scholarly journals Foreign Accent Syndrome Secondary to Medication Withdrawal: A Case Report

2017 ◽  
Vol 8 (3) ◽  
pp. 5
Author(s):  
Michael J. Schuh
Keyword(s):  
Case Report ◽  
Conflicts Of Interest ◽  
Case Reports ◽  
High Amplitude ◽  
Foreign Accent ◽  
Caucasian Woman ◽  
High Dose ◽  
First Case ◽  
Foreign Accent Syndrome ◽  
Psychotic Exacerbation

Objective: The purpose of this case report is to demonstrate a possible alternative etiology related to dopamine may exist for foreign accent syndrome (FAS). Methods: A 79-year-old, 205 pound, Caucasian woman originally presented to the department of Neurology for treatment and subsequently to the pharmacist pharmacotherapy service for evaluation of bilateral upper extremity tremor of high amplitude but was found to also exhibit FAS. Discussion: This case report contributes to the limited literature regarding foreign accent syndrome and adds to the few case reports of psychogenic origin, as opposed to the majority, which are of neurogenic origin. This also represents the first case that seems related to withdrawal of medication rather than psychotic exacerbation and ranks a six on the Naranjo algorithm. Conclusion: FAS is a rare disorder and little is understood about it. This case presentation also suggests that chronic use of high-dose dopamine and/or anticholinergic agents may alter pathways in the brain, which in this case, may have potentially contributed to the development of FAS. There remain many unanswered questions regarding FAS, but hopefully more clarity may be found as more cases are discovered and published. Conflict of Interest I declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties.   Type: Case Study

Successful Management of a Left-Sided Endocarditis Patient Complicated with Hemophagocytic Lymphohistiocytosis---a Rare Case Report and Literature Review

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 4889-4889 ◽  
Author(s):  
Qiguo Zhang ◽  
Hui Zeng ◽  
Peipei Xu ◽  
Jing Wang ◽  
Ronggong Yang ◽  
...  
Keyword(s):  
Case Report ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Conflicts Of Interest ◽  
Case Reports ◽  
Good Condition ◽  
Infectious Endocarditis ◽  
High Dose ◽  
Ultrasound Images ◽  
Liver Support ◽  
Multi Disciplinary Team

Abstract Objective: To increase the knowledge and experience of treating left-sided endocarditis patients complicated with hemophagocytic lymphohistiocytosis. Method: One case with left-sided endocarditis and secondary hemophagocytic lymphohistiocytosis was reported and related PubMed literatures were reviewed. Results: A 40-year-old Asian female came to hospital with uncontrolled repeated fever that had lasted for more than one month. Prior to this admission, the patient suffered a sub-acute liver failure of unknown cause and received artificial liver support and intravenous hepatic protectants in the local hospital, and the patient responded well. At that time echocardiography revealed congenital heart disease. After admission to our hospital, her lab results showed pancytopenia, coagulation abnormal and significantly elevated levels of total bilirubin, soluble CD25 and serum ferritin. Bone marrow biopsy was negative for hemaphagocytosis. The full body PET-CT was performed and the results demonstrated hepato-splenomegaly and relatively increased standard uptake value (SUV) of the spleen, with no signs of malignancies. Several sets of blood cultures were all positive for methicillin-resistant Staphylococcus epidermidis (MRSE). Two weeks later, cardiac ultrasound images were obtained and showed a completely well-shaped vegetation attached to the aorta valve, which confirmed the diagnosis of definite infectious endocarditis (IE). So the final diagnosis was the MRSE-related left-sited infectious endocarditis and acquired HLH. The Multi-disciplinary team (MDT) discussed this critical case, since the allergic reaction of vancomycin and no therapeutic effect of tecolplanin for 10 days, the patient was treated by high dose daptomycin(10 mg/kg once daily) and chemotherapy according to HLH-2004 protocol, afterwards the patient's condition was improved, cardiothoracic surgery was performed smoothly and the vegetation on the aortic valve was successfully removed. Till now the patient has been in good condition for more than 2 years. There are only 4 case reports pertinent to endocarditis with HLH published in PubMed and these related cases were also reviewed. Conclusion: This case report is the description of another rare and complicated condition in which the patient concurrently developed left-sided infectious endocarditis and acquired HLH. High dose daptomycin monotherapy was effective for controlling MRSE-related left-sided IE. Early diagnosis and intervention is very important for the successful treatment of HLH. Our case also highlights the importance of the multi-disciplinary team (MDT) model in dealing with similar critical cases in the clinic work. Disclosures No relevant conflicts of interest to declare.

