scholarly journals Practical lesson «Secondary acute encephalopolyradiculoneuropathy»

2016 ◽  
pp. 30-34
Author(s):  
V. Sereda ◽  
N. Svyrydova ◽  
T. Parnikoza ◽  
N. Khanenko ◽  
T. Cherednichenko ◽  
...  
Keyword(s):  
Nervous System ◽  
Differential Diagnosis ◽  
Effective Treatment ◽  
Clinical Case ◽  
Cranial Nerves ◽  
Pain Syndrome ◽  
Disease Symptoms ◽  
Mild Pain ◽  
Secondary Damage

Acute encephalopolyradiculoneuropathy - syndromic disease, which is mostly representing secondary damage of the nervous system. Among patients with verified herpetic neuroinfection, encephalopolyradiculoneuropathy type composes 20% cases. In 30-60% of cases infection, hypothermia, toxic lesions, vaccination, surgery precede this disease. Symptoms increase within few days till 1 month. In 25% of cases respiratory and bulbar muscles, cranial nerves are affected. The clinical case of secondary acute encephalopolyradiculoneuropathy with bulbar disorders and mild pain syndrome has a mixed genesis - infectious and allergic, arouses interest because of increasing frequency. The attention focused on this group of diseases, namely because of the difficulties in differential diagnosis and effective treatment.

scholarly journals Acute Disseminated Encephalomyelitis (ADEM): A Demyelinating Disease with Specific Morphological Features

2021 ◽  
pp. 106689692199356
Author(s):  
Fleur Cordier ◽  
Lars Velthof ◽  
David Creytens ◽  
Jo Van Dorpe
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Differential Diagnosis ◽  
Clinical Case ◽  
Demyelinating Disease ◽  
Acute Disseminated Encephalomyelitis ◽  
Demyelinating Diseases ◽  
Demyelinating Disorder ◽  
Immune Mediated ◽  
The Central Nervous System

Acute disseminated encephalomyelitis (ADEM) is a rare immune-mediated inflammatory and demyelinating disorder of the central nervous system. Its characteristic perivenular demyelination and inflammation aid in the differential diagnosis with other inflammatory demyelinating diseases. Here, we present a clinical case of ADEM, summarize its histological hallmarks, and discuss pitfalls concerning the most important neuropathological differential diagnoses.

CLINICAL CASE OF SUCCESSFUL MANAGEMENT OF PREGNANCY AND CHILDBIRTH IN A PATIENT WITH PERIPHERAL NERVOUS SYSTEM PATHOLOGY

2021 ◽  
Vol 2 (1) ◽  
pp. 42-47
Keyword(s):  
Nervous System ◽  
Pregnant Woman ◽  
Peripheral Nervous System ◽  
Clinical Case ◽  
Test Preparation ◽  
Pain Syndrome ◽  
Delivery Method ◽  
Successful Management ◽  
Pregnancy And Childbirth ◽  
Joint Management

The purpose of our study was to study the case of successful management of pregnancy and childbirth in patient K., 39 years old with pathology of the peripheral nervous system: spinal stenosis L5 – S1, herniated L5-S1, surgery in 2014 (hemilaminectomy L5-S1, disc resection L5-S1), vertebrogenic pain syndrome. At the stage of pre-test preparation and during pregnancy, she is consulted by a neurologist to determine the tactics of pregnancy and childbirth management. Rational pregnancy planning, joint management of a pregnant woman by an obstetrician-gynecologist and a neurologist allowed choosing the optimal pregnancy management tactics and delivery method.

scholarly journals Refractory neuroblastoma, victory over pain (clinical case)

Pain medicine ◽  
2019 ◽  
Vol 3 (4) ◽  
pp. 64-58
Author(s):  
O O Kalinchuk ◽  
T G Korol ◽  
S S Blazhko ◽  
N U Kosechenko
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Clinical Case ◽  
Adrenal Glands ◽  
Pain Syndrome ◽  
Sympathetic Ganglia ◽  
Protective Mechanism ◽  
Thoracic Cavity ◽  
Oncological Patients ◽  
The Central Nervous System

Neuroblastoma is a malignant tumor that develops from the stem cells of the sympathetic ganglia and the adrenal medulla and belongs to the group of neuroendocrine tumors. It is most often localized in the adrenal glands and the retroperitoneal space, less – in sympathetic ganglia of the neck and thoracic cavity. Pain syn-drome is one of the leading manifestations in patients with disease progression. Unlike other patients, a pain syndrome in oncological patients is not a temporary or periodic sensation, it has no physio-logical expediency, it does not have a protective mechanism, but, on the contrary, pain in this group of patients leads to inadaptation, distorted perception of pain and small impulses, most importantly, accompanied by various disorders of the functions of the central nervous system in the patient’s body.

