scholarly journals Short-Lasting Unilateral Neuralgiform Headache Attacks with Conjunctival Injection and Tearing (SUNCT) Status Like Condition: A Rare Case Report and Review of the Literature.

2020 ◽  
Vol 14 (1) ◽  
pp. 75-79
Author(s):  
Jayanti K Gurumukhani ◽  
Dhruvkumar M. Patel ◽  
Mukundkumar V. Patel ◽  
Maitri M. Patel ◽  
Anand V Patel ◽  
...  
Keyword(s):  
Case Report ◽  
High Dose ◽  
Temporal Region ◽  
Conjunctival Injection ◽  
High Dose Methylprednisolone ◽  
Rare Case Report ◽  
History Of ◽  
Laboratory Investigations ◽  
Trigeminal Autonomic Cephalgia ◽  
Potassium Replacement

Background: SUNCT (short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing) is rare trigeminal autonomic cephalgia characterized by recurrent, brief, excruciating unilateral, intermittent headache paroxysms over orbital, frontal or temporal region occurring multiple times per day and it can rarely present as “SUNCTstatus like condition” (SSLC). Case Report: A 28-year old male with a history of SUNCT headache for 6 months presented with left forehead stabs lasting for 30 seconds with a frequency of 40-45 episodes per hour for three days followed by infective gastroenteritis. His neurological examination was normal, except left-sided ptosis, tearing, and conjunctival injection. His MRI brain with contrast, MR angiography, and laboratory investigations were unremarkable except mild hypokalemia. He was treated with intravenous fluids, potassium replacement, and high dose methylprednisolone along with an escalated dose of carbamazepine. Review and Conclusion: We have reviewed the previously reported seven cases and our case of SSLC. Female: Male ratio was 3:1and the mean age was 40.87 years. Three patients responded to high dose steroids and three to lignocaine along with rapid escalation or change of anticonvulsant drugs. One case responded to the high dose of lamotrigine, and in a pregnant lady, the pain subsided only after the termination of the pregnancy. One case was secondary to multiple sclerosis, while the rest of seven were primary episodic SSLC. The condition is highly disabling, and the treatment with steroids or lignocaine, along with the rapid escalation of preventive drugs, can provide long-lasting relief

scholarly journals Short-Lasting Unilateral Neuralgiform Headache Attacks with Conjunctival Injection and Tearing (SUNCT) Status Like Condition: A Rare Case Report and Review of the Literature.

2020 ◽  
Vol 14 (1) ◽  
pp. 74-78
Author(s):  
Jayanti K Gurumukhani ◽  
Dhruvkumar M. Patel ◽  
Mukundkumar V. Patel ◽  
Maitri M. Patel ◽  
Anand V Patel ◽  
...  
Keyword(s):  
Case Report ◽  
High Dose ◽  
Temporal Region ◽  
Conjunctival Injection ◽  
High Dose Methylprednisolone ◽  
Rare Case Report ◽  
History Of ◽  
Laboratory Investigations ◽  
Trigeminal Autonomic Cephalgia ◽  
Potassium Replacement

Background: SUNCT (short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing) is rare trigeminal autonomic cephalgia characterized by recurrent, brief, excruciating unilateral, intermittent headache paroxysms over orbital, frontal or temporal region occurring multiple times per day and it can rarely present as “SUNCTstatus like condition” (SSLC). Case Report: A 28-year old male with a history of SUNCT headache for 6 months presented with left forehead stabs lasting for 30 seconds with a frequency of 40-45 episodes per hour for three days followed by infective gastroenteritis. His neurological examination was normal, except left-sided ptosis, tearing, and conjunctival injection. His MRI brain with contrast, MR angiography, and laboratory investigations were unremarkable except mild hypokalemia. He was treated with intravenous fluids, potassium replacement, and high dose methylprednisolone along with an escalated dose of carbamazepine. Review and Conclusion: We have reviewed the previously reported seven cases and our case of SSLC. Female: Male ratio was 3:1and the mean age was 40.87 years. Three patients responded to high dose steroids and three to lignocaine along with rapid escalation or change of anticonvulsant drugs. One case responded to the high dose of lamotrigine, and in a pregnant lady, the pain subsided only after the termination of the pregnancy. One case was secondary to multiple sclerosis, while the rest of seven were primary episodic SSLC. The condition is highly disabling, and the treatment with steroids or lignocaine, along with the rapid escalation of preventive drugs, can provide long-lasting relief

scholarly journals Case Report. Extracorporeal Membrane Oxygenation in Nivolumab Associated Pneumonitis