scholarly journals Intoxication after Extreme Oral Overdose of Quetiapine to Attempt Suicide: Pharmacological Concerns of Side Effects

2009 ◽  
Vol 2009 ◽  
pp. 1-5 ◽  
Author(s):  
C. Müller ◽  
H. Reuter ◽  
C. Dohmen
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Case Report ◽  
Psychotic Disorders ◽  
Case Reports ◽  
Gastric Lavage ◽  
High Dose ◽  
Airway Protection ◽  
Residual Symptoms ◽  
First Case

Quetiapine is an atypical antipsychotic approved for the treatment of patients with psychotic disorders. Since approvement several case reports about intoxication with quetiapine were linked mainly with tachycardia,QTc-prolongation, somnolence, and hyperglycemia. Here, we present the first case report of an intoxication with an extreme overdose of quetiapine (36 g), ingested by a 32-year-old female (62 kg bodyweight) to attempt suicide. Symptoms associated with intoxication were coma without arterial hypotension, persistent tachycardia, hyperglycemia, and transient hypothyreoidism.QTc-interval was moderately extended. Management consisted of intubation for airway protection, gastric lavage, the use of activated charcoal, i.v. saline, and observation for 17 hours on an intensive care unit. Despite the extremely high dose of quetiapine, the patient recovered completely without residual symptoms.

Proteus syndrome in pregnancy: A case report

2020 ◽  
pp. 1753495X2097079
Author(s):  
Niccole Ranaei-Zamani ◽  
Mandeep K Kaler ◽  
Rehan Khan
Keyword(s):  
Case Report ◽  
Case Reports ◽  
Proteus Syndrome ◽  
Cutaneous Lesions ◽  
Genetic Syndrome ◽  
Skeletal Tissue ◽  
First Case ◽  
Large Teaching Hospital ◽  
Clinical Presentations ◽  
In Pregnancy

Proteus syndrome is a rare, multi-system, genetic syndrome characterised by atypical and excessive growth of skeletal tissue. Clinical presentations include abnormal musculoskeletal growth and cutaneous lesions. Due to its rarity, there have been a limited number of published case reports of Proteus syndrome. This is the first case report on the management of Proteus syndrome in pregnancy. We present the case of a pregnant woman with Proteus syndrome in her first pregnancy in a large teaching hospital and discuss the considerations and challenges faced in her antenatal, intrapartum and postnatal care.

scholarly journals Intraperitoneal ampicillin treatment for peritoneal dialysis- related peritonitis with Listeria monocytogenes – a case report

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Kristina Boss ◽  
Ina Wiegard-Szramek ◽  
Jan Dziobaka ◽  
Andreas Kribben ◽  
Sebastian Dolff
Keyword(s):  
Peritoneal Dialysis ◽  
Case Report ◽  
Listeria Monocytogenes ◽  
Case Reports ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Serum Concentrations ◽  
Duration Of Treatment ◽  
First Case ◽  
Listeria Infection

