Late-onset mononeuritis multiplex: the importance of differential diagnosis

2020 ◽  
Vol 179 (10) ◽  
Author(s):  
Sofia F. Tavares ◽  
Vanessa M. Chaves ◽  
Verónica B. Guiomar ◽  
Pedro M. Rodrigues ◽  
Ana O. Monteiro ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Late Onset ◽  
Mononeuritis Multiplex

Late-onset schizophrenia

2020 ◽  
pp. 671-694
Author(s):  
Ellen E. Lee ◽  
Baichun Hou ◽  
Ipsit V. Vahia ◽  
Dilip V. Jeste
Keyword(s):  
Risk Factors ◽  
Differential Diagnosis ◽  
Life Events ◽  
Genetic Risk ◽  
Psychiatric Symptoms ◽  
Late Onset ◽  
Sociodemographic Factors ◽  
Sensory Loss ◽  
Adverse Life Events

Late-onset schizophrenia remains an understudied subtype of schizophrenia, despite growing recognition of its impact and distinction from early-onset schizophrenia. This chapter reviews the existing literature on late-onset schizophrenia including beginning with the nomenclature and epidemiology. Then we provide a review of key risk factors and correlates—including genetic risk, sex differences, comorbid sensory loss and physical illness, cognitive and psychiatric symptoms, sociodemographic factors, adverse life events, neuropathology, and inflammation. The chapter ends with clinical issues, including symptoms, differential diagnosis, treatments, and prognosis. Recent studies have examined the role of oestrogen treatments and a new therapy for tardive dyskinesia therapy as well as inflammatory mechanisms in schizophrenia.

scholarly journals Maternal Serum Angiogenic Factor sFlt-1 to PlGF Ratio in Preeclampsia: A Useful Marker for Differential Diagnosis and Prognosis Evaluation in Chinese Women

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Wei-zhen Lou ◽  
Fang Jiang ◽  
Jing Hu ◽  
Xiao-xu Chen ◽  
Ying-na Song ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Early Onset ◽  
Late Onset ◽  
Gestational Hypertension ◽  
Angiogenic Factor ◽  
Chronic Hypertension ◽  
Control Groups ◽  
Roc Curve Analysis ◽  
And Control ◽  
Plgf Ratio

The ratio of soluble fms-like tyrosine kinase-1 to placental growth factor (sFlt-1/PlGF) is elevated and proved to be useful in preeclampsia (PE) diagnosis. Its value in differential diagnosis with other pregnancy complications and prediction of pregnancy duration has yet to be clarified in Chinese population. We retrospectively analyzed 118 singleton pregnancies with suspected or diagnosed PE at the Peking Union Medical College Hospital (PUMCH) in China. Among these, 62 pregnancies were diagnosed as PE (48 early onsets and 14 late onsets, with 39 and 5 severe PE, respectively), 12 gestational hypertension (GH), 15 chronic hypertension (chrHTN), 16 autoimmune diseases, and 13 pregnancies with uncomplicated proteinuria. And 76 normal pregnancies were included as control. The results showed (1) the sFlt-1/PlGF ratio in early onset PE subgroup was significantly higher than that in GH, chrHTN, and control groups; the sFlt-1/PlGF ratio in late onset PE subgroup was significantly higher than that in chrHTN and control groups, but similar as GH group; the sFlt-1/PlGF ratio was similar among GH, chrHTN, and control groups. (2) The sFlt-1/PlGF ratio was significantly increased in the PE group compared with autoimmune disease and uncomplicated proteinuria pregnancies. (3) By ROC curve analysis, the cutoff value of the sFlt-1/PlGF ratio was less than 21.5 to rule out PE and higher than 97.2 to confirm the diagnosis of PE. (4) The sFlt-1/PlGF ratio was higher in PE pregnancies delivering within 7 days than those more than 7 days, either in early onset PE or severe PE. In conclusion, we show that maternal sFlt-1/PlGF ratio is an efficient biomarker in the diagnosis and differential diagnosis of PE. This ratio can be used to predict the timing of delivery for PE pregnancies.

scholarly journals Late-onset psychosis in older outpatients: a retrospective chart review

2014 ◽  
Vol 27 (4) ◽  
pp. 694-696 ◽  
Author(s):  
Teruyuki Matsuoka ◽  
Hiroshi Fujimoto ◽  
Yuka Kato ◽  
Kenji Fukui ◽  
Jin Narumoto
Keyword(s):  
Differential Diagnosis ◽  
Older People ◽  
Mood Disorders ◽  
Clinical Setting ◽  
Chart Review ◽  
Late Onset ◽  
Retrospective Chart Review ◽  
Aged Society

Late-onset psychosis (LOP) has become increasingly prevalent in the clinical setting, especially in the highly aged society, due to the increasing numbers of older people and its disruptive impact on the lives of patients and caregivers. Although previous studies have identified some of the features of LOP (Webster and Grossberg, 1998; Mitford et al., 2010; Tan and Seng, 2012), some of the previous studies did not include patients with dementia and mood disorders. This study addresses the features of LOP in consecutive outpatients to provide information that supports the differential diagnosis.

scholarly journals Julius Caesar's Late Onset Epilepsy: A Case of Historic Proportions

2010 ◽  
Vol 37 (5) ◽  
pp. 557-561 ◽  
Author(s):  
Richard S. McLachlan
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Clinical Presentation ◽  
Late Onset ◽  
Real Possibility

