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1.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 43(2): 131-137, Mar.-Apr. 2021. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1285522

ABSTRACT

Objectives: A previous study has shown that schizophrenia (SCZ) is accompanied by lowered levels of trace/metal elements, including cesium. However, it is not clear whether changes in cesium, rubidium, and rhenium are associated with activated immune-inflammatory pathways, cognitive impairments, and the symptomatology of SCZ. Methods: This study measured cesium, rubidium, and rhenium, cognitive impairments (using the Brief Assessment of Cognition in Schizophrenia [BACS]), and the levels of cytokines/chemokines interleukin (IL)-1β, tumor necrosis factor (TNF)-α, and eotaxin (CCL11) in 120 patients with SCZ and 54 healthy controls. Severity of illness was assessed using the Brief Psychiatric Rating Scale (BPRS), the Scale for the Assessment of Negative Symptoms (SANS), the Fibromyalgia and Chronic Fatigue Syndrome Rating (FF) Scale, and the Hamilton Depression Rating Scale (HAM-D). Results: Serum cesium was significantly lower in patients with SCZ as compared with controls. Further, serum cesium was significantly and inversely associated with CCL11 and TNF-α, but not IL-1β, in patients with SCZ; significant inverse associations were also noted between serum cesium levels and BPRS, FF, HAM-D, and SANS scores. Finally, cesium was positively correlated with neurocognitive probe results including the Tower of London, Symbol Coding, Controlled Word Association, Category Instances, Digit Sequencing Task, and List Learning tests. Conclusion: The results suggest that lowered serum cesium levels may play a role in the pathophysiology of SCZ, contributing to specific symptom domains including negative, depressive and fatigue symptoms, neurocognitive impairments (spatial working, episodic, and semantic memory and executive functions), and neuroimmune pathways.

2.
Medisur ; 19(2): 274-279, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1279443

ABSTRACT

RESUMEN: Introducción: Las complicaciones neurológicas como consecuencia de anestesia espinal se han reportado frecuentemente debido al amplio uso de dicha anestesia, la cual puede ocasionar una mielopatía tóxica. Presentación del Caso Paciente de 26 de edad con antecedentes de salud, fue ingresada en el Hospital Clínico Quirúrgico Freyre de Andrade 24 horas después de operada por hemorroides con anestesia espinal (lidocaína hiperbárica). Comienza con ptosis palpebral derecha y dificultad para la marcha. Es egresada y dos días después ingresa en obnubilación y rigidez de nuca con LCR (Líquido Cefalorraquídeo) - positivo y sospecha de meningoencefalitis. Evoluciona en coma sin respuesta satisfactoria a antibióticos durante 14 días. Se constata edema cerebral, trastornos autonómicos, hemiparesia alterna y paraplejía fláccida. Se retira antibiótico y se trata con betametasona parenteral durante dos meses más fisioterapia durante 10 meses. Tuvo mejoría progresiva y recuperación casi total. Todos los estudios microbiológicos fueron normales en suero y líquido cefalorraquídeo Discusión: Se han reportado disímiles lesiones neurológicas por anestesia espinal que incluyen 3 síndromes: meningoencefalitis, lesión de pares craneales y paraparesia(plejía). El caso que presentamos presentó los 3 tipos de lesiones más edema cerebral. Conclusiones: Es infrecuente la asociación de los tres síndromes pues no encontramos caso igual en bases de datos. La resolución con betametasona es un aspecto terapéutico a considerar ante casos similares.


Abstract: Introduction: Neurological complications as a consequence of spinal anesthesia have been frequently reported due to its extensive use, which can cause toxic myelopathy. Case Presentation A 26-years-old patient with a health history was admitted to the Freyre de Andrade Clinical Surgical Hospital 24 hours after surgery for hemorrhoids with spinal anesthesia (hyperbaric lidocaine). It begins with right palpebral ptosis and difficulty walking. She was discharged and two days later she was admitted with drowsiness and stiff neck with positive CSF and suspected meningoencephalitis. She evolves into a coma with no satisfactory response to antibiotics for 14 days. Cerebral edema, autonomic disorders, alternating hemiparesis, and flaccid paraplegia are noted. The antibiotic was withdrawn and she was treated with parenteral betamethasone for two months plus physiotherapy for 10 months. She had progressive improvement and almost total recovery. All serum and cerebrospinal fluid microbiological studies were normal. Discussion: Dissimilar neurological injuries have been reported by spinal anesthesia that include 3 syndromes: meningoencephalitis, cranial nerve injury and paraparesis (plegia). This case had 3 types of lesions plus cerebral edema. Conclusions: The association of the three syndromes is infrequent since we did not find the same case in databases. Resolution with betamethasone is a therapeutic aspect to consider in similar cases

