders to piloid astrocytoma

Practical medicine ◽

10.32000/2072-1757-2021-1-78-81 ◽

2021 ◽

Vol 19 (1) ◽

pp. 78-81

Author(s):

E. N. Voronina ◽

◽

D. V. Pechkurov ◽

A. A. Tyazheva ◽

E. V. Kozarez ◽

...

Keyword(s):

Differential Diagnosis ◽

Nutritional Status ◽

Clinical Case ◽

Anxiety Symptom ◽

Functional Gastrointestinal Disorders ◽

Integrated Approach ◽

Gastrointestinal Disorders ◽

Wide Range ◽

High Prevalence ◽

Recurrent Vomiting

The urgency of the problem of recurrent vomiting in children is due not only to the high prevalence of this syndrome, but also to a wide range of reasons for its development. The article presents a clinical case of observation of a child with recurrent vomiting syndrome. It shows the dynamics of the disease, the importance of identifying such «anxiety symptom» as the nutritional status violation. In this case, the cause of vomiting of central genesis was not immediately taken into account, although differential diagnosis presupposes an integrated approach, and doctors' oncological alertness should be constantly preserved even in pediatrics.

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Acute Bilateral Blindness in the Setting of Sudden Onset of Bilateral Proptosis and Ophthalmoplegia: A Case Report With Literature Review

Neurology Clinical Practice ◽

10.1212/cpj.0000000000001090 ◽

2021 ◽

pp. 10.1212/CPJ.0000000000001090

Author(s):

sara zarei ◽

Phuong Vo ◽

Christian Sam ◽

Robert W Crow ◽

Charles Stout ◽

...

Keyword(s):

Differential Diagnosis ◽

Visual Pathway ◽

Rapid Onset ◽

Sudden Onset ◽

Acute Onset ◽

Posterior Chamber ◽

Ischemic Optic Neuropathy ◽

Radiographic Findings ◽

Underlying Pathophysiology ◽

Eye Retina

ABSTRACTPurposeof review: Acute bilateral blindness has an extensive differential diagnosis that requires a careful history and physical exam to narrow down. In this paper we discuss the pathophysiology and radiographic findings of each possible diagnosis for acute bilateral blindness.Recent findings:Visual pathology with respect to bilateral blindness can be broadly broken down into three anatomic categories: media (i.e. the anterior and posterior chamber of the eye), retina, and neural visual pathway. Possible causes of rapid onset bilateral blindness include bilateral occipital infarcts, endogenous bacterial endophthalmitis, orbital cellulitis, orbital compartment syndrome, cavernous sinus thrombophlebitis, thyroid disease and bilateral non-arteritic ischemic optic neuropathy.Summary:In this case we present a patient with acute onset of bilateral blindness, in addition to bilateral ophthalmoplegia, proptosis, and orbital chemosis. We believe this rare case of acute bilateral blindness is thought provoking and aids in the understanding of the differential diagnosis and underlying pathophysiology of visual loss.

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