This is a case report of Julius Caesar's epilepsy that onset when he was 54-years-old. The differential diagnosis of late onset epilepsy is discussed and the rationale presented for concluding from the clinical presentation that the cause was neurocysticercosis. That this man's disease and its consequences altered the course of history is a very real possibility.

scholarly journals Dramatic improvement of segmental Zoster Paresis by late-onset antiviral therapy

2021 ◽  
Vol 18 (4) ◽  
pp. 44-48
Author(s):  
Halil Onder ◽  
Gokcen Celik
Keyword(s):  
Neuropathic Pain ◽  
Differential Diagnosis ◽  
Case Report ◽  
Herpes Zoster ◽  
Clinical Course ◽  
Late Onset ◽  
Neurological Complication ◽  
Dramatic Improvement ◽  
Antiviral Medication ◽  
Low Dosage

Focal paresis secondary to Herpes zoster (HZ) is a rare neurological complication and should be kept in mind in the differential diagnosis of acute weakness with corresponding dermatomal rashes. In this case report, we illustrate an 84-year-old male patient, who presented with focal upper extremity weakness following HZ on right C4-8 dermatome. After clinical and electrophysiological evaluations, segmental zoster paresis was diagnosed. Although antiviral medication(oral brivudine) had been administered previously, oral valacyclovir and low dosage methylprednisolone were initiated. In the following 2 months interval, a progressive and dramatic recovery in extremity weakness and neuropathic pain were achieved. The clinical course of this patient may give substantial perspectives regarding the clinical evaluation of similar cases.

scholarly journals Electrocardiographic differences between Anderson-Fabry and sarcomeric hypertrophic cardiomyopathy and correlation with cardiac magnetic resonance

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
G Vitale ◽  
F Di Nicola ◽  
I Tanini ◽  
A Camporeale ◽  
F Graziani ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Cardiac Magnetic Resonance ◽  
Hypertrophic Cardiomyopathy ◽  
Magnetic Resonance ◽  
Late Onset ◽  
Lateral Wall ◽  
Left Ventricular ◽  
Maximal Wall Thickness ◽  
Group A ◽  
T Waves

Abstract Background Differential diagnosis between Anderson-Fabry (AF) and sarcomeric hypertrophic cardiomyopathy (HCM) is often very challenging particularly in AF patients with late onset cardiac involvement. Purpose To gain new insights from standard electrocardiogram (ECG) in AF disease for differential diagnosis from sarcomeric HCM. Additionally, to better understand ECG features in AF patients, a correlation substudy ECG-cardiac magnetic resonance (CMR) has been performed. Methods From 162 patients with definite diagnosis of AF disease, 111 [65 males, median age 57 (51–67) years] with pathologic left ventricular hypertrophy (LVH) (Group A) were compared with 111 sarcomeric HCM patients (Group B) sex, age and maximal wall thickness matched by 1:1 propensity score. Results AF patients showed shorter PR interval [155 (140–180) vs 163 (149–184) msec; p=0.005) and wider QRS interval [110 (100–134) vs 100 (90–106) msec; p<0.0001). Additionally AF patients had a higher prevalence of complete (22% vs 3%; p<0.0001) and incomplete (13% vs 1%; p<0.0001) right bundle branch block (RBBB) and a higher percentage of ST segment depression (12% vs 1%; p=0.001) and inferior negative T waves (34% vs 19%; p=0.01). No differences in terms of Sokolow-Lyon and Cornell scores were found whereas total QRS score was higher in Group A [20 (16–27) vs 18 [14–22] mV; p=0.0004). Low QRS voltages and inferior Q waves were not present in AF patients. Among the 69 AF patients who underwent MRI, the 44 with late gadolinium enhancement (LGE) were older [59 (52–66) vs 53 (40–59) years; p=0.017] and had more frequently negative T waves on ECG, particularly in the inferior leads (64% vs 8%; p<0.0001), compared to the 25 without LGE. At multivariate analysis, age and negative T waves were independently associated to the presence of LGE on CMR. Conclusions Compared to matched sarcomeric HCM, AF patients had a shorter PR, wider QRS and a higher percentage of RBBB in relation to to the different aetiology (storage vs “pure” hypertrophy). The higher total QRS score and the absence of inferior Q waves could reflect the more frequent concentric distribution of LVH. Additionally negative T waves, especially in inferior leads, are related to the presence of LGE on CMR (often in the postero-lateral wall). Funding Acknowledgement Type of funding source: None

Case 27

2018 ◽  
Author(s):  
Bashar Katirji
Keyword(s):  
Differential Diagnosis ◽  
Connective Tissue ◽  
Peripheral Nerves ◽  
Pathological Findings ◽  
Mononeuritis Multiplex ◽  
Vasculitic Neuropathy ◽  
Peripheral Polyneuropathy ◽  
Pathologic Findings ◽  
Electrophysiological Findings ◽  
Nonsystemic Vasculitic Neuropathy

Mononeuropathy multiplex is a disorder which distinguishes itself from peripheral polyneuropathy by involvement of specific individual peripheral nerves. Mononeuropathy multiplex is often asymmetrical and is classified, based on electrophysiologic and pathologic findings, into axonal and demyelinating types. Mononeuritis multiplex is a term that is used exclusively for cases of axonal multiple mononeuropathies due to peripheral nerve vasculitis. This may be associated with connective tissue disease or hepatitis B and C infection. This case outlines the clinical and electrophysiological findings in mononeuritis multiplex and discusses the differential diagnosis of systemic and nonsystemic vasculitic neuropathy. The causes and pathological findings that characterize vasculitic neuropathy are highlighted.

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