3.
Acta neurol. colomb ; 37(1): 33-38, ene.-mar. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1248568

ABSTRACT

RESUMEN La encefalomielitis aguda diseminada (ADEM) es una enfermedad desmielinizante del sistema nervioso central (SNQ, de baja prevalencia, con predominio de presentación en población pediátrica. Describir y revisar la presentación clínica de un paciente con ADEM, su proceso diagnóstico y el manejo terapéutico, de acuerdo con la evidencia disponible. Adolescente masculino de 17 años, sin antecedentes de importancia, con cuadro de cefalea hemicraneal derecha, tipo punzada, de alta intensidad, dos semanas de evolución y posterior compromiso agudo neurológico multifocal con encefalopatía, hemiparesia y diplopía. Se realiza estudio con resonancia de cerebro contrastada que pone en evidencia lesiones hiperintensas a nivel de tallo, cerebelo y ganglios basales. Estas lesiones son asimétricas, unilaterales y agudas y siguen el trayecto vascular de la arteria cerebelosa posteroinferior (PICA), sin restricción a la difusión o cambios en mapa ADC. Inicialmente se sospecha evento cerebrovascular (ECV) y se estudia con angiorresonancia normal, ayudas diagnósticas para causas cardioembólicas y trombofilias negativas. Al considerar lesiones no se sugieren cambios de origen isquémico, pero si desmielinizantes. Se inicia manejo con pulsos de metilprednisolona con resolución de hemiparesia y encefalopatía. En seguimiento a 18 meses, el paciente no ha presentado nuevos eventos clínicos o radiológicos. La ADEM es una patología infrecuente en la edad pediátrica, con un diagnóstico basado en la clínica y hallazgos imagenológicos en resonancia magnética. Su presentación clínica puede ser inespecífica y como en este caso simular enfermedad cerebrovascular, y el tratamiento se basa en inmunomoduladores, principalmente corticoides, con una tasa de recuperación favorable en las series previamente reportadas.


SUMMARY Acute disseminated encephalomyelitis (ADEM) is a low-prevalence demyelinating disease of the central nervous system (CNS) with a predominance of presentation in the pediatric population. To describe and review the clinical presentation of a patient with ADEM, its diagnostic process and therapeutic management according to the available evidence. A 17-year-old male adolescent, with a 2-week history of high-intensity right-sided headache, stitching type, subsequent acute multifocal neurological compromise with encephalopathy, hemiparesis, and diplopia. A contrast-enhanced brain resonance study with evidence of hyperintense lesions at the level of the stem, cerebellum, and basal ganglia, asymmetric, unilateral, acute, following the vascular path of the posteroinferior cerebellar artery (PICA), but without restriction to diffusion or changes on the ADC map, so that an initial suspicion of cerebrovascular event (CVD) is made, studying with normal angioresonance, diagnostic aids for negative cardioembolic causes and thrombophilias. Considering that lesions do not suggest changes of ischemic origin, but if they are demyelinating, management with methylprednisolone pulses with resolution of hemiparesis and encephalopathy is initiated. In the 18-month follow-up, the patient has not presented new clinical or radiological events. ADEM, is an infrequent pathology in pediatric age, with a diagnosis based on the clinic and magnetic resonance imaging findings, its clinical presentation may be nonspecific and as in this case simulate cerebrovascular disease, the treatment is based on immunomodulatory treatment, mainly corticosteroids, with a favorable recovery rate in the previously reported series.

4.
Palliative Care Research ; : 209-213, 2021.
Article in Japanese | WPRIM | ID: wpr-886245

ABSTRACT

We encountered a case of HHV-6 encephalomyelitis following blood stem cell transplantation. A woman in her 30’s suffered from paroxysmal electric shock-like pain, itching, tremor of lower limbs and excessive sweating on the 15th day after cord blood transplantation. Urinary retention also occurred. Pregabalin and opioid administration was started, and foscarnet was administered after a finding of HHV-6DNA positive in cerebrospinal fluid. Combined use of levetiracetam 1000 mg per day decreased both frequency and intensity of the electric shock-like pain. In a week before the negative results of HHV-6 amplification, she became excessively drowsy. With withdrawal of levetiracetam, her consciousness returned to be clear. The main symptoms on discharge were pain and itching with numbness around the anus, and were well controlled with oxycodone 15 mg, pregabalin 225 mg, and lorazepam 0.5 mg per day. In our case of HHV-6 encephalomyelitis after cord blood transplantation, levetiracetam was effective in suppressing electric shock-like pain.

