Neurological Symptoms
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Tatiana Varsegova ◽  
Olga Vladimirovna Diuriagina ◽  
Nikolai Ivanovich Antonov ◽  
Sergey Olegovich Ryabykh

Neuropathies of the lumbar plexus trunks, in particular those of the femoral nerve, are the most common complications of lateral interbody spondylodesis of the lumbar spine. Modeling of this surgical intervention in normal animals experimentally makes it possible to assess the degree of its trauma to the nervous structures, and to understand what is the reason for the persistence or aggravation of neurological symptoms iatrogenic injuries or the existing pathology progression. Purpose of the Study. To study histological and morphometric changes in the femoral nerve in the long-term periods after modeling of the lateral interbody spondylodesis of the canine lumbar spine. Design of the Study. An experimental prospective continuous uncontrolled study. Material and Methods. Discectomy via lateral approach was performed in 18 mongrel dogs (aged 2-3 years, mass 13.2-17.6 kg) at the level of L4-5 и L5-6, interbody titanium implants were mounted, the lumbar spine was stabilized with a wire device for external fixation within 30 days. Clinical-and-neurological evaluation was performed, as well as histological investigation of the femoral nerves from the side of surgical approach. Results. In the early postoperative period a temporary decrease in the femoral nerve function was observed, which was manifested by the disorder of the support function and muscle weakness of the pelvic limbs, decrease in the knee reflex, the foot support shift to the metatarsal pad. Later, until the end of the study (18 months), the general condition of all animals was satisfactory, there were no disorders of the limb support function and motor reflexes. After six months, in the femoral nerve there was 4-fold decrease in the proportion of large fast-conducting myelin fibers D 10 m and 3-fold increase in that of the small ones. The mean axon diameter and myelin thickness were 62% and 53% of the norm. After 12-18 months, the dimensional characteristics of myelin fibers were restored. During the entire experiment, 4-6% of myelin fibers were reactively-and-destructively altered. Conclusions. The modeling of the lateral interbody spondylodesis of the lumbar spine in normal animals experimentally demonstrated the absence of neurological symptoms after 6-18 months, which indicated low invasiveness of the surgical intervention. Nevertheless, the subclinical reactive-and-destructive changes in the myelin fibers of the femoral nerve revealed 6 months after the surgery indicated the need for preventive anti-neurotic therapy.

2021 ◽  
Saba Islam ◽  
Mirren Charnley ◽  
Guneet Bindra ◽  
Julian Ratcliffe ◽  
Jiangtao Zhou ◽  

COVID-19 is primarily known as a respiratory disease caused by the virus SARS-CoV-2. However, neurological symptoms such as memory loss, sensory confusion, cognitive and psychiatric issues, severe headaches, and even stroke are reported in as many as 30% of cases and can persist even after the infection is over (so-called 'long COVID'). These neurological symptoms are thought to be caused by brain inflammation, triggered by the virus infecting the central nervous system of COVID-19 patients, however we still don't fully understand the mechanisms for these symptoms. The neurological effects of COVID-19 share many similarities to neurodegenerative diseases such as Alzheimer's and Parkinson's in which the presence of cytotoxic protein-based amyloid aggregates is a common etiological feature. Following the hypothesis that some neurological symptoms of COVID-19 may also follow an amyloid etiology we performed a bioinformatic scan of the SARS-CoV-2 proteome, detecting peptide fragments that were predicted to be highly amyloidogenic. We selected two of these peptides and discovered that they do rapidly self-assemble into amyloid. Furthermore, these amyloid assemblies were shown to be highly toxic to a neuronal cell line. We introduce and support the idea that cytotoxic amyloid aggregates of SARS-CoV-2 proteins are causing some of the neurological symptoms commonly found in COVID-19 and contributing to long COVID, especially those symptoms which are novel to long COVID in contrast to other post-viral syndromes.

2021 ◽  
Vol 9 ◽  
Amélie Cyr ◽  
Ryan Frehlick ◽  
David Stammers ◽  
Megan Crone

Vitamin B12 deficiency in childhood presents with a wide variety of symptoms including anemia, failure to thrive and developmental delays. It is a diagnostic consideration in children who are exclusively breastfed or have minimal solid intake, especially if their mother is vegetarian or has underlying vitamin B12 deficiency. Infantile tremor syndrome (ITS) has been associated with vitamin B12 deficiency. ITS presents with neurological symptoms such as developmental delays and tremors. The tremors seen in ITS can be profound and interfere with daily functioning. Different therapies have been tried for those tremors without much evidence or information regarding their efficacy and dosing regimens. We present the case of a 13-month-old girl with vitamin B12 deficiency who developed ITS with significant tremors after initiation of vitamin B12 therapy. She was treated with propranolol which resulted in significant improvement in her tremors. This case highlights the efficacy and safety of propranolol for the treatment of ITS in the context of vitamin B12 deficiency.

