scholarly journals A case of chronic progressive Lyme encephalitis as a manifestation of late Lyme neuroborreliosis

2014 ◽  
Vol 6 (4) ◽  
Author(s):  
Vivek Verma ◽  
Matthew Roman ◽  
Disha Shah ◽  
Marina Zaretskaya ◽  
Mohamed H. Yassin
Keyword(s):  
White Matter ◽  
Short Term Memory ◽  
Treatment Options ◽  
Chronic Fatigue ◽  
Short Term ◽  
Mri Findings ◽  
White Matter Changes ◽  
Neurological Improvement ◽  
Magnetic Resonance Imaging Mri

A 54-year-old female living in Europe presented with gait ataxia, dizziness, and bilateral hearing loss. Magnetic resonance imaging (MRI) revealed non-specific white matter changes. The patient’s condition gradually deteriorated over two years without diagnosis. The patient continued to decline cognitively and neurologically with worsening ataxia and upper motor neuron signs. Repeat MRI showed worsening white matter changes. Lumbar puncture, not previously done, showed positive Lyme testing. Treatment with intravenous ceftriaxone resulted in marked neurological improvement. Four years after symptom, the patient has short-term memory deficits and chronic fatigue, but is otherwise neurologically, cognitively, and functionally intact. Follow up MRI findings remain largely unchanged. Because cases of intraparenchymal or encephalopathic neuroborreliosis in America are lacking, so are treatment options. We present a rare case and discuss our experience with antibiotic treatment. This case lends evidence to define optimal treatment of this disease, imperative for hastening neurological recovery.

scholarly journals A severe anti-NMDA-receptor encephalitis case with extensive cortical and white matter changes, cerebral atrophy and communicating hydrocephalus

2016 ◽  
Vol 26 (1) ◽  
pp. 58-61 ◽  
Author(s):  
Nor Amelia Mohd Fauzi ◽  
Joyce Pauline Joseph ◽  
Norzaini Rose Mohd Zain ◽  
Hilwati Hashim
Keyword(s):  
White Matter ◽  
Short Term Memory ◽  
Clinical Status ◽  
Brain Magnetic Resonance Imaging ◽  
Cerebral Atrophy ◽  
Ovarian Teratoma ◽  
Communicating Hydrocephalus ◽  
Intravenous Immunoglobulin Therapy ◽  
White Matter Changes

A 21-year-old woman presented with a viral prodrome, abnormal behaviours, confusion and short-term memory loss, followed by status epilepticus that later evolved to orofacial dyskinesias, autonomic dysfunctions and hypoventilation requiring prolonged ventilator support and ICU admission. Cerebrospinal fluid (CSF) and serum analysis confirmed the presence of anti-NMDAR autoantibodies. A left salpingoopherectomy was performed on day 35 of admission revealing an immature ovarian teratoma. Following surgical and two courses of intravenous immunoglobulin therapy, her response remained poor. Initial brain magnetic resonance imaging (MRI) during the acute stage showed enlarged left hippocampus. Further MRI follow-up 13 weeks after admission showed unusual findings of extensive cortical and white matter changes, generalised cerebral atrophy, dilated ventricles and possible transependymal CSF seepage of communicating hydrocephalus. A ventriculo-peritoneal shunt was performed subsequently and she was discharged 6 months after admission without significant change in her clinical status. Follow-up 4 months later showed some improvement but patient remained severely disabled.

The Link Between Verbal Short-Term Memory and Anomia Treatment Gains

2019 ◽  
Vol 28 (3) ◽  
pp. 1039-1052
Author(s):  
Reva M. Zimmerman ◽  
JoAnn P. Silkes ◽  
Diane L. Kendall ◽  
Irene Minkina
Keyword(s):  
Short Term Memory ◽  
Controlled Trial ◽  
Treatment Success ◽  
Linear Regression Models ◽  
Language Performance ◽  
Short Term ◽  
Term Memory ◽  
Treatment Gains ◽  
Post Hoc