5.
Article in English | WPRIM | ID: wpr-880748

ABSTRACT

The present study was conducted to clarify the therapeutic effect of cornuside on experimental autoimmune encephalomyelitis (EAE) and its influence on T helper 17 (Th17) cell and regulatory T (Treg) cell infiltration into the central nervous system. Rats were randomly placed into four treatment groups: control, EAE, EAE+cornuside, and EAE+prednisolone. The neurological function scores of rats were assessed daily. On the second day after EAE rats began to show neurological deficit symptoms, the four groups were treated with normal saline, normal saline, cornuside (150 mg/kg), and prednisolone (5 mg/kg), respectively. The treatment was discontinued after two weeks, and the spinal cord was obtained for hematoxylin and eosin (H&E) and luxol fast blue staining, as well as retinoic acid receptor-related orphan receptor γ (RORγ) and forkhead box protein P3 (Foxp3) immunohistochemical staining. Blood was collected for Th17 and Treg cell flow cytometry testing, and the serum levels of interleukin (IL)-17A, IL-10, transforming growth factor-β (TGF-β), IL-6, IL-23, and IL-2 were measured via enzyme-linked immunosorbent assay (ELISA). Compared with rats in the EAE group, rats in the EAE+cornuside and EAE+prednisolone groups began to recover from neurological deficits earlier, and had a greater degree of improvement of symptoms. Focal inflammation, demyelination, and RORγ-positive cell infiltration were reduced by cornuside or prednisolone treatment, whereas the Foxp3-positive cell numbers were not significantly different. Meanwhile, the number of Th17 cells and the IL-17A, IL-6, and IL-23 levels were lower in the blood after cornuside or prednisolone treatment, whereas the number of Treg cells or the levels of IL-10, TGF-β, and IL-2 were not markedly different. Cornuside can alleviate symptoms of EAE neurological deficits through its anti-inflammatory and immunosuppressive effects, and Th17 cells may be one of its therapeutic targets.

6.
Acta Pharmaceutica Sinica B ; (6): 3364-3378, 2021.
Article in English | WPRIM | ID: wpr-922801

ABSTRACT

As a cellular bulk degradation and survival mechanism, autophagy is implicated in diverse biological processes. Genome-wide association studies have revealed the link between autophagy gene polymorphisms and susceptibility of autoimmune diseases including systemic lupus erythematosus (SLE) and inflammatory bowel disease (IBD), indicating that autophagy dysregulation may be involved in the development of autoimmune diseases. A series of autophagy modulators have displayed protective effects on autoimmune disease models, highlighting the emerging role of autophagy modulators in treating autoimmune diseases. This review explores the roles of autophagy in the autoimmune diseases, with emphasis on four major autoimmune diseases [SLE, rheumatoid arthritis (RA), IBD, and experimental autoimmune encephalomyelitis (EAE)]. More importantly, the therapeutic potentials of small molecular autophagy modulators (including autophagy inducers and inhibitors) on autoimmune diseases are comprehensively analyzed.

7.
Article in Chinese | WPRIM | ID: wpr-878674

ABSTRACT

Objective To investigate the therapeutic effect of SPK1 gene transfected adipose derived mesenchymal stem cells(ADMSC)on experimental autoimmune encephalomyelitis mice and the effect on T helper cell 17(Th17)/regulatory T(Treg) cells balance. Methods EAE was induced by myelin oligodendrocyte glycoprotein 35-55 in mice.Totally 44 mice were randomly divided into four groups:normal control group(NC group),model group(EAE group),ADMSC group,and ADMSC-SPK1 group.Forty days after injection,the pathological changes of brain and spinal cord,Th17/Treg-related inflammatory markers in brain tissue,expressions of interleukin-17A(IL-17A)and forkhead box protein p3(Foxp3)in brain and spinal cord tissue,and flow cytometric results of spleen immune cells were detected. Results Forty days after the injection,serious inflammatory cell infiltration and demyelination occurred in the brain and spinal cord of EAE group,whereas demyelination and axonal injury were improved in ADMSC group and ADMSC-SPK1 group.Compared with EAE group,the ADMSC group and ADMSC-SPK1 group had significantly improved levels of IL-17A(


Subject(s)
Adipose Tissue/cytology , Animals , Cytokines , Encephalomyelitis, Autoimmune, Experimental/therapy , Interleukin-17 , Mesenchymal Stem Cell Transplantation , Mesenchymal Stem Cells/cytology , Mice , Mice, Inbred C57BL , Phosphotransferases (Alcohol Group Acceptor)/genetics , T-Lymphocytes, Regulatory/cytology , Th17 Cells/cytology , Transfection
8.
Chinese Journal of Neurology ; (12): 19-24, 2020.
Article in Chinese | WPRIM | ID: wpr-870759

ABSTRACT

Objective To explore the clinical and radiological features of myelin oligodendrocyte glycoprotein (MOG) antibody associated disease.Methods The clinical data of 22 MOG antibody associated disease cases treated in the Department of Neurology,Qilu Hospital of Shandong University from January 2017 to June 2019 were retrospectively analyzed.The clinical data of MOG antibody associated disease were summarized,including clinical and imaging features.Results Of the 22 included patients with MOG antibody associated disease,the average age was 38.5 years,13 were male and nine were female.Among them,11 cases manifested as aquaporin-4 (AQP4)-negative neuromyelitis optica spectrum disorder (NMOSD),four cases optic neuritis,two cases transverse myelitis,one case acute disseminated encephalomyelitis (ADEM),two cases cortical encephalitis and two cases vestibular neuronitis.Magnetic resonance imaging (MRI) results showed that multiple anatomical areas were involved.Among the nine patients with optic nerve involvement,five patients had longitudinally extensive optic nerve lesions,which were longitudinally enhanced.In eight patients,MRI lesions in the spinal cord showed mostly long or short segments involvement,involving 2-5 spinal cord segments.Five cases involved the cervical spinal cord,six cases involved the thoracic spinal cord,and one case involved the lumbar spinal cord.Brain MRI abnormalities were found in 13 cases and the lesions were mostly patchy and point-shaped.MRI lesions demonstrated T2 hyperintensity and some of them could be strengthened,which may involve the basal ganglia,thalamus,radiographic crown,frontal temporal lobe,brain stem and other parts.Among them,16 patients were sensitive to high-dose intravenous/oral methylprednisolone in the acute phase.Seven patients had recurrence after two months to two years of follow-up.Conclusions MOG antibody associated disease include multiple manifestations.Among them,AQP4-negative NMOSD is the most common form.The clinical manifestations of patients showed diversity.Imaging is characterized by multiple parts involvement such as optic nerve,spinal cord,and brain.Most patients are sensitive to high-dose intravenous/oral methylprednisolone,and have a good prognosis in the acute phase,but some patients may relapse.

