Keraunoparalysis, a neurological manifestation after lightning strike: a case Report

2017 ◽  
Vol 4 (1) ◽  
pp. 47-50
Author(s):  
Sumana Bajracharya ◽  
Ashis Shrestha ◽  
Sajan Shrestha ◽  
Sitaram Shrestha ◽  
Samita Acharya ◽  
...  
Keyword(s):  
Case Report ◽  
Cardiac Rhythm ◽  
Neuropsychiatric Symptoms ◽  
Neurological Complications ◽  
Neurological Symptoms ◽  
Neurological Manifestation ◽  
Lightning Strike ◽  
Wide Range ◽  
Secondary Injuries ◽  
Tissue Damages

Lightning strike can have wide range of physical and neuropsychiatric symptoms. Burn, extensive tissue damages, cardiac rhythm disturbances and secondary injuries are well described and observed. The patient may also go through transient neurological symptoms, which may go unseen in some cases while in some cases it may get extra attention and series of investigations. Keraunoparalysis is one of the immediate neurological complications encountered after lightning strike. This manifests as transient self-limiting symptoms.

Peripheral facial nerve palsy as a presenting symptom of COVID-19 infection: A case report

2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Narges Karimia ◽  
◽  
Athena Sharifi-Razavi ◽  
Keyword(s):  
Case Report ◽  
Facial Nerve ◽  
Facial Paralysis ◽  
Respiratory Symptoms ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Neurological Complications ◽  
Neurological Symptoms ◽  
Neurological Manifestation ◽  
Peripheral Facial Nerve Palsy

New corona virus named as COVID-19 can presented not only by respiratory symptoms, but also with other organs involvement such as gastrointestinal, cardiac, renal and neurological symptoms. We reported a patient who presented with peripheral facial nerve palsy and evaluations revealed COVID-19 infection. We suggest from this case, that COVID-19 infection may be a potential cause of facial paralysis and during this terrible pandemic, neurologists will need to be vigilant for the any neurological manifestation or neurological complications of covid-19.

scholarly journals Neurological manifestations in coronavirus disease 2019 (COVID-19) patients: a systematic review of literature

CNS Spectrums ◽  
2020 ◽  
pp. 1-12
Author(s):  
Wael Ibrahim
Keyword(s):  
Wide Spectrum ◽  
Neurological Complications ◽  
Severe Form ◽  
Small Sample ◽  
Neurological Symptoms ◽  
Controlled Trials ◽  
Neurological Manifestations ◽  
Number Of Patients ◽  
Wide Range ◽  
Neurological Patients

Abstract Background The exact incidence of neurological complications from coronavirus disease 2019 (COVID-19) infection remains unknown. Neurological symptoms are more common with severe form of the disease. Through neuro-invasion, the virus can affect both neurons and glial cells and induce wide range of neurological pathologies. Objectives To systematically assess the neurological manifestations in patients diagnosed with COVID-19. Methods A systematic literature search of the PubMed, Scopus, and Cochrane databases was performed. Randomized controlled trials, nonrandomized controlled trials, observational studies of neurological manifestations in patients diagnosed with COVID-19. Results All three-database search identified 89 publications. A total of 22 full-text articles assessed for eligibility with 12 articles excluded. Altogether, the included studies reported 290 patients with neurological manifestations. Neurological manifestations were subdivided into central causes (CNS) and peripheral causes (PNS). CNS symptoms is commoner representing 91% of all neurological patients with 9% only with PNS. Headache represented the commonest neurological symptoms in regard to number of patients, meanwhile dizziness has the highest incidence with 11.9%. Neurological manifestations were divided according to COVID-19 severity into: (1) nonsevere and (2) severe; with all CNS manifestations were more in severe patients except headache were more in nonsevere patients. All included studies were on adult patients except one study in pediatric patients with limited number of participants. Conclusions From the descriptive analyses and available data of relatively small sample-sized studies, it can be concluded that in spite of the aforementioned limitations, that a wide spectrum of neurological manifestations including CNS and PNS can occur in COVID-19 patients.