2021 ◽  
Vol 2 ◽  
Jude P. J. Savarraj ◽  
Angela B. Burkett ◽  
Sarah N. Hinds ◽  
Atzhiry S. Paz ◽  
Andres Assing ◽  

COVID-19 is an ongoing pandemic with a devastating impact on public health. Acute neurological symptoms have been reported after a COVID-19 diagnosis, however, the long-term neurological symptoms including pain is not well established. Using a prospective registry of hospitalized COVID-19 patients, we assessed pain and neurological function (including functional, cognitive and psychiatric assessments) of several hospitalized patients at 3 months. Our main finding is that 60% of the patients report pain symptoms. 71% of the patients still experienced neurological symptoms at 3 months and the most common symptoms being fatigue (42%) and PTSD (25%). Cognitive symptoms were found in 12%. Our preliminary findings suggests the importance of investigating long-term outcomes and rationalizes the need for further studies investigating the neurologic outcomes and symptoms of pain after COVID-19.

2021 ◽  
Vol 9 ◽  
Ilaria Stolfi ◽  
Maria Giulia Conti ◽  
Alessandra Marciano ◽  
Lucia Dito ◽  
Fabio Natale ◽  

Neonatal SARS-CoV-2 infection can occur antenatally, peripartum, or postnatally. In the newborn, clinical manifestations may vary including fever and respiratory, gastrointestinal and neurological symptoms. Most commonly, they are subclinical. We herein present a case of vertical transmission of SARS-CoV-2 presenting with liver injury, characterized by an increase in serum transaminases.

2021 ◽  
Vol 10 (22) ◽  
pp. 5225
Agata Czarnowska ◽  
Katarzyna Kapica-Topczewska ◽  
Olga Zajkowska ◽  
Monika Adamczyk-Sowa ◽  
Katarzyna Kubicka-Bączyk ◽  

(1) Background: To report and analyze the presence of residual symptoms after SARS-CoV-2 infection among Polish patients with multiple sclerosis (MS) treated with different disease-modifying therapies (DMTs). (2) Methods: The study included 426 individuals with MS treated with DMTs and confirmed SARS-CoV-2 infection from 12 Polish MS centers. The data were collected through to 31 May 2021. The information included demographics, specific MS characteristics, course of SARS-CoV-2 infection, and residual (general and neurological) symptoms lasting more than four and 12 weeks after the initial infection. The results were obtained using maximum likelihood estimates for odds ratio and logistic regression. (3) Results: A total of 44.84% patients with MS reported symptoms lasting between four and 12 weeks after the initial infection; 24.41% people had symptoms that resolved up to 12 weeks, and 20.42% patients had symptoms that lasted over 12 weeks. The most common symptoms were: fatigue, disturbance of concentration, attention, and memory, cognitive complaints, and headache. None of the DMTs were predisposed to the development of residual symptoms after the initial infection. A total of 11.97% of patients had relapse three months prior or after SARS-CoV-2 infection. (4) Conclusion: Almost half of individuals with MS treated with different DMTs had residual symptoms after SARS-CoV-2 infection. None of the DMTs raised the probability of developing post-acute COVID symptoms.

2021 ◽  
Vol 99 (10) ◽  
pp. 66-72
E. V. Korzh ◽  
N. A. Podchos ◽  
S. A. Iskevich ◽  
O. E. Perederiy

The article presents a clinical case of pulmonary tuberculosis with destruction and bacterial excretion in the patient with systemic sarcoidosis and cerebral lesions. Tuberculosis was characterized by the infiltrate and cavity in S1+2 of the left lung, tuberculous mycobacteria were detected by microscopy, GeneXpertMBT/Rif, and culture. Systemic sarcoidosis with brain involvement was diagnosed based on intrathoracic lymphadenopathy in 2015, development of dissemination in the lungs and neurological symptoms by 2018, deterioration of changes by 2019, rapid partial resolution of foci in the lungs, and moderate regression of neurological disorders during the treatment with prednisolone. A full course of anti-tuberculosis chemotherapy (316 doses) resulted in persistent sputum conversion, resolution of the infiltrate and cavity healing. Prednisolone was administered simultaneously for 318 days with increased doses (45-35 mg) for the first 2 months, then titrated down to 15 mg and remained so until the end of the treatment with gradual reduction and discontinuation. Changes in the lungs and improvement of clinical and radiological manifestations of neurosarcoidosis were documented.

2021 ◽  
Vol 16 (3) ◽  
pp. 69-74
E. V. Saifullina ◽  
E. V. Gaysina ◽  
R. V. Magzhanov ◽  
A. A. Yalaev ◽  
I. O. Nagornov

Leukoencephalopathy with vanishing white matter (VWM disease) is a progressive neurodegenerative disease with a specific magnetic resonance pattern characterized by diffuse lesions to the white matter and cystic degeneration. In this article, we report a case VWM disease in a boy with white matter lesions, in whom early onset and neurological symptoms suggested infantile form of the disease. The diagnosis was confirmed by the detection of biallelic mutations c.1688G>A (p.Arg563Gln) and c.1309G>A (p.Val437Met) in the EIF2B5 gene. The c.1309G>A mutation (p.Val437Met) was detected for the first time; it caused the development of severe disease.

Cureus ◽  
2021 ◽  
Abdullah A Tawakul ◽  
Ahmad H Alharbi ◽  
Ahaad M Basahal ◽  
Abdulrahman M Almalki ◽  
Bashaer Alharbi ◽  

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