Abstract Background Peritoneal dialysis (PD)-related peritonitis is a rare but serious complication and is associated with increased morbidity and mortality rates. It is most commonly caused by Staphylococcus aureus or Staphylococcus epidermidis, but infection with Listeria monocytogenes may also occur. Recommendations for antibiotic treatment of a Listeria infection are currently based on a small number of case reports and suggest the administration of ampicillin. But unlike vancomycin or gentamicin, for ampicillin the route of application, the dosage, and the duration of treatment have not yet been established. We report a case in which PD-associated peritonitis due to Listeria infection was treated with ampicillin administered intravenously and intraperitoneally, separately and in combination. Case presentation A 72-year-old man with chronic kidney disease stage 5 dialysis (CKDG5D) secondary to hypertension and diabetes was hospitalised in April 2020 because of PD-related peritonitis caused by a Listeria infection. In accordance with the results of resistance tests, the patient was treated with intravenous ampicillin at a dosage of 6 g twice daily. After initial treatment the leukocyte count in the PD effluent had decreased substantially, but it was permanently reduced only with the addition of intraperitoneal ampicillin (4 g daily). Efficient serum concentrations of ampicillin were determined for both routes of administration, intravenous and intraperitoneal. Conclusion This is the first case report demonstrating that PD-related peritonitis due to Listeria monocytogenes infection can be treated with intraperitoneal ampicillin and monitored by the determination of peripheral serum concentrations of ampicillin.

scholarly journals Myelopathy in sickle cell disease: a case-oriented review

2021 ◽  
Author(s):  
Igor Vilela Brum ◽  
Guilherme Diogo Silva ◽  
Diego Sant'Ana Sodre ◽  
Felipe Melo Nogueira ◽  
Samira Luisa dos Apostolos Pereira ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Case Reports ◽  
Spinal Cord Infarction ◽  
Sensory Level ◽  
Cell Disease ◽  
Hematopoietic Tissue ◽  
First Case

Background: Although neurological complications are well recognized in sickle cell disease (SCD), myelopathy has been rarely described. We present the first case report of longitudinally extensive myelitis (LETM) in SCD and review the differential diagnosis of myelopathy in these patients. Design and setting: case-oriented review. Methods: We report the case of a 29-year-old African-Brazilian man with SCD, who experienced a subacute flaccid paraparesis, with T2 sensory level and urinary retention. CSF analysis showed a lymphocytic pleocytosis and increased protein levels. MRI disclosed a longitudinally extensive spinal cord lesion, with a high T2/STIR signal extending from C2 to T12. Serum anti-aquaporin-4 antibody was negative. We searched Medline/ PubMed, Embase, Scopus, and Google Scholar databases for myelopathy in SCD patients. Results: Spinal cord compression by vertebral fractures, extramedullary hematopoietic tissue, and Salmonella epidural abscess have been reported in SCD. We found only three case reports of spinal cord infarction, which is unexpectedly infrequent compared to the prevalence of cerebral infarction in SCD. We found only one case report of varicella-zoster myelitis and no previous report of LETM in SCD patients. Conclusion: Specific and time-sensitive causes of myelopathy should be considered in SCD patients. In addition to compression and ischemia, LETM should be considered as a possible mechanism of spinal cord involvement in SCD.

Foreign Accent syndrome: neurolinguistics aspects in a case report

2014 ◽  
Vol 22 (02) ◽  
pp. 300-307
Author(s):  
Maria Cristina de Almeida Freitas Cardoso ◽  
Michelle Apellanis Borges ◽  
Erica Luciana Martinovski ◽  
Marina Luiza dos Santos
Keyword(s):  
Case Report ◽  
Foreign Accent ◽  
Foreign Accent Syndrome

scholarly journals Metastatic Pancreatic Cancer with BRAF and P53 Mutations: Case Report of Therapeutic Response to Doublet Targeted Therapy

2020 ◽  
Vol 13 (3) ◽  
pp. 1239-1243
Author(s):  
Shenthol Sasankan ◽  
Lorraine Rebuck ◽  
Gloria Darrah ◽  
Moises Harari Turquie ◽  
Ian Rabinowitz
Keyword(s):  
Pancreatic Cancer ◽  
Case Report ◽  
Targeted Therapy ◽  
Therapeutic Response ◽  
Case Reports ◽  
Clinical History ◽  
P53 Mutation ◽  
Metastatic Pancreatic Cancer ◽  
First Case ◽  
History Of

We report on the clinical history of a 49-year-old female with metastatic pancreatic cancer. She was initially treated with standard chemotherapy as per current guidelines. She was found to have both a BRAF and P53 mutation, and received dabrafenib and trametinib with deep responses, both radiographically and biochemically (CA19-9). Her response has been more clinically relevant than responses in previous case reports of patients with BRAF-positive pancreatic cancer treated with targeted therapy. To the best of our knowledge, this is the first case report showing a dramatic therapeutic response to combination therapy with dabrafenib and trametinib in metastatic pancreatic cancer.

