scholarly journals Acute confusional state in SLE. Coexisting SLE and non-SLE etiology

2021 ◽  
Author(s):  
Daniela Gomes Chicre Oliveira ◽  
Marina Ferreira Simões ◽  
CARLOS EDUARDO GARCEZ TEIXEIRA ◽  
ISABELA TAMBELLI PIRES CARDOSO ◽  
PATRICK FONTES RODRIGUES ◽  
...  
2021 ◽  
Vol 14 (2) ◽  
pp. e240536
Author(s):  
Smit Sunil Deliwala ◽  
Murtaza Hussain ◽  
Anoosha Ponnapalli ◽  
Dominic Awuah ◽  
Thair Dawood ◽  
...  

COVID-19 is well known for its respiratory symptoms, but severe presentations can alter haemostasis, causing acute end-organ damage with poor outcomes. Among its various neurological presentations, cerebrovascular events often present as small-vessel strokes. Although uncommon, in predisposed individuals, large-vessel occlusions (LVOs) can occur as a possible consequence of direct viral action (viral burden or antigenic structure) or virus-induced cytokine storm. Subtle presentations and complicated stroke care pathways continue to exist, delaying timely care. We present a unique case of COVID-19 LVO manifesting as an acute confusional state in an elderly man in April 2020. CT angiography revealed 'de novo' occlusions of the left internal carotid artery and proximal right vertebral artery, effectively blocking anterior and posterior circulations. Delirium can lead to inaccurate stroke scale assessments and prolong initiation of COVID-19 stroke care pathways. Future studies are needed to look into the temporal relationship between confusion and neurological manifestations.


2006 ◽  
Vol 13 (9) ◽  
pp. e2-e3
Author(s):  
Y. Ueno ◽  
K. Kimura ◽  
Y. Iguchi ◽  
T. Inoue ◽  
K. Wada ◽  
...  

PEDIATRICS ◽  
1970 ◽  
Vol 45 (4) ◽  
pp. 628-635
Author(s):  
Generoso Gascon ◽  
Charles Barlow

In the literature, complicated migraine usually connotes paroxysmal unilateral headache and vomiting associated with neurological signs, such as hemiplegia, hemianopsia, aphasia, ophthalmoplegia, or syncope. A not uncommon form of complicated migraine in childhood is the presentation with an acute confusional state. Four cases are described. Emphasis is placed on the initial presentation with disturbed sensorium and consciousness, with varying degrees of agitation, and the difficulty for the clinician in distinguishing from other causes of acute mental disturbance, such as toxic-metabolic psychoses due to drug ingestion or known metabolic disease, encephalitis, acute toxic encephalopathy, and epilepsy, particularly petit mal status and postictal confusion. The diagnosis of migraine was made only after the acute episode, when the usual clinical criteria for making a diagnosis of migraine was established in retrospect or by subsequent course. In all cases the episodes of confusion were single ones, with no repetition of similar attacks, although the classic or common types of migraine often reoccurred.


Author(s):  
G.S. Venables ◽  
D. Bates ◽  
N.E.F. Cartlidge

2020 ◽  
Vol 12 (3) ◽  
pp. 359-364
Author(s):  
Zohaib Yousaf ◽  
Mohammed Yaseen Ahmed Siddiqui ◽  
Kamran Mushtaq ◽  
Sayeda Efath Feroz ◽  
Mohamed Aboukamar ◽  
...  

COVID-19 has a broad spectrum of clinical presentations, including central nervous system manifestations that are not uncommon. The high pretest probability of COVID-19 in pandemic can lead to anchoring. We present a patient of COVID-19 pneumonia who presented with dyspnea and acute confusional state. His initial workup was suggestive of tuberculous meningoencephalitis with lymphocytic pleocytosis, high protein in CSF analysis, and suspicious MRI findings, which was later confirmed with a positive CSF culture. To the best of our knowledge, it is the first such case. Anchoring to the diagnosis of COVID-19 may deter clinicians from considering other concurrent diagnoses and a poor outcome consequently.


1983 ◽  
Vol 28 (2) ◽  
pp. 179-180 ◽  
Author(s):  
Dorothea McAreavey ◽  
Penelope J. Redding

Two weeks following a renal arteriogram a 56-year-old man with severe hypertension developed a staphylococcal septicaemia. After six weeks treatment with intravenous fusidic acid and cloxacillin he became icteric, confused and disorientated. The fusidic acid was stopped and the serum bilirubin fell to normal. His confusion persisted and serum cloxacillin levels were found to be grossly elevated. The patient's mental state returned to normal following withdrawal of cloxacillin. We attribute his jaundice to treatment with fusidic acid and his acute confusional state to cloxacillin neurotoxicity.


BMJ ◽  
2002 ◽  
Vol 325 (Suppl S6) ◽  
pp. 0212454
Author(s):  
Hidayath Ansari ◽  
N Balcombe

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