acute encephalopathy
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Cureus ◽  
2022 ◽  
Author(s):  
Sohaib Khatib ◽  
Fouad Jaber ◽  
Marwa Elsayed ◽  
Islam M Shatla ◽  
Majdi S Hamarshi

2021 ◽  
Author(s):  
Jeremy Jones
Keyword(s):  

Cureus ◽  
2021 ◽  
Author(s):  
Jawaher Al Zeyoudi ◽  
Aisha Al Naqbi ◽  
Deanne Kashiwagi ◽  
Mustaqeem Siddiqui

Author(s):  
Atsuko Ohno ◽  
Akihisa Okumura ◽  
Tatsuya Fukasawa ◽  
Tomohiko Nakata ◽  
Motomasa Suzuki ◽  
...  
Keyword(s):  

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tomonori Nagai ◽  
Nozomu Hanaoka ◽  
Harutaka Katano ◽  
Masami Konagaya ◽  
Keiko Tanaka-Taya ◽  
...  

Abstract Background Certain types of enteroviruses, including coxsackieviruses, cause encephalitis, and other neurological complications. However, these pathogens rarely cause fatal infections, especially in immunocompetent infants. In this study, we present a rare case of acute encephalopathy caused by coxsackievirus A2 (CV-A2), which progressed rapidly in a previously healthy female child. Case presentation In June 2013, a 26-month-old female child from Kanagawa, Japan, was found unresponsive during sleep. She was healthy until that morning. Her temperature was 37 °C at 08:00. She was feeling fine and went to the nursery that same morning. However, her condition worsened around noon. Therefore, she went home and slept at around 13:00. Surprisingly, after 2 h, her parents checked on her and found that she was lying on her back and was not breathing. Hence, she was immediately taken to a hospital by ambulance, but she was declared dead on arrival at the hospital. Subsequently, pathological autopsy and pathogenetic analysis, including multiple pathogen detection real-time PCR, were conducted to investigate the cause of death. The examination results revealed that she had an infectious respiratory disease and acute encephalopathy due to a CV-A2 infection. Conclusions Based on our findings, we concluded that a previously healthy girl who had no immediate history of underlying medical condition were susceptible to death by acute encephalopathy due to CV-A2 infections. We proposed this conclusion because the patient’s condition progressed rapidly in less than 2 h and eventually led to her death. This is the first report on an acute encephalitis-dependent death in a child due to CV-A2 infection.


2021 ◽  
Vol 22 ◽  
Author(s):  
Peter Akpunonu ◽  
Regan A. Baum ◽  
Andrew Reckers ◽  
Blake Davidson ◽  
Ross Ellison ◽  
...  

Author(s):  
Hashaam Arshad ◽  
Zhenhua Gui ◽  
Dakota Owens ◽  
Binod Wagle ◽  
Charles Donohoe

Introduction : A 51‐year‐old lady with a past medical history of Essential Hypertension, Hypothyroidism, prior Herpes Zoster infection 8 weeks ago was admitted with complaints of abdominal pain, bilateral flank pain, and restlessness. Her initial workup was significant for hyponatremia and hypokalemia. On the 3rd day of admission, she developed acute hypoxemic respiratory failure which led to intubation. At that time, CTA Chest was not done but CT Chest revealed prominent mucous plugging with left side glass ground opacities, Ultrasound of lower extremities revealed right common femoral vein DVT which led to concerns that she may have suffered from Pulmonary Embolism and led to starting Heparin drip. On the 6th day of admission, she developed Acute Encephalopathy, MRI Brain revealed acute infarcts in bilateral cerebral cortices and cerebella, CT Angiogram Head showed acute subarachnoid hemorrhage in the high posterior right parietal lobe, stenosis of the right high cervical internal carotid artery, and irregular, the appearance of the arterial vasculature throughout and CT Angiogram Neck abrupt change in caliber of the right ICA, 1.5 cm distal to the bifurcation with markedly severe narrowing of the majority of the extracranial right ICA throughout its course. A cerebral Angiogram was done which showed diffuse tandem segments of tandem cervical and intracranial portions of the right internal carotid artery and she was given nitroglycerin was administered as a therapeutic intervention. Lumbar Puncture showed WBC 2, RBC 7, Protein 162, Glucose 64, VZV PCR was negative, CSF VZV IgG Antibody positive at 303 IV (>165 IV indicative of current or past infection). Serum VZV IgG Antibody was positive at >4000 IV. Infectious Diseases were consulted after Lumbar Puncture, they initially started Acyclovir but once the Serum VZV IgG Antibody came back much higher than Serum VZV IgG Antibody levels, their assessment was that VZV vasculitis is unlikely and Acyclovir was discontinued. Eventually, the case was discussed at Neuroradiology which led to us getting a repeat MRA Neck without contrast which showed a concentric T1 and T2 hyperintensity along with a small and irregular caliber right cervical ICA consistent with dissection. She eventually completed a 21‐day course of Nimodipine due to underlying Subarachnoid Hemorrhage. Methods : NA Results : NA Conclusions : Our case demonstrates how it can become difficult to ascertain the etiology of stroke in certain patients. Our patient presented with multiple non‐specific symptoms initially and it was later on due to her Acute Encephalopathy that her Strokes and Subarachnoid Hemorrhage were discovered. It is still difficult to pinpoint whether the cause of strokes was dissection or VZV infection. Lumbar Puncture remains an essential tool to complete work up on uncommon etiologies of stroke.