2017 ◽  
Vol 3 (2) ◽  
pp. 84-88
Author(s):  
Thomas-Michael Schneider ◽  
Friederike Klenner ◽  
Franz Brettner
Keyword(s):  
Case Report ◽  
Extracorporeal Membrane Oxygenation ◽  
Therapeutic Option ◽  
High Dose ◽  
Great Success ◽  
Case Presentation ◽  
Computed Tomographic ◽  
Rehabilitation Hospital ◽  
Membrane Oxygenation ◽  
History Of

Abstract Background: Newly approved immunotherapeutic agents, like CTLA-4 inhibitors and antibodies against PD-1, are a promising therapeutic option in cancer therapy. Case presentation: A 74-year-old man, with a history of advanced stage melanoma and treatment with ipilimumab, pembrolizumab and nivolumab, was admitted to the hospital due to respiratory failure with hypoxemia and dyspnoea. He rapidly developed severe acute respiratory distress syndrome (ARDS), which required treatment in the intensive care unit which included mechanical ventilation and extracorporeal membrane oxygenation (ECMO). Computed tomographic imaging (CT) showed signs of a pneumonitis, with an ARDS pattern related to the use of PD-1 antibodies. Treating the patient with high-dose immunosuppressive steroids led to an overall improvement. He was transferred to a rehabilitation hospital and subsequently to his home. Discussion and conclusion: This is a unique case report of a patient suffering a grade 4 adverse event under nivolumab who survived having been treated with ECMO. It highlights the possibility of associated adverse reactions as well as the use of ECMO in palliative care patients. ECMO can be of great success even in patients with malignancies, but careful decision making should be done on a case by case basis.

scholarly journals Non-painful severe variant form of eruptive lingual papillitis: A case report and literature review

2021 ◽  
Vol 13 (2) ◽  
Author(s):  
Manal Ahmed Halwani
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Literature Review ◽  
Oral Hygiene ◽  
Rare Case ◽  
Dorsal Surface ◽  
Variant Form ◽  
Girl Child ◽  
Rare Case Report ◽  
History Of

Eruptive lingual papillitis is a common benign disorder manifested by inflammation of fungiform papillae on the dorsolateral surface of the tongue. Several variants of lingual papillitis have been reported since 1997, most or all of them with painful erythematous papules. Here we report a case of 6 years old girl child with non-painful severe variant form of eruptive lingual papillitis presented to the emergency department. The entire dorsal surface of the tongue was surfaced by 2-3mm by multiple erythematous papules and some with a white or yellowish colour. The papules were excessively inflamed, pigmented, aggregated, and crusted. The cause was idiopathic which resolved within ten days. The parent and patient were reassured with advice to practice oral hygiene. This is a rare case report describing non-painful lingual papillitis without a history of any prior episodes.

scholarly journals A ruptured cornual pregnancy successfully managed in a patient with a history of oophorectomy and salpingectomy: A rare case report

2021 ◽  
Vol 9 (10) ◽  
Author(s):  
Marah Mansour ◽  
Amr Hamza ◽  
AlHomam AlMarzook ◽  
Ilda moafak kanbour ◽  
Tamim Alsuliman ◽  
...  
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Cornual Pregnancy ◽  
Rare Case Report ◽  
History Of

The fatal cholera like diarrhoea in coronavirus disease 2019(COVID-19)- a rare case report in toddler

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1894-1897
Author(s):  
Varsha Gajbhiye ◽  
Shubhangi Patil (Ganvir) ◽  
Sarika Gaikwad
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Digestive System ◽  
Gastrointestinal Symptoms ◽  
Female Child ◽  
Multiple Organ ◽  
Mild Case ◽  
Severe Dehydration ◽  
Rare Case Report ◽  
History Of

A 14-month female child came with complain of cholera like watery loose stool 10-12 times and vomiting 6-7 times, 24 hrs before admission. She was in severe dehydration, hypotension, unconscious with no recorded fever during her stay in hospital and no history of contact with COVID-19. Patient was COVID-19 positive Dehydration and hypotension was corrected, metabolic acidosis continued and eventually patient succumb due to multiple organ failure. This case report should arouse us to suspect COVID infection in every acute Gastroenteritis child who may not have any common symptoms as seen in COVID patient, also who have no history of significant contact with COVID positive patient in family. Some people with COVID-19 develop gastrointestinal symptoms either alone or with respiratory symptoms. Recently, researchers at Stanford University found that a third of patients they studied with a mild case of COVID-19 had symptoms affecting the digestive system. Another recent study Trusted Source published by researchers in Beijing found that anywhere from 3 to 79 percent of people with COVID-19 develop gastrointestinal symptoms.