A variable presentation of Joubert syndrome: Case report and a brief review

2020 ◽  
Vol 13 (4) ◽  
pp. 587-591
Author(s):  
S. Vinod ◽  
E. Ghaly ◽  
P. Cruz Soriano ◽  
H. Sampath ◽  
M. February ◽  
...  
Keyword(s):  
Early Childhood ◽  
Case Report ◽  
Breathing Pattern ◽  
Neonatal Period ◽  
Joubert Syndrome ◽  
Neurological Symptoms ◽  
Oxygen Desaturation ◽  
Neurological Manifestation ◽  
Abnormal Breathing ◽  
Variable Presentation

Joubert syndrome is a rare neurological manifestation usually present in late infancy or early childhood with characteristic episodes of abnormal breathing pattern along with the neurological and other systemic involvement.We report a case of confirmed Joubert syndrome present in the immediate neonatal period with isolated spells of oxygen desaturations not accompanied by the classically described breathing pattern and absent neurological symptoms causing delay in the diagnosis. Isolated oxygen desaturation episodes could be a presenting manifestation of Joubert syndrome in a neonatal period.

scholarly journals Spectrum of Neurological Manifestations in COVID-19: A Review

2021 ◽  
Vol 32 (2) ◽  
pp. 120-137
Author(s):  
Firoz Ahmed Quraishi ◽  
Aminur Rahman ◽  
Furial Quraishi Twinkle
Keyword(s):  
Nervous System ◽  
Peripheral Nervous System ◽  
Neuromuscular Junctions ◽  
Respiratory Illness ◽  
The Body ◽  
Neurological Symptoms ◽  
Neurological Manifestation ◽  
Neurological Manifestations ◽  
Long Term Effects ◽  
Wide Range

The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV- 2) is causing a worldwide pandemic of COVID-19 within a short span of time. Although patients with COVID-19 primarily present with fever and respiratory illness; a wide range of symptoms involving different systems have been described. While the neurological sequelae of the virus remain poorly understood, there are a growing number of reports of neurological manifestation of COVID-19.The neurological manifestation including both central and peripheral nervous system are increasingly reported in a very subset of COVID-19 patients. The SARS-CoV-2 enters the body mainly via the ACE- 2 receptors within the respiratory system, which causes the body to initiate an immunologic response against potential damage to non-renewable cells. There’s increasing evidence of accumulating that COVID-19, particularly in severe cases, can have neurological consequences although respiratory symptoms nearly always develop before neurological ones. Patients with pre-existing neurological conditions could also be at elevated risk for COVID-19 associated neurological symptoms. The neurological presentations of COVID-19 patients maybe acute and post-acute state. The acute presentations are classified into specific (such as stroke, encephalitis, acute polyneuropathy, etc.) and nonspecific (such as delirium, headache, dizziness, etc.) symptoms with anatomical involvement of either central nervous system including brain or spinal cord, and/or peripheral nervous system, neuromuscular junctions or muscles. Several neurological symptoms have also been demonstrated in post-acute or long covid-19 syndrome. There is a possibility to overlook or misinterpretation of, neurological symptoms in some COVID-19 patients. In infants and young children, the foremost common CNS phenomena are febrile seizures; in adults, non-focal abnormalities will be either neurological or constitutional. To date, neurological manifestations of COVID-19 are described largely within the disease trajectory, and also the long-term effects of such manifestations still remain unexplored and unfolded. This article is intended to review the possible neuro-invasive routes of SARS-CoV-2 and its mechanisms which initiate the neurological damage with neurological presentations of COVID-19 patients. Bangladesh J Medicine July 2021; 32(2) : 120-137

scholarly journals SARS-CoV-2 and the Nervous System: From Clinical Features to Molecular Mechanisms

2020 ◽  
Vol 21 (15) ◽  
pp. 5475 ◽  
Author(s):  
Manuela Pennisi ◽  
Giuseppe Lanza ◽  
Luca Falzone ◽  
Francesco Fisicaro ◽  
Raffaele Ferri ◽  
...  
Keyword(s):  
Nervous System ◽  
Molecular Mechanisms ◽  
Neuronal Damage ◽  
Neurological Complications ◽  
Neurological Manifestations ◽  
Wide Range ◽  
Inflammatory State ◽  
Acute Polyneuropathy ◽  
The Central Nervous System ◽  
The Impact

Increasing evidence suggests that Severe Acute Respiratory Syndrome-coronavirus-2 (SARS-CoV-2) can also invade the central nervous system (CNS). However, findings available on its neurological manifestations and their pathogenic mechanisms have not yet been systematically addressed. A literature search on neurological complications reported in patients with COVID-19 until June 2020 produced a total of 23 studies. Overall, these papers report that patients may exhibit a wide range of neurological manifestations, including encephalopathy, encephalitis, seizures, cerebrovascular events, acute polyneuropathy, headache, hypogeusia, and hyposmia, as well as some non-specific symptoms. Whether these features can be an indirect and unspecific consequence of the pulmonary disease or a generalized inflammatory state on the CNS remains to be determined; also, they may rather reflect direct SARS-CoV-2-related neuronal damage. Hematogenous versus transsynaptic propagation, the role of the angiotensin II converting enzyme receptor-2, the spread across the blood-brain barrier, the impact of the hyperimmune response (the so-called “cytokine storm”), and the possibility of virus persistence within some CNS resident cells are still debated. The different levels and severity of neurotropism and neurovirulence in patients with COVID-19 might be explained by a combination of viral and host factors and by their interaction.