Purpose A significant relationship between verbal short-term memory (STM) and language performance in people with aphasia has been found across studies. However, very few studies have examined the predictive value of verbal STM in treatment outcomes. This study aims to determine if verbal STM can be used as a predictor of treatment success. Method Retrospective data from 25 people with aphasia in a larger randomized controlled trial of phonomotor treatment were analyzed. Digit and word spans from immediately pretreatment were run in multiple linear regression models to determine whether they predict magnitude of change from pre- to posttreatment and follow-up naming accuracy. Pretreatment, immediately posttreatment, and 3 months posttreatment digit and word span scores were compared to determine if they changed following a novel treatment approach. Results Verbal STM, as measured by digit and word spans, did not predict magnitude of change in naming accuracy from pre- to posttreatment nor from pretreatment to 3 months posttreatment. Furthermore, digit and word spans did not change from pre- to posttreatment or from pretreatment to 3 months posttreatment in the overall analysis. A post hoc analysis revealed that only the less impaired group showed significant changes in word span scores from pretreatment to 3 months posttreatment. Discussion The results suggest that digit and word spans do not predict treatment gains. In a less severe subsample of participants, digit and word span scores can change following phonomotor treatment; however, the overall results suggest that span scores may not change significantly. The implications of these findings are discussed within the broader purview of theoretical and empirical associations between aphasic language and verbal STM processing.

scholarly journals PTSD, depression and anxiety in Ebola virus disease survivors in Beni town, Democratic Republic of the Congo

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Célestin Kaputu-Kalala-Malu ◽  
Eric Mafuta Musalu ◽  
Tim Walker ◽  
Olga Ntumba-Tshitenge ◽  
Steve Ahuka-Mundeke
Keyword(s):  
Ebola Virus ◽  
Democratic Republic ◽  
Short Term Memory ◽  
Virus Disease ◽  
Ebola Virus Disease ◽  
Depression And Anxiety ◽  
Short Term ◽  
Republic Of The Congo ◽  
Persistent Headache

Abstract Background Ebola Virus Disease (EVD) is a deadly and feared infectious disease, which can be responsible of debilitating physical and psychological sequelae in survivors including depression and anxiety disorders. Unfortunately, there are scarce data on survivor sequelae in Democratic Republic of the Congo. So this study assessed PTSD, depression and anxiety symptoms among EVD survivors enrolled in the follow-up program of the psychosocial care team of Beni town’s general hospital. Methods A cross-sectional study used consecutive sampling to recruit 144 Ebola virus disease survivors who came for follow up from October 23 to November 13; 2019. Basic socio-demographic data, presence of headache and short-term memory function were assessed. The Post-traumatic Checklist Scale and Hospital Anxiety and Depression Scale were used to assess psychological burden among participants. Descriptive statistics were used to summarized data and Pearson’s or likelihood chi-square were used to test association between psychiatric disorders and associated factors. Results The prevalence of PTSD, depression and anxiety was 24.3, 24.3 and 33.3% respectively. Being male (OR = 0.42, 95% CI: 0.16, 0.95, p = 0.049), suffering from persistent headache (OR = 2.62, 95% CI: 1.12, 6.14, p = 0.014), losing a loved one because of EVD (OR: 2.60, 95% CI: 1.11, 6.15, p = 0. 015) and being young − 18-24 years - (OR: 0. 261, 95% CI: 0. 08, 0.82, p = 0,026) were statistically associated with PTSD diagnosis. Having short-term memory impairment and suffering from persistent headache were statistically associated with depression and anxiety diagnoses (OR = 2.44, 95% CI: 1.03, 5.82, p = 0.026); (OR = 2.24, 95% CI: 1.04, 4.85, p = 0.025); (OR = 2.62, 95% CI: 1.12, 6.14, p = 0.014); (OR = 2.31, 95% CI: 1.06, 5.01, p = 0.020). Conclusion The prevalence of PTSD, depression and anxiety is high among EVD survivors. Development of specialized psychiatric services to sustain psychiatric and psychological health amongst survivors in the cultural context of the Eastern part of the DRC should be considered by the teams fighting against EVD in the DRC.