Rare case of perforated appendicitis presenting as persistent perineal discharge following laparoscopic abdominoperinal excision of rectum (APER)

2021 ◽  
Vol 14 (1) ◽  
pp. e236312
Author(s):  
Tanmoy Mukherjee ◽  
Shantata Jayant Kudchadkar ◽  
Jayesh Sagar ◽  
Shashank Gurjar
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Perforated Appendicitis ◽  
Perineal Wound ◽  
Abdominoperineal Excision ◽  
Major Surgery ◽  
Salvage Procedure ◽  
Uncommon Presentation ◽  
Rare Case Report ◽  
History Of

Abdominoperineal excision of rectum (APER) is one of the widely used surgical procedures to treat low rectal cancer, benign conditions like Crohn’s proctitis with anal involvement and as a salvage procedure for anal cancer. Perineal wound infection is a well-recognised complication following such major surgery. Occurrence of appendicitis in a few weeks’ time following such a major surgery is uncommon. However, here we present a rare case report of perforated appendicitis presenting as persistent perineal discharge in an elderly man, following laparoscopic APER for a low rectal tumour. To our knowledge, this is the first time such a rare clinical presentation of appendicitis is reported in the history of medical literature. Through this case report, we aim to highlight the importance of considering such an uncommon presentation in patients with perineal discharge, following APER.

Encephalopathy With Alternating Hemispheric MRI Abnormalities

2021 ◽  
pp. 181-183
Author(s):  
Andrew McKeon
Keyword(s):  
Genetic Testing ◽  
Oral Prednisone ◽  
Autoimmune Encephalitis ◽  
High Dose ◽  
Temporal Region ◽  
Sharp Waves ◽  
Signal Abnormality ◽  
History Of ◽  
Fluctuating Course ◽  
Short Time

A 21-year-old woman with a long-standing history of migraine sought care at her local provider for a 1-week history of confusion and mixing up her words. She then had a witnessed seizure, with dyscognitive features and secondary generalization. On hospitalization, electroencephalography demonstrated left temporal theta slowing and sharp waves. Magnetic resonance imaging showed patchy T2-signal abnormality, nonenhancing, in the left temporal region (only a report was available). Thyroid peroxidase antibodies were increased at 271 IU/mL. A diagnosis of an autoimmune encephalopathy was made, and the patient was treated with phenytoin, levetiracetam, and high-dose corticosteroids, followed by a slow oral prednisone taper. The patient improved cognitively but had considerable emotional lability and an increase in headache frequency and severity and, thus, sought a second opinion. Blood was drawn for genetic testing. The patient died in her sleep a short time later, most likely in the context of sudden unexplained death in epilepsy. Her genetic testing results became available 1 month later, which showed findings consistent with MELAS syndrome: heteroplasmic sequence variation m.3243A>G (tRNA Leu) and homoplasmic rare variant m.2294A>G (16S rRNA). Encephalopathy or encephalitis of subacute onset with fluctuating course is not unique to autoimmune encephalitis. Common acquired metabolic disorders must be considered and excluded in all cases, such as deficiencies of vitamin B12 and folate, hypothyroidism, sepsis, and central nervous system–active medications.

Bizarre extensive erythematous plaques on the abdomen

2018 ◽  
Vol 49 (1) ◽  
pp. 39-42
Author(s):  
Sidharth Tandon ◽  
Surabhi Sinha ◽  
Jasmeet Singh
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Rare Case Report ◽  
History Of ◽  
Erythematous Plaques

We present a rare case report of a 28-year-old man with a five-month history of bizarre extensive erythematous plaques on the abdomen extending in a dermatomal fashion to the left upper back.