Psychiatric Presentations of Central Nervous System Tumors

2016 ◽  
Vol 33 (S1) ◽  
pp. S499-S499
Author(s):  
L. Maia ◽  
A. Sofia Coutinho ◽  
G.C. Irina ◽  
L. Carneiro
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Differential Diagnosis ◽  
Pituitary Adenoma ◽  
Clinical Case ◽  
Psychiatric Symptoms ◽  
Cns Tumors ◽  
Clinical Approach ◽  
Medical Specialties ◽  
Important Differential Diagnosis

IntroductionFor the most part, central nervous system (CNS) tumors present themselves with focal neurologic sing or manifestations resulting from increased intracranial pressure. However, in particular cases, these tumors may present exclusively psychiatric symptoms.ObjectiveThis communication explores importance of CNS tumors as differential diagnosis of various psychiatric disorders.AimsHighlight the need of acknowledging this important differential diagnosis (CNS tumors) in current psychiatry practice, while presenting a clinical case as an example of the subject.MethodsIt is exposed a bibliographic review of the topic, followed by the description of a clinical case regarding a patient with pituitary adenoma and simultaneous installation of psychotic symptoms namely delusional paranoid ideation.ResultsThe authors present a case report of a 66-year-old patient admitted compulsively in a Psychiatric ward in the context of behavioral changes associated with delusional ideation of paranoid content. Multidisciplinary assessed by specialties of Psychiatry, Neurology, Neurosurgery, Endocrinology and Psychology, concluded by the presence of nonfunctioning pituitary adenoma associated with cognitive major disturbance.ConclusionsThe tumors of the CNS can be associated with a whole variety of psychiatric symptoms such as psychosis, anxiety, depression or cognitive impairment, even in the absence of organic/neurological symptoms. Its role in the genesis of psychiatric symptomatology makes these neoplasias an important differential diagnosis, whose clinical approach should include different medical specialties integrated as a multidisciplinary team.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Neuropathic pain due to malignancy: Mechanisms, clinical manifestations and therapy

2004 ◽  
Vol 57 (1-2) ◽  
pp. 33-40 ◽  
Author(s):  
Miroslava Pjevic ◽  
Erzebet Patarica-Huber ◽  
Dragana Radovanovic ◽  
Sanja Vickovic
Keyword(s):  
Nervous System ◽  
Neuropathic Pain ◽  
Dorsal Horn ◽  
Cranial Nerves ◽  
Clinical Manifestations ◽  
Pain Syndrome ◽  
Afferent Input ◽  
Nerve Tissue ◽  
Spontaneous Pain ◽  
Antiinflammatory Drugs

Introduction Neuropathic pain in cancer patients requires a focused clinical evaluation based on knowledge of common neuropathic pain syndromes. Definition Neuropathic pain is a non-nociceptive pain or "differentiation" pain, which suggests abnormal production of impulses by neural tissue that is separated from afferent input. Impulses arise from the peripheral nervous system or central nervous system. Causes of neuropathic pain due to malignancy Neuropathic pain is caused directly by cancer-related pathology (compression/infiltration of nerve tissue, combination of compression/infiltration) or by diagnostic and therapeutic procedures (surgical procedures, chemotherapy, radiotherapy). Mechanisms Pathophysiological mechanisms are very complex and still not clear enough. Neuropathic pain is generated by electrical hyperactivity of neurons along the pain pathways. Peripheral mechanisms (primary sensitization of nerve endings, ectopically generated action potentials within damaged nerves, abnormal electrogenesis within sensory ganglia) and central mechanisms (loss of input from peripheral nociceptors into dorsal horn, aberrant sprouting within dorsal horn, central sensitization, loss of inhibitory interneurons, mechanisms at higher centers) are involved. Diagnosis The quality of pain presents as spontaneous pain (continuous and paroxysmal), abnormal pain (allodynia, hyperalgesia, hyperpathia), paroxysmal pain. Clinical manifestations Clinically, neuropathic pain is described as the pain in the peripheral nerve (cranial nerves, other mononeuropathies, radiculopathy, plexopathy, paraneoplastic peripheral neuropathy) and relatively infrequent, central pain syndrome. Therapy Treatment of neuropathic pain remains a challenge for clinicians, because there is no accepted algorithm for analgesic treatment of neuropathic pain. Pharmacotherapy is considered to be the first line therapy. Opioids combined with non-steroidal antiinflammatory drugs are warrented. If patient is relatively unresponsive to an opioid, a trial with adjuvant analgesics might be considered. Tricyclic antidepressants might be selected for patients with continuous dysesthesia, and anticonvulsants might be used if the pain is predominanty lancinating or paroxysmal. The complexity of neuropathic syndromes and underlying etiologic mechanisms warrant clinical trials to determine appropriate treatment.

scholarly journals A clinical case of SYNGAP1-associated encephalopathy in a girl with epilepsy, intellectual disability, and autism

2018 ◽  
Vol 10 (1S) ◽  
pp. 62-65
Author(s):  
N. N. Savelieva ◽  
A. V. Yakunina ◽  
I. E. Poverennova
Keyword(s):  
Valproic Acid ◽  
Differential Diagnosis ◽  
Intellectual Disability ◽  
Effective Treatment ◽  
Female Patient ◽  
Clinical Case ◽  
De Novo ◽  
Chromosome 22 ◽  
Symptomatic Epilepsy ◽  
Bckdhb Gene