9.
Article in Chinese | WPRIM | ID: wpr-817683

ABSTRACT

@#【Objective】 To study the mechanisms and therapeutic effects of human olfactory mucosa-derived mesenchymal stem cells(OMSC)on experimental autoimmune encephalomyelitis(EAE)in mice.【Methods】Under local anesthesia by using nasal endoscopy,olfactory epithelia of healthy donors were obtained,digested and cultured up to the 5th passage. OMSC were identified,differentiated and stained. EAE models were induced in C57 female mice by myelin oligodendrocyte glycoprotein(MOG35- 55)and pertussis toxin(PT). Neurological function was documented daily. On day 16 after immunization(peak of incidence),the mice were divided randomly into two groups and treated with OMSC and PBS via tail vein injection respectively. On day 24 after immunization ,blood was collected from angular vein and levels of IL-10,IL-17,IFN-γ and IL-6 were determined by cytometric beads array(CBA). The size of the spinal cord lesion in mice was observed and measured by using HE and LFB staining. Peripheral blood lymphocytes(PBL)of healthy donors were obtained and then co-cultured with OMSC. The proportions of CD4+ T cells secreting IFN- γ(Th1 cells)in lymphocyte group and co-culture group were compared after 2 days of cultivation. Adding IDO or COX pathway inhibitor to co- culture group and cultivating for 2 days,we observed and compared the proportions of Th1 cells in lymphocyte group,co-culture group and inhibitor treatment group respectively.【Results】OMSC exhibited certain mesenchymal stem cell-like characteristics with respect to expression of stem cell surface markers and multilineage differentiation potentials. After induced by MOG35- 55 and PT,EAE models showed different levels of neurological damage. Compared with those in PBS treatment group,in OMSC treatment group,the severity of neural dysfunction in mice was significantly reduced(P =0.002),the level of IFN-γ in serum was lower(P = 0.032),but no significant differences in the levels of IL-10,IL-17 and IL-6 were found between two groups. HE and LFB staining revealed that the inflammatory infiltration and demyelinating areas in OMSC treatment group were less than those in PBS treatment group. The proportion of Th1 cells was lower in co-culture group than that in lymphocyte group(P = 0.001),higher in IDO inhibitor group than that in co-culture group(P = 0.01),but no significant difference was found between IDO inhibitor group and lymphocyte group or between COX inhibitor group and co-culture group.【Conclusions】OMSC may regulate the proportion of Th1 lymphocytes through IDO pathway so as to inhibit the demyelinating injuries of EAE in mice. This study provides a new idea for the clinical treatment of multiple sclerosis.

10.
Einstein (Säo Paulo) ; 18: eRC5041, 2020. tab
Article in English | LILACS | ID: biblio-1090042

ABSTRACT

ABSTRACT The yellow fever is a systemic disease that was under control due to the effective campaigns against the vector and promotion of vaccines programs. However, since 1999, outbreaks appeared because of inefficient control of the vector, and led to the need of amplifying the immunization in large scale against the yellow fever virus, and consequently, raising the risk of adverse reactions to the vaccine. We report a case of previously healthy infant, who was referred to our care service, after 3 days with fever, chills, nausea and vomits, he received support therapy and was discharged from the hospital. After 24 hours of supportive measures, he was discharge. The patient returned to our service with general condition decline, strabismus, inability to control of cervical musculature and reduced force of the legs. The patient vaccine had received all vaccines from the calendar, and he was vaccinated for yellow fever 20 days before symptoms. During the hospitalization, liquor was collected, and ceftriaxone and aciclovir were administered. After negative cultures from the liquor, the antibiotics were suspended. The computed tomography of patient's brain showed no alterations. Research for antibodies against yellow fever was requested, being positive for IgM in the liquor, and confirming the neurotropic disease associated with the yellow fever vaccine. On the fifth day of hospitalization, the patient showed improvement on the strabismus, cervical tonus, and musculature force. On the tenth day of hospitalization, patient showed complete improvement, and his laboratory exams no alterations. Subsequently, patient was discharged. The vaccine against yellow fever is safe, efficient and highly recommended, however it is not completely free from serious adverse reactions, including death.