25 Cerebellar cognitive affective syndrome – a case report of diagnosis and management using selective serotonin and norepinephrine reuptake inhibitors

2020 ◽  
Vol 91 (8) ◽  
pp. e18.1-e18
Author(s):  
B Sridharan ◽  
YW Liao
Keyword(s):  
Case Report ◽  
Emotional Regulation ◽  
Complex Disease ◽  
Functional Independence ◽  
Selective Serotonin ◽  
High Dose ◽  
Cerebellar Cognitive Affective Syndrome ◽  
History Of ◽  
Cerebellar Haemangioblastoma ◽  
Norepinephrine Reuptake

Objectives/aimsThe objective of this case is to describe and report on a case of Cerebellar Cognitive Affective Syndrome (CCAS) which improved after the use of high dose venlafaxine therapy. To our knowledge, there are only a few case reports discussing on the effectiveness of various drug therapies in CCAS patients and none had reported on the use of Selective Serotonin and Norepinephrine Reuptake Inhibitors (SNRI).MethodsWe describe a 55-year-old male with a history of partially excised grade 1 left cerebellar haemangioblastoma in 2005 followed by Gamma Knife in 2006.Unfortunately, he suffered a recurrence in 2018 requiring embolisation of the haemangioblastoma followed with surgery to resect the tumour. He presented to our specialist neuropsychiatric unit following episodes of new acute unprovoked behavioural changes after surgery. During these episodes, he would become verbally abusive, refuse to engage in any rehab activity, refuse any oral intake, become sexually disinhibited, and experience distressing hallucinations. On the neuropsychiatric ward, he continued to have episodes of severe emotional regulation difficulties. There were no obvious triggers identified and it was noted that the peaks and troughs in his behaviour lasted for a few days before self-resolving and did not follow any particular pattern. In between these episodes, the patient was pleasant, engaging in physiotherapy, and conversed normally with staff.ResultsHe scored a total of 4 out of 10 on the CCAS-scale. A diagnosis of CCAS was concluded given the extensive history of cerebellar injury, nature of presenting complain, and his CCAS-scale score. He was started on high dose SNRI (Venlafaxine XL 150 mg BD). On repeating the CCAS-scale after being on SNRI for 4 months, his score was worse at 6 out of 10. However, we observed a decrease in the frequency, duration, and severity of behavioural change after commencement of SNRI. He benefited greatly from physiotherapy on the ward however despite our best efforts functional independence was not regained. He had to be transferred with the aid of 2 members of staff and mobilises with the aid of an electronic wheelchair.ConclusionsCCAS is a complex disease and the management is yet to be agreed on by the neuropsychiatry community. Our case report illustrated the therapeutic benefit of venlafaxine in the treatment of severe emotional regulation difficulties associated with resection of a cerebellar haemangioblastoma. Furthermore, patients with cerebellar injuries should be managed in a multi-disciplinary manner with input from neurology, neuropsychiatry, neuropsychology, occupational therapist, and physiotherapist.

scholarly journals High Dose Methylprednisolone: Effective in Pregnancy Associated Post-splenectomy Refractory Chronic Immune Thrombocytopenic Purpura

2014 ◽  
Vol 9 (1) ◽  
pp. 64-66
Author(s):  
A Singh ◽  
A Solanki
Keyword(s):  
Past History ◽  
Oral Steroid ◽  
High Dose ◽  
Third Trimester ◽  
Thrombocytopenic Purpura ◽  
Platelet Counts ◽  
Male Baby ◽  
High Dose Methylprednisolone ◽  
History Of ◽  
Acute Crisis

We present a case of 23 years multigravid woman (G2P0+1) with chronic idiopathic thrombocytopenic purpura (ITP), refractory to treatment in forms of oral steroid, dapsone, azathioprine and splenectomy. She presented to the hospital in third trimester of pregnancy, with reduced platelet counts and purpuric rashes over abdomen and both upper extremeties. There was a past history of spontaneous abortion at 18 weeks. The patient responded to intravenous high dose methylprednisolone (HDMP) infusion leading to delivery of full term male baby. The baby also required treatment for thrombocytopenia with intravenous immunoglobulin (IVIG). This case lays down the importance of HDMP in form of using it effectively in managing acute crisis of low platelet counts in pregnant patients with ITP refractory to splenectomy. DOI: http://dx.doi.org/10.3126/njog.v9i1.11192 NJOG 2014 Jan-Jun; 2(1):64-66

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