scholarly journals Morvan’s syndrome: case report

2021 ◽  
Author(s):  
Thaís Neves Lima ◽  
Eustáquio Claret dos Santos ◽  
Diego Dias Ramos Dorim ◽  
Gisele Novaes Matias Sion ◽  
Pedro Henrique da Silva Ferraz
Keyword(s):  
Case Report ◽  
Internal Capsule ◽  
Spontaneous Remission ◽  
Progressive Dementia ◽  
Neurological Condition ◽  
Morvan’S Syndrome ◽  
Magnetic Resonance Imaging Mri ◽  
Sudden Decrease ◽  
Simplex Virus ◽  
High Level

Introduction: Morvan’s syndrome is a rare neurological condition characterized by the combination of central and peripheral symptoms such as neuromyotonia by fasciculation, dysautonomy and encephalopathy associated with laboratory evidence of the VGKC antibodies LGI1 and CASPR2. Case report: A 77-year-old man was admitted to the emergency room with a 3-month history of mental confusion, alteration in memory and language, visual and auditory hallucinations, and seizures. He had a sudden decrease level of consciousness and generalized myoclonus, being admitted to the intensive care unit. Due to non-improvement of the neurological condition, the possibility of encephalitis rose, herpes simplex virus (HSV) polymerase chain reaction (PCR) and 14.3.3 protein in cerebrospinal fluid (CSF) were performed, which resulted negative later. Analysis of CSF showed a high level of protein and cells. Magnetic resonance imaging (MRI) of the brain showed hypersignal activity in the bilateral internal capsule, temporal and frontal region. An extensive propaedeutic was performed for rapidly progressive dementia, including an autoimmune panel, with anti-glioma rich in inactivated leucine 1 (LGI-1) positive by indirect immunofluorescence. Discussion: the diagnosis of Morvan’s Syndrome is clinical. Some cases are reported with spontaneous remission and others that require extensive treatment, with immunotherapy, including plasmapheresis and immunosuppression. VGKC antibodies have been reported in association with three main clinical syndromes: neuromyotonia, Morvan’s syndrome and limbic encephalitis.

Top-Ten Tips for Imaging the Brachial Plexus with Ultrasound and MRI

2019 ◽  
Vol 23 (04) ◽  
pp. 405-418 ◽  
Author(s):  
James F. Griffith ◽  
Radhesh Krishna Lalam
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Brachial Plexus ◽  
Muscle Denervation ◽  
Resonance Imaging ◽  
Neural Injury ◽  
Clinical Indications ◽  
Magnetic Resonance Imaging Mri ◽  
High Level ◽  
Extensive Involvement

AbstractWhen it comes to examining the brachial plexus, ultrasound (US) and magnetic resonance imaging (MRI) are complementary investigations. US is well placed for screening most extraforaminal pathologies, whereas MRI is more sensitive and accurate for specific clinical indications. For example, MRI is probably the preferred technique for assessment of trauma because it enables a thorough evaluation of both the intraspinal and extraspinal elements, although US can depict extraforaminal neural injury with a high level of accuracy. Conversely, US is probably the preferred technique for examination of neurologic amyotrophy because a more extensive involvement beyond the brachial plexus is the norm, although MRI is more sensitive than US for evaluating muscle denervation associated with this entity. With this synergy in mind, this review highlights the tips for examining the brachial plexus with US and MRI.

scholarly journals Lymphangiography and focal pleurodesis treatment of chylothorax with an aberrant thoracic duct following oesophagectomy: a case report

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Tomoyuki Ishida ◽  
Jun Kanamori ◽  
Hiroyuki Daiko
Keyword(s):  
Magnetic Resonance Imaging ◽  
Interventional Radiology ◽  
Case Report ◽  
Magnetic Resonance ◽  
Thoracic Duct ◽  
Rare Case ◽  
Resonance Imaging ◽  
Case Presentation ◽  
Thoracostomy Tube ◽  
Magnetic Resonance Imaging Mri

Abstract Background Management of postoperative chylothorax usually consists of nutritional regimens, pharmacological therapies such as octreotide, and surgical therapies such as ligation of thoracic duct, but a clear consensus is yet to be reached. Further, the variation of the thoracic duct makes chylothorax difficult to treat. This report describes a rare case of chylothorax with an aberrant thoracic duct that was successfully treated using focal pleurodesis through interventional radiology (IVR). Case presentation The patient was a 52-year-old man with chylothorax after a thoracoscopic oesophagectomy for oesophageal cancer. With conventional therapy, such as thoracostomy tube, octreotide or fibrogammin, a decrease in the amount of chyle was not achieved. Therefore, we performed lymphangiography and pleurodesis through IVR. The patient appeared to have an aberrant thoracic duct, as revealed by magnetic resonance imaging (MRI); however, after focal pleurodesis, the leak of chyle was diminished, and the patient was discharged 66 days after admission. Conclusions Chylothorax remains a difficult complication. Focal pleurodesis through IVR can be one of the options to treat chylothorax.