Abstract 115: One-Year Outcomes in Individual Domains of the Cerebral Performance Category Extended

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Katharyn L Flickinger ◽  
Melissa J Repine ◽  
Stephany Jaramillo ◽  
Allison C Koller ◽  
Margo Holm ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Return To Work ◽  
Short Term Memory ◽  
Demographic Data ◽  
Cerebral Performance Category ◽  
Logical Thinking ◽  
Short Term ◽  
Performance Category ◽  
Term Memory

Introduction: Cognitive and physical impairments are common in cardiac arrest survivors. Global measures including the Modified Rankin Scale (mRS), Cerebral Performance Category (CPC) and the 10-domain CPC-Extended (CPC-E) tend to improve over 1 year. The CPC-E is scored from 1-5 with higher scores signifying greater impairment. However, with the CPC-E, individual functional domains (alertness, logical thinking, attention, motor skills, short-term memory, basic and complex activities of daily living (ADL), mood, fatigue, and return to work) may recover at different rates. Hypothesis: We hypothesized that patients would have recovery in all domains of the CPC-E at 1 year after index cardiac arrest. Methods: A prospective cohort study of cardiac arrest survivors was conducted between 2/1/16 and 5/31/17. Chart review was done for baseline demographic data. Outcome measures including mRS, CPC, and CPC-E scores were assessed at discharge, 3 months, 6 months, and 1 year. We defined recovery of a CPC-E domain when >90% of patients had scores of 1-2 in that domain. Results: Of 71 subjects, 35 completed the CPC-E at discharge, 35 at 3 months, 25 at 6 months and 31 at 1 year. The most common reasons for exclusion were patient declined or were lost to follow up. The majority (N=37; 52%) were female, with a mean (SD) age of 58(17) years. Most arrests occurred out of hospital (N= 49; 69%), 27 (38%) had a shockable rhythm and the majority (N=37; 54%) were discharged home. CPC-E domains of alertness (N=35, 100%) logical thinking (N=35; 100%), and attention (N=33; 94%) recovered by hospital discharge. BADLs were recovered by 3 months (N=33; 94%). The majority of patients (N=24;77%) experienced slight-to-no disability or symptoms (mRS 0-2 / CPC 1-2) at 1 year follow up. CPC-E short term memory (67%), motor (87%), mood (87%), fatigue (13%), complex ADL (74%), and return to work (55%) did not recover fully by 1 year. Conclusions: In survivors of cardiac arrest, CPC-E domains of alertness, logical thinking, and attention recover rapidly, while domains of short term memory, motor, mood, fatigue, complex ADL and ability to return to work are chronically impaired 1 year after arrest. Interventions to improve recovery in these domains are needed.

Abstract TMP119: High Homocysteine Level is not Associated With White Matter Changes, Dementia nor Mortality After Ischemic Stroke

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Susanna Melkas ◽  
Sami Curtze ◽  
Gerli Sibolt ◽  
Niku K Oksala ◽  
Jukka Putaala ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
White Matter ◽  
Homocysteine Level ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Small Vessel ◽  
Cross Sectional ◽  
White Matter Changes ◽  
Vessel Disease

Background: Association between high homocysteine level and cerebral small-vessel disease has been implicated in cross-sectional studies, but results from longitudinal studies have been less clear. The aim of this study was to investigate whether homocysteine level at 3-months poststroke relates to the occurrence of white matter changes (WMC), the surrogate of cerebral small-vessel disease. We also investigated whether it relates to the prognosis after ischemic stroke regarding the risk of dementia at 3-months and mortality in long-term follow-up. Methods: A total of 321 consecutive acute ischemic stroke patients aged 55 to 85 were included in the study and followed up to 12 years. Plasma homocysteine level and occurrence of WMC in MRI were measured 3 months poststroke and dementia according to DSM-III was evaluated at the same time. Findings: The median homocysteine level was 13.50 μmol/l (interquartile range [IQR] 10.60-18.50 μmol/l). Total of 81 patients (25.2%) had homocysteine level above 18.50 μmol/l. In logistic regression analysis, homocysteine level above 18.50 μmol/l was not associated with severe WMC nor with dementia at 3 months poststroke. In Kaplan-Meier analysis, homocysteine level above 18.50 μmol/l was not associated with survival in 12-year follow-up. For further analysis, the group was divided in quartiles according to homocysteine level. The quartiles did not differ in occurrence of severe WMC at baseline, in the risk of dementia at 3 months, nor in the risk of mortality in 12-year follow-up. Interpretation: In our poststroke cohort homocysteine level is not associated with WMC. Further, it does not relate to impaired prognosis manifested as dementia at 3 months or mortality in 12-year follow-up.