2021 ◽  
Vol 12 ◽  
Author(s):  
Masanori Maeda ◽  
Tohru Okanishi ◽  
Yosuke Miyamoto ◽  
Takuya Hayashida ◽  
Tatsuya Kawaguchi ◽  
...  

Background: Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) often causes various neurological sequelae, necessitating early and objective differentiation of AESD from a febrile seizure (FS). Therefore, we developed a scoring system that predicts AESD onset using only early laboratory data.Methods: We selected patients with AESD or FS admitted to the Tottori University Hospital between November 2005 and September 2020 and collected laboratory data from onset to discharge in patients with FS and from onset to the second neurological events in patients with AESD.Results: We identified 18 patients with AESD and 181 patients with FS. In comparison with patients with FS, patients with AESD showed statistically significant increases in ammonia (NH3), blood sugar (BS), and serum creatinine (Cr) levels, and the white blood cell (WBC) count, and a significant decrease in pH at <3 h from onset. We set the cut-off values and adjusted the weight of each of these parameters based on data obtained <3 h from onset and proposed a scoring system for predicting AESD. This system showed 91% sensitivity and 94% specificity for distinguishing AESD from FS. These accuracies were only slightly improved by the addition of information related to consciousness and seizure duration (sensitivity, 91%; specificity, 96%).Conclusion: NH3, BS, and Cr levels, WBC count, and pH were significantly different between patients with AESD and patients with FS at <3 h from seizure onset. This scoring system using these data may enable the prediction of AESD onset for patients under sedation or without precise clinical information.


Neurología ◽  
2021 ◽  
Author(s):  
A. Jové Blanco ◽  
J. Lorente Romero ◽  
E. Barredo Valderrama ◽  
P. Castro de Castro

2021 ◽  
pp. 155005942110467
Author(s):  
Xavier Merchán-del-Hierro ◽  
Gabriel Persi ◽  
María C. Vulycher ◽  
Carla Chicco ◽  
Emilia M. Gatto ◽  
...  

Introduction. In clinical practice, it is difficult to define the prognosis of patients with acute encephalopathy; a syndrome characterized by cognitive dysfunction and altered sensorium. Discharges with triphasic morphology (DTM) are an electroencephalographic pattern that might be useful to establish the risk of death. The aim of this study was to define the prognostic value of DTM regarding mortality in patients with acute encephalopathy. Methods. We conducted an observational retrospective cohort study including patients with acute encephalopathy with and without DTM paired by age and gender in a 1:2 ratio. We calculated the odds ratio (OR) to determine the association between DTM and mortality. In addition, we calculated sensibility, specificity, and predictive values. Results. We included 72 patients, 24 with DTM and 48 without DTM. Mortality was higher in patients with DTM (41.6% vs 14.5%, P  =  .01). Factors associated with a higher risk of death were DTM (OR  =  4.1, 95% confidence interval [CI] 1.3-13, P  =  .01) and sequential organ failure assessment score (OR  =  1.3, 95% CI 1.04-1.67, P  =  .02). A higher Glasgow coma scale score was associated with a lower risk of death (OR  =  0.65, 95% CI 0.51-0.83, P  =  .001). The sensibility and specificity of DTM were 59% and 75%, respectively. Positive and negative likelihood ratios were 2.36 and 0.55. Discussion. Our results revealed high mortality in patients with acute encephalopathy and DTM. This electroencephalographic pattern was associated with 4 times higher risk of death. However, its usefulness for predicting death was limited.


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