scholarly journals R1352Q CACNA1A Variant in a Patient with Sporadic Hemiplegic Migraine, Ataxia, Seizures and Cerebral Oedema: A Case Report

2021 ◽  
pp. 123-130
Author(s):  
Anker Stubberud ◽  
Emer O’Connor ◽  
Erling Tronvik ◽  
Henry Houlden ◽  
Manjit Matharu
Keyword(s):  
Mental Retardation ◽  
Case Report ◽  
Genetic Testing ◽  
Head Trauma ◽  
Cerebral Oedema ◽  
De Novo ◽  
Minor Head Trauma ◽  
Hemiplegic Migraine ◽  
Wide Range ◽  
History Of

Mutations in the <i>CACNA1A</i> gene show a wide range of neurological phenotypes including hemiplegic migraine, ataxia, mental retardation and epilepsy. In some cases, hemiplegic migraine attacks can be triggered by minor head trauma and culminate in encephalopathy and cerebral oedema. A 37-year-old male without a family history of complex migraine experienced hemiplegic migraine attacks from childhood. The attacks were usually triggered by minor head trauma, and on several occasions complicated with encephalopathy and cerebral oedema. Genetic testing of the proband and unaffected parents revealed a de novo heterozygous nucleotide missense mutation in exon 25 of the <i>CACNA1A</i> gene (c.4055G&#x3e;A, p.R1352Q). The R1352Q <i>CACNA1A</i> variant shares the phenotype with other described <i>CACNA1A</i> mutations and highlights the interesting association of trauma as a precipitant for hemiplegic migraine. Subjects with early-onset sporadic hemiplegic migraine triggered by minor head injury or associated with seizures, ataxia or episodes of encephalopathy should be screened for mutations. These patients should also be advised to avoid activities that may result in head trauma, and anticonvulsants should be considered as prophylactic migraine therapy.

scholarly journals Neurological symptoms, manifestations, and complications associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 19 (COVID-19)

2021 ◽  
Author(s):  
Biyan Nathanael Harapan ◽  
Hyeon Joo Yoo
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Case Reports ◽  
Case Series ◽  
Altered Mental Status ◽  
Neurological Complications ◽  
Neurological Symptoms ◽  
Neurological Manifestations ◽  
Fisher Syndrome ◽  
Novel Coronavirus ◽  
The Impact

AbstractSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus, is responsible for the outbreak of coronavirus disease 19 (COVID-19) and was first identified in Wuhan, China in December 2019. It is evident that the COVID-19 pandemic has become a challenging world issue. Although most COVID-19 patients primarily develop respiratory symptoms, an increasing number of neurological symptoms and manifestations associated with COVID-19 have been observed. In this narrative review, we elaborate on proposed neurotropic mechanisms and various neurological symptoms, manifestations, and complications of COVID-19 reported in the present literature. For this purpose, a review of all current published literature (studies, case reports, case series, reviews, editorials, and other articles) was conducted and neurological sequelae of COVID-19 were summarized. Essential and common neurological symptoms including gustatory and olfactory dysfunctions, myalgia, headache, altered mental status, confusion, delirium, and dizziness are presented separately in sections. Moreover, neurological manifestations and complications that are of great concern such as stroke, cerebral (sinus) venous thrombosis, seizures, meningoencephalitis, Guillain–Barré syndrome, Miller Fisher syndrome, acute myelitis, and posterior reversible encephalopathy syndrome (PRES) are also addressed systematically. Future studies that examine the impact of neurological symptoms and manifestations on the course of the disease are needed to further clarify and assess the link between neurological complications and the clinical outcome of patients with COVID-19. To limit long-term consequences, it is crucial that healthcare professionals can early detect possible neurological symptoms and are well versed in the increasingly common neurological manifestations and complications of COVID-19.

Prodromal Dementia With Lewy Bodies: Evolution of Symptoms and Predictors of Dementia Onset

2021 ◽  
pp. 089198872110235
Author(s):  
Kathryn A. Wyman-Chick ◽  
Lauren R. O’Keefe ◽  
Daniel Weintraub ◽  
Melissa J. Armstrong ◽  
Michael Rosenbloom ◽  
...  
Keyword(s):  
Clinical Features ◽  
Dementia With Lewy Bodies ◽  
Clinical Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Lewy Bodies ◽  
Rem Sleep Behavior Disorder ◽  
Data Set ◽  
Wide Range ◽  
Prodromal Dementia ◽  
Dementia Onset