scholarly journals Volume of white matter hyperintensities increases with blood pressure in patients with hypertension

2019 ◽  
Vol 47 (8) ◽  
pp. 3681-3689 ◽  
Author(s):  
Yu Zhao ◽  
Zunyu Ke ◽  
Wenbo He ◽  
Zhiyou Cai
Keyword(s):  
Blood Pressure ◽  
White Matter ◽  
White Matter Hyperintensities ◽  
Clinical Analysis ◽  
Primary Diagnosis ◽  
Mri Findings ◽  
Scale Scores ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Fazekas Scale

Objective Hypertension is a risk factor for development of white matter hyperintensities (WMHs). However, the relationship between hypertension and WMHs remains obscure. We sought to clarify this relationship using clinical data from different regions of China. Methods We analyzed the data of 333 patients with WMHs in this study. All included patients underwent conventional magnetic resonance imaging (MRI) examination. A primary diagnosis of WMHs was made according to MRI findings. The volume burden of WMHs was investigated using the Fazekas scale, which is widely used to rate the degree of WMHs. We conducted retrospective clinical analysis of the data in this study. Results Our findings showed that WMHs in patients with hypertension were associated with diabetes, cardiovascular diseases, history of cerebral infarct, and plasma glucose and triglyceride levels. Fazekas scale scores for WMHs increased with increased blood pressure values in patients with hypertension. Conclusion This analysis indicates that hypertension is an independent contributor to the prevalence and severity of WMHs.

Impact of intrathecal cell therapy with autologous stromal cells on short‐term memory binding in early Alzheimer’s disease: One‐year follow‐up assessment

2020 ◽  
Vol 16 (S9) ◽  
Author(s):  
Sara Fernández Guinea ◽  
Mercedes Zurita ◽  
Jorge Mucientes ◽  
Estefanía García ◽  
Javier González Marqués ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Cell Therapy ◽  
Stromal Cells ◽  
Short Term Memory ◽  
Short Term ◽  
Term Memory ◽  
Memory Binding ◽  
Early Alzheimer’S Disease ◽  
One Year

scholarly journals Degenerative Jargon Aphasia: Unusual Progression of Logopenic/Phonological Progressive Aphasia?

2013 ◽  
Vol 26 (1-2) ◽  
pp. 89-93 ◽  
Author(s):  
Paolo Caffarra ◽  
Simona Gardini ◽  
Stefano Cappa ◽  
Francesca Dieci ◽  
Letizia Concari ◽  
...  
Keyword(s):  
Short Term Memory ◽  
Primary Progressive Aphasia ◽  
Healthy Controls ◽  
Semantic Fluency ◽  
Short Term ◽  
Middle Temporal ◽  
Progressive Aphasia ◽  
Executive Deficits ◽  
Semantic Variant

Primary progressive aphasia (PPA) corresponds to the gradual degeneration of language which can occur as nonfluent/agrammatic PPA, semantic variant PPA or logopenic variant PPA. We describe the clinical evolution of a patient with PPA presenting jargon aphasia as a late feature. At the onset of the disease (ten years ago) the patient showed anomia and executive deficits, followed later on by phonemic paraphasias and neologisms, deficits in verbal short-term memory, naming, verbal and semantic fluency. At recent follow-up the patient developed an unintelligible jargon with both semantic and neologistic errors, as well as with severe deficit of comprehension which precluded any further neuropsychological assessment. Compared to healthy controls, FDG-PET showed a hypometabolism in the left angular and middle temporal gyri, precuneus, caudate, posterior cingulate, middle frontal gyrus, and bilaterally in the superior temporal and inferior frontal gyri. The clinical and neuroimaging profile seems to support the hypothesis that the patient developed a late feature of logopenic variant PPA characterized by jargonaphasia and associated with superior temporal and parietal dysfunction.

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