This paper describes a female patient aged 3 years 6 months with SYNGAP1-associated encephalopathy manifesting with symptomatic epilepsy, intellectual disability, and autism. There were difficulties in  differential diagnosis, since in addition to SYNGAP1 mutation (c2214_2217deltgag), heterozygous BCKDHB gene mutation  (chr6: 80910740G>a, rs3834233) and microduplication of a segment of chromosome 22 were found de novo. The features of the course and  treatment of epilepsy in SYNGAP1 are discussed. A combination of  valproic acid and oxcarbazepine was the most effective treatment for epilepsy.

scholarly journals Contemporary views on disorders of neuromiyelitis optica spectrum. Clinical case from personal practice

2021 ◽  
pp. 90-94
Author(s):  
Svitlana Shkrobot ◽  
Olena Budarna ◽  
Khrystyna Duve ◽  
Nataliya Tkachuk ◽  
Lyubov Milevska-Vovchyk
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Differential Diagnosis ◽  
Clinical Case ◽  
Clinical Observation ◽  
Demyelinating Disease ◽  
Survey Methods ◽  
Demyelinating Diseases ◽  
Research Issue ◽  
Scientific Report

Neuromyelitis optica (Devic’s disease) is a demyelinating disease of central nervous system. This disease is progressive and might be fatal. The authors have analyzed data of domestic and foreign literature on research issue. The idea of modern laboratory and instrumental survey methods was summarized, because clinical manifestation of the disease may be non-specific and differential searching might be extremely wide. The modern schemes of treatment of described syndrome are represented. As an illustration we used own clinical observation confirmed by the results of neuroimaging. The practical orientation of the represented scientific report is proved. Key words neuromiyelitis optica, differential diagnosis, antibodies to aquaporin-4, demyelinating diseases

A Historical Review of Complex Regional Pain Syndrome in the “Guides Library”

2009 ◽  
Vol 14 (6) ◽  
pp. 1-9
Author(s):  
Robert J. Barth
Keyword(s):  
Differential Diagnosis ◽  
Complex Regional Pain Syndrome ◽  
Reflex Sympathetic Dystrophy ◽  
International Association ◽  
Historical Review ◽  
Pain Syndrome ◽  
Sixth Edition

Abstract Complex regional pain syndrome (CRPS) is a controversial, ambiguous, unreliable, and unvalidated concept that, for these very reasons, has been justifiably ignored in the “AMA Guides Library” that includes the AMAGuides to the Evaluation of Permanent Impairment (AMA Guides), the AMA Guides Newsletter, and other publications in this suite. But because of the surge of CRPS-related medicolegal claims and the mission of the AMA Guides to assist those who adjudicate such claims, a discussion of CRPS is warranted, especially because of what some believe to be confusing recommendations regarding causation. In 1994, the International Association for the Study of Pain (IASP) introduced a newly invented concept, CRPS, to replace the concepts of reflex sympathetic dystrophy (replaced by CRPS I) and causalgia (replaced by CRPS II). An article in the November/December 1997 issue of The Guides Newsletter introduced CRPS and presciently recommended that evaluators avoid the IASP protocol in favor of extensive differential diagnosis based on objective findings. A series of articles in The Guides Newsletter in 2006 extensively discussed the shortcomings of CRPS. The AMA Guides, Sixth Edition, notes that the inherent lack of injury-relatedness for the nonvalidated concept of CRPS creates a dilemma for impairment evaluators. Focusing on impairment evaluation and not on injury-relatedness would greatly simplify use of the AMA Guides.

Reconsidering NMIHBA Core Features: Macrocephaly Is Not a So Unusual Sign in PRUNE1-Related Encephalopathy

2020 ◽  
Author(s):  
Roberta Battini ◽  
Enrico Bertini ◽  
Roberta Milone ◽  
Chiara Aiello ◽  
Rosa Pasquariello ◽  
...  
Keyword(s):  
Nervous System ◽  
Differential Diagnosis ◽  
Clinical Features ◽  
Neurodevelopmental Disorder ◽  
Recurrent Mutation ◽  
Clinical Suspicion ◽  
Alexander Disease ◽  
Brain Anomalies ◽  
Progressive Encephalopathy ◽  
Core Features

Abstract PRUNE1-related disorders manifest as severe neurodevelopmental conditions associated with neurodegeneration, implying a differential diagnosis at birth with static encephalopathies, and later with those manifesting progressive brain damage with the involvement of both the central and the peripheral nervous system.Here we report on another patient with PRUNE1 (p.Asp106Asn) recurrent mutation, whose leukodystrophy, inferior olives hyperintensity, and macrocephaly led to the misleading clinical suspicion of Alexander disease. Clinical features, together with other recent descriptions, suggest avoiding the term “microcephaly” in defining this disorder that could be renamed “neurodevelopmental disorder with progressive encephalopathy, hypotonia, and variable brain anomalies” (NPEHBA).

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