RESUMO A febre amarela é uma doença sistêmica que estava controlada graças às efetivas campanhas de combate ao vetor e aos programas de vacinação. Porém, desde 1999, os surtos reiniciaram-se, devido à ineficácia do controle do vetor, levando à necessidade da imunização em larga escala contra o vírus da febre amarela, gerando aumento do risco de ocorrência de reação adversa à vacina. O presente estudo se propôs a relatar o caso de um lactente previamente saudável, que procurou pronto atendimento, pois, há 3 dias, apresentava febre, calafrios, náusea e vômitos. Em 24 horas após medidas de suporte e alta, evoluiu com queda do estado geral, estrabismo, falta de controle da musculatura cervical e redução da força muscular de membros inferiores. O caderno vacinal encontrava-se completo, tendo recebido vacina contra febre amarela há 20 dias. Durante a internação, foi realizada coleta do liquor, e foram administrados ceftriaxona e aciclovir. Após cultura negativa do liquor, o antibiótico foi suspenso. A tomografia computadorizada de crânio não apresentou alterações. Solicitou-se pesquisa de anticorpos contra o vírus da febre amarela no liquor, sendo positiva para IgM e confirmando a doença neurotrópica associada à vacina da febre amarela. A partir do quinto dia de internação, o paciente evoluiu com melhora do estrabismo, do tônus cervical e da força muscular. No décimo dia de internação, apresentou melhora completa do quadro, sem alterações laboratoriais, recebendo alta. A vacina contra febre amarela é segura, eficaz e fortemente recomendada, porém não está completamente isenta de reações adversas graves, inclusive podendo levar a quadros fatais.


Subject(s)
Humans , Male , Infant , Yellow Fever Vaccine/adverse effects , Nervous System Diseases/etiology , Immunoglobulin M/analysis , Strabismus/etiology , Muscle Weakness/etiology
11.
Rev. Soc. Bras. Med. Trop ; 53: e20190160, 2020. graf
Article in English | LILACS | ID: biblio-1057295

ABSTRACT

Abstract Acute disseminated encephalomyelitis (ADEM) is a demyelinating autoimmune neuropathic condition characterized by extensive bilateral and confluent lesions in the cerebral white matter and cerebellum. The basal ganglia and gray matter may also be involved. In most cases, the symptoms are preceded by viral infection or vaccination. In this report, we present a case of ADEM associated with optic neuritis presenting alongside two potential triggering factors: chikungunya virus infection and yellow fever immunization.


Subject(s)
Humans , Male , Adult , Chikungunya virus/immunology , Optic Neuritis/diagnostic imaging , Encephalomyelitis, Acute Disseminated/virology , Encephalomyelitis, Acute Disseminated/diagnostic imaging , Chikungunya Fever/complications , Magnetic Resonance Imaging , Encephalomyelitis, Acute Disseminated/complications , Chikungunya Fever/diagnosis
12.
Article in English | WPRIM | ID: wpr-781226

ABSTRACT

Given the rapid increase of patients with autoimmune diseases and the lack of satisfactory therapies, the discovery of novel and effective therapeutic targets have been in an urgent demand. Recent studies have revealed that long noncoding RNAs (lncRNAs) play crucial roles in the development of multiple sclerosis (MS), which provides a new opportunity of uncovering novel mechanism associated with the progression of MS. This review highlights the dysregulation of lncRNAs in the development of MS in patients and animal models. Additionally, the potential clinical relevance of lncRNAs severed as therapeutic targets and diagnostic markers are discussed.

13.
Article in Chinese | WPRIM | ID: wpr-847828

ABSTRACT

BACKGROUND: There are increasing reports about autophagy, but the relationship between the level of autophagy in neurons and the neuroprotection mechanism is not clear. OBJECTIVE: To investigate whether rapamycin, an mammalian target of rapacmycin (mTOR) autophagy pathway inhibitor, could activate autophagy by mediating the P70s6k and mTOR protein levels to protect spinal cord neurons in experimental autoimmune encephalomyelitis mice. METHODS: Fifty-four healthy female C57BL/6 mice were divided into three groups: control group, model group and treatment group, with 18 mice in each group. Mice in the model group and treatment group were injected with complete Freund’s adjuvant containing MOG35-55 and pertussis diluent for establishing models of experimental autoimmune encephalomyelitis. At the same time, the mice in the treatment group were given rapamycin (1 mg/kg per day), and those in the model and control groups were given the same amount of normal saline. The mice in the model and treatment were sacrificed at the peak of the onset, and the non-morbid mice, including those in the control group, were sacrificed after 4 weeks of feeding. The spinal cord tissue from each animal was taken to isolate the intumescentia lumbalis of the spinal cord. Nissl staining was used for pathological observation of the spinal cord tissue. Immunofluorescence double staining was used to observe the expression and co-localization of autophagy markers LC3 and NeuN in spinal cord tissue. Western blot was used to detect mTOR, P70S6K proteins and their phosphorylation levels in spinal cord tissue. RESULTS AND CONCLUSION: No mice in the control group had an attack, but those in the other groups developed experimental autoimmune encephalomyelitis to different extents. Compared with the model group, the treatment group had prolonged incubation time (P < 0.01), shortened progressive stage (P < 0.01), and decreased neurologic dysfunction score (P < 0.05). Compared with the control group, the model group had the significantly less number of Nissl bodies (P < 0.05), while the number of Nissl bodies in the treatment group was significantly higher than that in the model group, but still lower than that in the control group (P < 0.05). In the model group, LC3 was scattered in the spinal cord neurons and had no obvious dot-like aggregation, whereas in the treatment group, LC3 showed obvious dot-like aggregation, and its distribution was basically consistent with that of NeuN. The phosphorylation levels of mTOR and P70S6K proteins were highest in the model group, followed by the treatment group and control group in turn. To conclude, rapamycin might through inhibiting the phosphorylation levels of mTOR and P70S6K proteins activate the activity of autophagy to protect the spinal cord neurons in experimental autoimmune encephalomyelitis mice.

