Acute onset of chronic infl ammatory demyelinating polyneuropathy in combination with COVID-19

2022 ◽  
Vol 26 (6) ◽  
pp. 35-42
Author(s):  
D. R. Safina ◽  
A. R. Safina ◽  
A. M. Gizdatova ◽  
R. G. Esin
Keyword(s):  
Peroneal Nerve ◽  
Clinical Case ◽  
Tibial Nerve ◽  
Pulse Therapy ◽  
Acute Onset ◽  
Demyelinating Polyneuropathy ◽  
Review Of Literature ◽  
Motor Functions ◽  
Demyelinating Lesions ◽  
Coronavirus Infection

Acute onset of chronic infl ammatory demyelinating polyneuropathy (A-CIDP) presents signifi cant diffi culties in differential diagnosis with acute infl ammatory demyelinating polyneuropathy (AIDP). The article presents review of literature about diff erential diagnosis between A-CIDP and AIDP and a clinical case of A-CIDP at 26-year-old man. The disease started after vaccination against infl uenza and an episode of enteritis, the clinical picture matched Guillain–Barré syndrome criteria, according to electromyography data: demyelinating lesion of the left facial nerve, motor and sensory fi bers of the median and ulnar nerves on both sides, demyelinating lesions of motor fi bers of the tibial nerve and peroneal nerve on both sides. Chronic infl ammatory demyelinating polyneuropathy was diagnosed. Lack of eff ect from plasma exchange was the reason for changing the treatment to pulse therapy with prednisolone (with a subsequent transition to a 1 mg/kg dose and further reduction until canceled within 16 weeks). Response to prednisolone — rapid recovery of motor functions, which worsened signifi cantly due to a new coronavirus infection during treatment in the neurology department. Further continuation of prednisolone therapy made it possible to restore motor functions completely, except mild prosopoparesis. At the same time, deep refl exes were absent; no signifi cant EMG dynamics was observed. Considering the eff ect of glucocorticosteroids and lack of positive dynamics on the second electromyography, the patient was diagnosed as A-CIDP.

scholarly journals Miller Fisher syndrome developed after a previous COVID-19 infection (case report)

2021 ◽  
Vol 11 (2) ◽  
pp. 56-60
Author(s):  
V. A. Malko ◽  
P. V. Klimov ◽  
M. P. Topuzova ◽  
I.  V. Yarush ◽  
K. V. Simakov ◽  
...  
Keyword(s):  
Clinical Case ◽  
Clinical Manifestations ◽  
Acute Onset ◽  
Miller Fisher Syndrome ◽  
Complete Regression ◽  
Speech Impairment ◽  
Fisher Syndrome ◽  
Coronavirus Infection ◽  
Clinical Triad ◽  
Classical Triad

Miller Fisher syndrome is one of the forms of Guillain–Barrе́ syndrome, characterized by a clinical triad that includes ophthalmoplegia, ataxia and areflexia, with the possible addition of moderate peripheral tetraparesis. During the year that has passed since the start of the pandemic of the new coronavirus infection COVID‑19, international publications have presented a few cases of Miller Fisher syndrome, which developed in patients at different times after the COVID‑19 infection – from 3–5 days to 3 weeks. The article presents a description of a clinical case of Miller Fisher syndrome, which occurred with 34‑year‑old man 21 days after the COVID‑19 infection. The clinical manifestations of Miller Fisher syndrome were typical and included diplopia, areflexia, and ataxia. At the beginning of the disease, there was a transient episode of speech impairment in the form of mild dysarthria. Oculomotor disorders predominated in the clinical picture over other components of the classical triad. On the background of treatment with human immunoglobulin G, there was a complete regression of symptoms.This description of Miller Fisher syndrome, which developed after the postponed infection with COVID‑19, is the first in Russia. The presented case demonstrates the ability of the SARS‑CoV‑2 virus to induce the development of an autoimmune disease. Practitioners should take into account the possibility of Miller Fisher syndrome developing in the event of an acute onset of diplopia, ataxia and areflexia in patients after a previous COVID‑19 infection.

Hypoglycemic Hemiparesis Masquerading As Ischemic Stroke: When Guideline Fails

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.