scholarly journals Traumatic Gallbladder Perforation in Children – Case Report and Review

2021 ◽  
Author(s):  
Melanie Thanh Phuong Le ◽  
Jochen Herrmann ◽  
Michael Groth ◽  
Konrad Reinshagen ◽  
Michael Boettcher
Keyword(s):  
Case Report ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Recent Literature ◽  
Signs And Symptoms ◽  
Gallbladder Wall ◽  
Gallbladder Perforation ◽  
Free Fluid ◽  
Key Points ◽  
Magnetic Resonance Imaging Mri

Background Gallbladder perforation is a very rare finding in children. Clinical and radiografic presentations are often vague. Hence it is a challenging diagnosis, often missed during initial evaluation with potentially fatal consequences. The aim of this case report and review was to identify factors that might help to diagnose and manage future cases. Methods We present a case of gallbladder perforation in an 8-year-old child after blunt abdominal trauma caused by a handlebar in which imaging modalities such as ultrasound and magnetic resonance imaging (MRI) helped us to determine proper management. We identified and evaluated comparable cases for isolated traumatic gallbladder injury. A review of the recent literature was performed by online search in Pubmed and Google Scholar using “gallbladder injury in children”, “gallbladder perforation children”, “blunt abdominal trauma children” as keywords. We focused on articles exclusively in the pediatric section. The literature from the period 2000–2020 was taken into account to review the state of the art in diagnosis and management. Results and Conclusion Recent literature for gallbladder injury in pediatrics is sparse compared to the adult counterpart. Only eight published cases of isolated gallbladder injury in children were identified. Since the onset of symptoms may not develop acutely and often develops in an indistinct manner, radiografic examinations play an important role in the diagnostic progress. The authors advise caution in cases of blunt abdominal trauma especially involving handlebars, intraperitoneal free fluid, and severe abdominal pain. We advocate high suspicion of gallbladder perforation if the gallbladder wall displays discontinuation or cannot be definitively differentiated in sonografic examination. Echogenic fluid within the gallbladder should always lead to suspicion of intraluminal bleeding. Repeated clinical and imaging examinations are mandatory since the onset of signs and symptoms may be delayed. Key Points:  Citation Format

scholarly journals Complete heart block in cardiac sarcoidosis reversed by corticosteroid therapy: time course of resolution

2021 ◽  
Vol 14 (3) ◽  
pp. e240834
Author(s):  
Anna Tomdio ◽  
Huzaefah Syed ◽  
Kenneth Ellenbogen ◽  
Jordana Kron
Keyword(s):  
Heart Block ◽  
Time Course ◽  
Cardiac Sarcoidosis ◽  
Complete Heart Block ◽  
Positron Emission ◽  
Av Conduction ◽  
Magnetic Resonance Imaging Mri ◽  
High Level ◽  
Active Inflammation ◽  
Lateral Walls

A 53-year-old man was admitted for recurrent syncope and found to have complete heart block (CHB). Cardiac magnetic resonance imaging MRI) showed extensive patchy late gadolinium enhancement in the apical and lateral walls, consistent with cardiac sarcoidosis (CS) but no scar in the septum. A fluorodeoxyglucose (FDG)–positron emission tomography showed FDG uptake in the septum and basal lateral walls. Imaging suggested active inflammation in the septum affecting atrioventricular (AV) conduction but no irreversible fibrosis. Diagnosis of isolated CS requires a high level of suspicion and multidisciplinary teamwork involving heart failure specialists, electrophysiologists and rheumatologists. After specialist and patient discussion, treatment of the disease was initiated with prednisone 40 mg daily, 11 months after presenting with CHB. Three weeks later, ECG with pacing inhibited showed second-degree AV block Mobitz type II and 4 weeks later, AV conduction recovery. This highlights the importance of immediate therapy in reversing AV conduction abnormalities in CS.

scholarly journals Multifocal glioblastoma multiform with “encephalitis-like presentation” : a case report