14.
Chinese Journal of Neurology ; (12): 19-24, 2020.
Article in Chinese | WPRIM | ID: wpr-798974

ABSTRACT

Objective@#To explore the clinical and radiological features of myelin oligodendrocyte glycoprotein (MOG) antibody associated disease.@*Methods@#The clinical data of 22 MOG antibody associated disease cases treated in the Department of Neurology, Qilu Hospital of Shandong University from January 2017 to June 2019 were retrospectively analyzed. The clinical data of MOG antibody associated disease were summarized, including clinical and imaging features.@*Results@#Of the 22 included patients with MOG antibody associated disease, the average age was 38.5 years, 13 were male and nine were female. Among them, 11 cases manifested as aquaporin-4 (AQP4)-negative neuromyelitis optica spectrum disorder (NMOSD), four cases optic neuritis, two cases transverse myelitis, one case acute disseminated encephalomyelitis (ADEM), two cases cortical encephalitis and two cases vestibular neuronitis. Magnetic resonance imaging (MRI) results showed that multiple anatomical areas were involved. Among the nine patients with optic nerve involvement, five patients had longitudinally extensive optic nerve lesions, which were longitudinally enhanced. In eight patients, MRI lesions in the spinal cord showed mostly long or short segments involvement, involving 2-5 spinal cord segments. Five cases involved the cervical spinal cord, six cases involved the thoracic spinal cord, and one case involved the lumbar spinal cord. Brain MRI abnormalities were found in 13 cases and the lesions were mostly patchy and point-shaped. MRI lesions demonstrated T2 hyperintensity and some of them could be strengthened, which may involve the basal ganglia, thalamus, radiographic crown, frontal temporal lobe, brain stem and other parts. Among them, 16 patients were sensitive to high-dose intravenous/oral methylprednisolone in the acute phase. Seven patients had recurrence after two months to two years of follow-up.@*Conclusions@#MOG antibody associated disease include multiple manifestations. Among them, AQP4-negative NMOSD is the most common form. The clinical manifestations of patients showed diversity. Imaging is characterized by multiple parts involvement such as optic nerve, spinal cord, and brain. Most patients are sensitive to high-dose intravenous/oral methylprednisolone, and have a good prognosis in the acute phase, but some patients may relapse.

15.
Fisioter. Bras ; 20(5): 675-680, Outubro 24, 2019.
Article in Portuguese | LILACS | ID: biblio-1281736

ABSTRACT

A dengue pode desencadear manifestações neurológicas como a Síndrome de Encefalomielite Aguda Disseminada (ADEM), de caráter inflamatório, desmielinizante, que pode ter dentre as consequências déficits motores e sensitivos, neurite ótica e disfunções vesicais, como a retenção urinária, tornando o indivíduo dependente da realização do cateterismo vesical intermitente (CVI). Desta forma, o objetivo deste estudo é descrever o tratamento fisioterapêutico de uma paciente com retenção urinária, decorrente de Síndrome de ADEM pós-dengue. Paciente do sexo feminino, 52 anos, internada em hospital de média complexidade com diagnóstico de ADEM. Na avaliação inicial apresentava grau de força muscular 3 de membros inferiores e 4 de membros superiores, 2 de musculatura do assoalho pélvico (MAP) e retenção urinária, necessitando realizar CVI. Foram realizados 32 atendimentos com duração de uma hora, incluindo o treinamento do assoalho pélvico em diferentes posturas e eletroestimulação de superfície da MAP com equipamento da marca Ibramed. Paciente recebeu alta hospitalar com evidente melhora da força muscular global e sem necessidade de CVI, apresentando micção voluntária e sem resíduo pós-miccional, favorecendo a prevenção de agravos do trato urinário inferior e superior. (AU)