Clinical case of fungal uveitis in a patient who underwent COVID-19

2021 ◽  
pp. 54-59
Author(s):  
A.V. Tereshchenko ◽  
◽  
I.G. Trifanenkova ◽  
Y.L. Ilina ◽  
N.N. Yudina ◽  
...  
Keyword(s):  
Fungal Infection ◽  
Anterior Chamber ◽  
Clinical Case ◽  
Bacterial Culture ◽  
Observation Time ◽  
Pigmentary Glaucoma ◽  
Blurred Vision ◽  
Number Of Patients ◽  
Complicated Cataract ◽  
Coronavirus Infection

Purpose. To analyze a clinical case of fungal uveitis in a patient who has undergone COVID-19. Material and methods. A patient born in 1962 was admitted to the Kaluga branch of the MNTK with complains of blurred vision. From the anamnesis: in the first half of 2020, he was treated at the Kaluga branch of the MNTK with a diagnosis of complicated cataract, highly complicated myopia, PCRD, CCRD, pigmentary glaucoma; in the autumn of 2020, he suffered a coronavirus infection complicated by severe bilateral interstitial pneumonia, he was in the intensive care unit for 2 weeks. Results. During examination of the patient, the clinical picture and data of objective methods indicated the development of bilateral uveitis in the patient. A course of anti-inflammatory therapy was prescribed, and positive dynamics were achieved. But there was a sharp deterioration on the 10th day. Concilium was held: a fungal etiology of uveitis was suspected. The anterior chamber was washed, material from the anterior chamber was taken for bacterial culture. At the 3rd day the results of bacterial culture showed the growth of Candida albicans fungi. A multistage complex medical and surgical treatment was carried out. The outcome is encouraged however, the observation time is insufficient to draw final conclusions. Conclusion. The incidence of COVID-19 remains high, so ophthalmologists should remain vigilant, collect a careful anamnesis and expect an increase of the number of patients with intraocular fungal infection. Key words: uveitis; fungal infection; COVID-19.

ULTRASONIC STUDY IN DIAGNOSTICS OF PERIPHERAL NEUROPATHIES (CASE FROM PRACTICE)

2021 ◽  
pp. 144-146
Author(s):  
Hamanovich A.I. ◽  
◽  
Baida A.G. ◽  
Koyalo L.G. ◽  
Levantsevich V.V. ◽  
...  
Keyword(s):  
Nervous System ◽  
Gold Standard ◽  
Peripheral Nerves ◽  
Peroneal Nerve ◽  
Clinical Case ◽  
Clinical Symptoms ◽  
Nerve Trunk ◽  
Peripheral Neuropathies ◽  
Ultrasound Scanning ◽  
Electrophysiological Methods

Electrophysiological methods, such as electromyography and neuromyography, are traditionally recognized as the "gold standard" for detecting pathology of the peripheral nervous system. It should be noted, however, that the information obtained during the above examinations does not give an idea of the state of the surrounding tissues, does not indicate the nature and cause of damage to the nerve trunk, and does not always accurately reflect the localization of changes. At the same time, it is this information that helps to determine the tactics of conservative or surgical treatment of the patient. Ultrasound scanning is quite successfully used in the diagnosis of damage and diseases of the peripheral nerves. The article presents a clinical case of a diagnostic search for a causative disease in a patient with clinical symptoms of neuropathy of the peroneal nerve.

The novel coronavirus infection (COVID-19) concurrent with pseudomembranous colitis in the early postpartum period: a clinical case

2021 ◽  
Vol 9_2021 ◽  
pp. 232-236
Author(s):  
Shklyaev A.E. Shklyaev A ◽  
Bessonov A.G. Bessonov A ◽  
Chushyalova D.A. Chushyalova D ◽  
Mikhailova M.D. Mikhailova M ◽  
Meleshkina M.V. Meleshkina M ◽  
...  
Keyword(s):  
Postpartum Period ◽  
Pseudomembranous Colitis ◽  
Clinical Case ◽  
The Novel ◽  
Early Postpartum Period ◽  
Early Postpartum ◽  
Coronavirus Infection ◽  
Novel Coronavirus

scholarly journals Tonsillectomy in IgA Nephropathy - Clinical Case

2021 ◽  
Vol 26 (3) ◽  
pp. 59-61
Author(s):  
Livia Mirela Popa ◽  
Livia Popa ◽  
Cătălin-Bogdan Osalciuc
Keyword(s):  
Antibiotic Therapy ◽  
Iga Nephropathy ◽  
Clinical Case ◽  
Acute Infection ◽  
Acute Onset ◽  
First Episode ◽  
Urinary Volume ◽  
Upper Airways ◽  
Macroscopic Hematuria ◽  
Nephritic Syndrome

Abstract This article presents the clinical case of IgA nephropathy of a patient hospitalized in order to investigate a nephritic syndrome, apparently with acute onset, discovered in the following circumstances: recurrent macroscopic hematuria, decreased urinary volume, the first episode occurring about a month ago in the context of an acute infection of upper airways, remitted under antibiotic therapy, with reappearance every 2 weeks, also accompanied by odynophagia and decreased urinary volume.

Sign in / Sign up

Export Citation Format

Share Document