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Issam Sa’adeh ◽  
Mohamed Jamal Saadh
Keyword(s):  
Vasogenic Edema ◽  
Neurological Deficits ◽  
Herpes Simplex Virus 1 ◽  
Glioblastoma Multiform ◽  
Atypical Clinical Presentation ◽  
Mri Scans ◽  
The Central Nervous System ◽  
Magnetic Resonance Imaging Mri ◽  
Simplex Virus ◽  
Multifocal Glioblastoma

Abstract Background Glioblastoma multiform is the most common and aggressive type of primary malignant tumor that affects the central nervous system in adults. It clinically presents with seizures, headache, and/or progressive focal neurological deficits. Radiologically, glioblastoma multiform appears as a single distinguishable, large heterogeneous lesion affecting the cerebrum with characteristic central necrosis, marginal enhancement, and surrounding vasogenic edema. This article describes a patient that exhibited an atypical clinical presentation of multifocal glioblastoma multiform with misleading early radiological features that simulated herpetic encephalitis. Results A 66-year-old female that presented with left-sided hemiparesis and left partial motor seizures underwent multi-slice computed tomography (MSCT) and magnetic resonance imaging (MRI) scans. A cerebrospinal fluid (CSF) polymerase chain reaction (PCR) test was also performed to screen for herpes simplex virus 1 (HSV-1). Conclusions The early stages of glioblastoma may manifest as symptoms typical to encephalitis, which can delay diagnosis and treatment. Therefore, early diagnosis and identification of atypical glioblastoma multiform presentations, as reported in this article, are essential.

scholarly journals Primary small cell type of non-Hodgkin lymphoma of the colon: a case report

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Eyal Meir ◽  
Chovav Handler ◽  
Uri Kaplan ◽  
Doron Kopelman ◽  
Ossama A. Hatoum
Keyword(s):  
Case Report ◽  
Hodgkin Lymphoma ◽  
Small Cell ◽  
Primary Lymphoma ◽  
Cell Type ◽  
Rare Type ◽  
Case Presentation ◽  
Carcinoma Of The Colon ◽  
Non Hodgkin Lymphoma ◽  
High Level

Abstract Introduction Primary lymphoma of the colon is exceedingly rare and comprises 0.2–1% of all colon tumors. The most common subtype of lymphoma in the colon is non-Hodgkin lymphoma. Symptoms are often nonspecific, and treatment varies between chemotherapy alone and a combination of surgery and chemotherapy. Case presentation We describe a case of a Ashkenazi Jew patient who presented in the typical way that carcinoma of the colon might present but turned out to have a very rare type of tumor in both its histology and its location. Conclusion There was apparent discordance between the relative bulkiness and gross appearance of the tumor with the unrevealing result of the biopsies, demanding a high level of suspicion as to the actual presence and possible type of such a tumor in the future.

Verrucous carcinoma of the esophagus – a case report and literature review

2020 ◽  
Vol 58 (10) ◽  
pp. 971-974
Author(s):  
Thomas Frieling ◽  
Christian Kreysel ◽  
Michael Blank ◽  
Dorothee Müller ◽  
P. Euler ◽  
...  
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Verrucous Carcinoma ◽  
Tumor Stage ◽  
Esophageal Resection ◽  
Middle Part ◽  
Herpes Simplex Virus 1 ◽  
Carcinoma Of The Esophagus ◽  
Tissue Specimens ◽  
Simplex Virus

Abstract Background Verrucous carcinoma of the esophagus is a rare disease leading to dysphagia, chest pain, and weight loss. The diagnosis is difficult because even repeated biopsies are often without tumor evidence. We present a patient with verrucous carcinoma of the esophagus and a literature review. Case report A 64-year-old patient with dysphagia and sore throat received esophagogastroduodenoscopy illustrating segmental circumferential verrucous inflammation and Candida esophagitis in the middle part of the esophagus. Repeated mucosal biopsies revealed reactive hyperkeratosis of the squamous epithelium with minimal atypia but without ulcera, eosinophilic esophagitis, or suspicion of cancer. Mucosal infection with adenovirus, herpes simplex virus 1, human papilloma virus types, and cytomegaly virus was ruled out. Veruccous carcinoma was detected finally by endoscopic mucosal resection. The patient was successfully treated by esophageal resection. Tumor stage was G1, pT1b, pN0, L0, V0, Pn0, R0. Conclusion The results suggest that macroscopic suspicion of verrucous esophageal carcinoma should lead to resections of larger tissue specimens by EMR to confirm the diagnosis.

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