Dengue can trigger neurological manifestations such as Acute Disseminated Encephalomyelitis (ADEM), with inflammatory, demyelinating condition, which may have, among the consequences, motor and sensory deficits, optic neuritis and bladder dysfunctions, such as urinary retention, making the individual dependent on intermittent bladder catheterization (IBC). Therefore, the objective of this study was to describe the physiotherapeutic treatment of a patient with urinary retention, due to ADEM syndrome after dengue. A 52-year-old female patient admitted to a hospital of medium complexity with a diagnosis of ADEM. In the initial evaluation, she presented a degree 3 of muscular strength in the lower limbs and 4 in the upper limbs, 2 in pelvic floor musculature (PFM) and urinary retention, requiring IBC. We performed 32 one hour sessions, including pelvic floor muscle training in different positions and surface electrostimulation of PFM with Ibramed brand equipment. Patient was discharged with evident improvement of global muscle strength and without IBC, presenting voluntary voiding and without post void residual, favoring the prevention of lower and upper urinary tract injuries. (AU)


Subject(s)
Humans , Urinary Retention , Pelvic Floor , Encephalomyelitis, Acute Disseminated , Urination , Urinary Bladder, Neurogenic , Dengue , Muscle Strength
16.
Medicina (B.Aires) ; 79(supl.3): 66-70, set. 2019. ilus
Article in Spanish | LILACS | ID: biblio-1040553

ABSTRACT

Se revisan dos de las principales enfermedades desmielinizantes en niños, la encefalomielitis aguda diseminada (EAD) y la esclerosis múltiple (EM). Por sus características fisiopatológicas, etiologías probables, manifestaciones clínicas, diagnóstico, tratamiento, pronóstico, evolución, así como alteraciones atípicas que complican su diagnóstico; cuanto más pequeño es el paciente se necesita estudiar más, antes de llegar al diagnóstico. El Grupo Internacional de Estudio de Esclerosis Múltiple Pediátrica publicó las definiciones operativas para enfermedades desmielinizantes adquiridas del sistema nervioso central: la EAD es monofásica, polisintomática y con encefalopatía. Su duración es de hasta 3 meses, con síntomas fluctuantes y hallazgos en resonancia magnética. La EM se define como síndrome aislado monofocal o polifocal, sin encefalopatía. Actualmente se consideran dos enfermedades diferentes y distinguibles desde el inicio de los síntomas.


The two main demyelinating diseases in children are reviewed. Acute disseminated encephalomyelitis (ADEM) and multiple sclerosis (MS). For its physiopathological characteristics, probable etiologies, clinical manifestations, diagnosis, treatment, prognosis, evolution, as well as atypical alterations that complicate its diagnosis, the smaller the child is, more study is needed before reaching the diagnosis. The International Study Group of Multiple Pediatric Sclerosis, published the operating definitions for demyelinating diseases acquired from the central nervous system in children: the ADEM is monophasic, polysymptomatic and with encephalopathy. Its duration is up to 3 months, with fluctuating symptoms and magnetic resonance findings. MS is an isolated monofocal or polyfocal syndrome, without encephalopathy. Currently, two different and distinguishable diseases are considered from the onset of symptoms.


Subject(s)
Humans , Child , Encephalomyelitis, Acute Disseminated/diagnostic imaging , Multiple Sclerosis/diagnostic imaging , Steroids/therapeutic use , Syndrome , Brain/physiopathology , Brain/diagnostic imaging , Magnetic Resonance Imaging , Drug Therapy, Combination , Encephalomyelitis, Acute Disseminated/drug therapy , Immunotherapy , Multiple Sclerosis/drug therapy
17.
Article | IMSEAR | ID: sea-210400

ABSTRACT

The aim of this study is to evaluate the effect of β-Caryophyllene (BCP) on the production of IL-17, transcription factors(T-bet and GATA-3), and remyellination in C57BL/6 mice induced for experimental autoimmune encephalomyelitis(EAE), the model for studying pathogenesis and new therapies for multiple sclerosis. EAE was induced in threegroups of C57BL/6, with administration of BCP in two groups (25 and 50 mg/kg/day) by gavage, after the 10th dayof induction. At 9 days of treatment, mice were euthanized and CNS was removed for the analysis. The profiles ofIL-17, T-bet, GATA-3, and the possible remyelination properties were investigated in the central nervous system(CNS) by immunohistochemistry and Weigert–Pal–Russel’s method, respectively. BCP group (50 mg/kg/day) showeda reduction of IL-17 in brain, cerebellum, and medulla (p < 0.05) and a decrease of T-bet (p < 0.05) in medullaand cerebellum, while GATA-3 was increased (p < 0.05) in cerebellum. In both BCP-treated groups were observedremyelination and better organization of myelin. In conclusion, BCP possesses markedly in vivo anti-inflammatoryand neuroprotective activities and remyelination properties in EAE-mice.