Background: Research criteria for prodromal dementia with Lewy bodies (DLB) were published in 2020, but little is known regarding prodromal DLB in clinical settings. Methods: We identified non-demented participants without neurodegenerative disease from the National Alzheimer’s Coordinating Center Uniform Data Set who converted to DLB at a subsequent visit. Prevalence of neuropsychiatric and motor symptoms were examined up to 5 years prior to DLB diagnosis. Results: The sample included 116 participants clinically diagnosed with DLB and 348 age and sex-matched (1:3) Healthy Controls. Motor slowing was present in approximately 70% of participants 3 years prior to DLB diagnosis. In the prodromal phase, 50% of DLB participants demonstrated gait disorder, 70% had rigidity, 20% endorsed visual hallucinations, and over 50% of participants endorsed REM sleep behavior disorder. Apathy, depression, and anxiety were common prodromal neuropsychiatric symptoms. The presence of 1+ core clinical features of DLB in combination with apathy, depression, or anxiety resulted in the greatest AUC (0.815; 95% CI: 0.767, 0.865) for distinguishing HC from prodromal DLB 1 year prior to diagnosis. The presence of 2+ core clinical features was also accurate in differentiating between groups (AUC = 0.806; 95% CI: 0.756, 0.855). Conclusion: A wide range of motor, neuropsychiatric and other core clinical symptoms are common in prodromal DLB. A combination of core clinical features, neuropsychiatric symptoms and cognitive impairment can accurately differentiate DLB from normal aging prior to dementia onset.

Neuropsychiatric Derangement by Polycythemia Vera: A Case Report of an Unexpected Disease Presentation and Review of the Literature

2021 ◽  
pp. 1-6
Author(s):  
Heleen De Lil ◽  
Michelle van Beek ◽  
Alexandra Herbers ◽  
Ellen van der Holst ◽  
Karen Keijsers
Keyword(s):  
Case Report ◽  
Chronic Disease ◽  
Cerebral Infarction ◽  
Polycythemia Vera ◽  
Neuropsychiatric Symptoms ◽  
Unusual Presentation ◽  
Review Of The Literature ◽  
Remarkable Recovery ◽  
Visual Complaints ◽  
Underlying Pathophysiology

Cerebral infarction as well as other thromboses, headaches, and visual complaints are well-known symptoms of polycythemia vera. However, chorea and neuropsychiatric disturbances are less recognized consequences of this chronic disease. Whereas chorea is a rare but acknowledged symptom of polycythemia vera, neuropsychiatric symptoms have only sporadically been reported. We depict 2 patients with an unusual presentation of polycythemia vera. Our first patient presented with right-sided hemiballism and psychosis, and the second patient had a long diagnostic trajectory of unexplained chorea. In both cases diagnosis of JAK2 positive polycythemia vera was established, and in both cases remarkable recovery occurred after the initiation of phlebotomies. The underlying pathophysiology of these symptoms has not been clearly elucidated. Because of the unfamiliarity of the link between especially neuropsychiatric symptoms and polycythemia, current reported numbers are probably an underestimation. Benefit of treatment appears to be large. We seek to create more awareness among physicians about this phenomenon.

scholarly journals Anesthetic management for cesarean delivery in a woman with congenital atlantoaxial dislocation and Chiari type I anomaly: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuyan Nie ◽  
Weimin Zhou ◽  
Shaoqiang Huang
Keyword(s):  
Case Report ◽  
Cesarean Delivery ◽  
Anesthetic Management ◽  
Neurological Complications ◽  
Atlantoaxial Dislocation ◽  
Epidural Needle ◽  
Team Approach ◽  
Anesthetic Techniques ◽  
Type I ◽  
Combined Spinal Epidural Anesthesia

Abstract Background The preferable choice of anesthesia for the patients with congenital atlantoaxial dislocation (CAAD) and type I Arnold Chiari malformations (ACM-I) has been a very confusing issue in clinical practice. We describe the successful administration of combined spinal-epidural anesthesia for a woman with CAAD and ACM-1 accompanied by syringomyelia. Case presentation Our case report presents the successful management of a challenging obstetric patient with CAAD and ACM-1 accompanied by syringomyelia. She had high risks of difficult airway and aspiration. The injection of bolus drugs through the spinal or epidural needle may worsen the previous neurological complications. The patient was well evaluated with a multidisciplinary technique before surgery and the anesthesia was provided by a skilled anesthesiologist with slow spinal injection. Conclusions An interdisciplinary team approach is needed to weigh risks and benefits for patients with CAAD and ACM-1 undergoing cesarean delivery. Therefore, an individual anesthetic plan should be made basing on the available anesthetic equipments and physicians’ clinical experience on anesthetic techniques.

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