PS02.182: EFFECTIVENESS OF ANTI-PD-1 ANTIBODY MONOTHERAPY FOR THE PRIMARY MALIGNANT MELANOMA OF THE ESOPHAGUS: A CASE REPORT

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 173-174
Author(s):  
Hiroto Muroi ◽  
Masanobu Nakajima
Keyword(s):  
Case Report ◽  
Malignant Melanoma ◽  
Conflicts Of Interest ◽  
Complete Response ◽  
Primary Malignant Melanoma ◽  
Innovative Strategies ◽  
First Case ◽  
Positron Emission ◽  
Programmed Death ◽  
Programmed Death 1

Abstract Background Primary malignant melanoma of the esophagus (PMME) is extraordinarily rare with a high prevalence of malignancy and poor prognosis, and a standard therapy remains to be established. Since conventional therapeutic methods have been limited in their effects on treatment outcomes, innovative strategies for treating PMME are being explored, especially molecular targeting strategies. The programmed death 1 (PD-1) protein/programmed death ligand-1(PD-L1) inhibitor nivolumab is a promising agent for various cancers. To our knowledge, this is the first case report of PMME where a complete response was achieved using nivolumab. Methods We report an 80-year-old woman who was diagnosed with PMME with bone metastasis and lymph node metastases. Although dacarbazine combined chemotherapy was performed and continued for six cycles, the primary tumor deteriorated and liver metastases appeared. The patient then received nivolumab monotherapy (2 mg/kg, once every three weeks). Results After three cycles, nivolumab monotherapy for PMME resulted in a complete response as shown by positron emission tomography, computed tomography, and esophagogastroduodenoscopy. Conclusion In our case, nivolumab exerted a curative effect on PMME, thus suggesting that nivolumab can be effective in the treatment of this rare disease. Disclosure All authors have declared no conflicts of interest.

scholarly journals Beyond prosody: Foreign accent syndrome in a Spanish-speaking patient. Case report

Case reports ◽  
2019 ◽  
Vol 5 (1) ◽  
pp. 68-80
Author(s):  
Kelly Estrada-Orozco ◽  
Kely Bonilla-Vargas ◽  
Carolina Alfonso ◽  
Fabian Riaño ◽  
Patricia Montañés ◽  
...  
Keyword(s):  
Case Report ◽  
Foreign Accent ◽  
Cognitive Domains ◽  
Spanish Speaking ◽  
Speaking Patient ◽  
Essential Components ◽  
Foreign Accent Syndrome ◽  
Speech Features ◽  
One Year

Introduction: Foreign accent syndrome (FAS) is a rare speech disorder. It is becoming increasingly common to find reports of cases about alterations different from the suprasegmental aspects of speech, although these reports are not frequent in Spanish-speaking patients.Case presentation: 48-year-old female patient from Colombia diagnosed with FAS, segmental and suprasegmental speech alterations, and changes in cognitive domains (executive functions and language). The woman also presented with motor and affective changes. Brain imaging studies ruled out structural involvement and follow-up at one year did not show significant changes in speech.Discussion: This case presents the neurological, neuropsychological and speech features of a Spanish-speaking patient with FAS. Greater alteration in vowels than in consonants, alteration in pronunciation time, variation in rhythm and intonation of words and phrases, decrease of time between syllables, and insertion of vowels are common elements between this patient and other cases of FAS in non-Spanish speaking subjects.Conclusions: FAS is essentially a speech alteration; however, it can be accompanied by other physical and psychological signs. This case report allows recognizing the essential components for the definition, diagnosis and intervention of this syndrome.

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