18.
Rev. argent. microbiol ; 51(2): 153-156, jun. 2019.
Article in Spanish | LILACS | ID: biblio-1013366

ABSTRACT

Se presenta el caso de un niño de 5 años sin antecedentes de enfermedad, que se internó en terapia intensiva por convulsiones tónico-clónicas focalizadas en la cara y en el hemicuerpo derecho, con documentación de temperatura axilar de 37,4°C. Se descartó la presencia de gérmenes comunes y la etiología viral a través de estudios de muestras de líquido cefalorraquídeo (LCR). Se sospechó la presencia de Mycoplasma pneumoniae por comprobarse inmunofluorescencia positiva en suero para anticuerpos de clase IgM. El diagnóstico se confirmó mediante la detección del ADN de dicho patógeno sobre la biopsia cerebral efectuada por el método de la reacción en cadena de la polimerasa (PCR) y una histología compatible con encefalomielitis aguda diseminada. El paciente recibió tratamiento con claritromicina y su evolución fue favorable. Al menos dentro de nuestros conocimientos, este es el primer caso en el que se detectó ADN de M. pneumoniae en una biopsia cerebral por el método de PCR.


We present here the case of a previously healthy 5 year-old boy hospitalized in an intensive care unit due to tonic-clonic seizures focused on the face and right side of the body, and axillary temperature of 37.4 °C. Common bacterial and viral etiology was ruled out through studies of cerebrospinal fluid (CSF) samples. Mycoplasma pneumoniae was suspected by a positive immunofluorescence serum test for IgM class antibodies. Finally, with a brain biopsy, M. pneumoniae was confirmed by polymerase chain reaction (PCR) and acute disseminated encephalomyelitis by pathological anatomy. The patient was treated with clarithromycin and had an uneventful evolution. At least to our knowledge, this is the first case in which M. pneumoniae DNA was detected by PCR in a brain biopsy.


Subject(s)
Humans , Male , Child, Preschool , Encephalomyelitis, Acute Disseminated/diagnosis , Encephalomyelitis, Acute Disseminated/therapy , Mycoplasma pneumoniae/pathogenicity , Biopsy/methods , Immunoglobulin M , Cerebrospinal Fluid/microbiology , Polymerase Chain Reaction/methods , Fluorescent Antibody Technique/methods
19.
Rev. cuba. med. trop ; 71(1): e281, ene.-abr. 2019. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1093551

ABSTRACT

Introducción: La infección por virus dengue es considerada una de las arbovirosis de mayor prevalencia en los países tropicales. La encefalomielitis diseminada aguda es un trastorno inflamatorio desmielinizante y multifocal que afecta al sistema nervioso central, de inicio agudo y curso clínico monofásico. El proceso inflamatorio se encuentra mediado por mecanismos inmunológicos y su relación con infecciones por el virus dengue aún no se establece con claridad. Objetivo: Describir un caso clínico con manifestaciones del sistema nervioso central después de una probable infección por el virus dengue. Presentación del caso: Paciente femenina de 50 años, con antecedentes de hipertensión arterial controlada. Quince días después de un cuadro de fiebre de 4 días de duración, que posiblemente fue por una infección por el virus dengue, comienza con síntomas y signos de afectación neurológica caracterizadas por ligera irritabilidad, dificultad para la concentración en una actividad específica de la vida cotidiana. Progresivamente se nota dificultad motora en el hemicuerpo izquierdo además de encontrarse agitada y distraída, motivo por el cual se decide su ingreso hospitalario. Se realiza el diagnóstico a través de los hallazgos en el examen físico, los estudios positivos de resonancia magnética nuclear y el resultado positivo de la IgM de dengue en sangre. Tanto la evolución clínica como la respuesta al tratamiento con esteroides fueron favorables. Conclusiones: El evento ocurrido en este caso sugiere que los facultativos deben tener presente el diagnóstico de encefalomielitis diseminada aguda en pacientes que han tenido infección previa o alta sospecha de esta por el virus dengue(AU)


Introduction: Dengue virus infection is one of the most prevalent arboviruses in tropical countries. Acute disseminated encephalomyelitis is an inflammatory demyelinating multifocal disorder affecting the central nervous system. Its onset is acute and its clinical course monophasic. The inflammatory process is mediated by immunological mechanisms, and its relationship to dengue virus infections is still not clear. Objective: Describe a clinical case of central nervous system manifestations after probable dengue virus infection. Case presentation: Female 50-year-old patient with a history of controlled hypertension. Fifteen days after a 4-day fever episode, possibly due to dengue virus infection, the patient starts presenting neurological signs and symptoms, such as slight irritability and difficulty to concentrate on a specific activity of daily living. The patient notices progressive motor difficulty in her left hemibody and she feels agitated and distracted. It is therefore decided for her to be hospitalized. A diagnosis is made based on physical examination findings, positive nuclear magnetic resonance studies, and the positive result of the dengue IgM blood test. Both the patient's clinical evolution and her response to treatment with steroids were favorable. Conclusions: The event herein described suggests that physicians should consider the diagnosis of acute disseminated encephalomyelitis in patients with previous infection or high suspicion of infection with dengue virus(AU)


Subject(s)
Humans , Female , Middle Aged , Dengue/complications , Encephalomyelitis, Acute Disseminated/complications , Encephalomyelitis, Acute Disseminated/diagnosis , Clinical Evolution , Encephalomyelitis, Acute Disseminated/diagnostic imaging
20.
Rev. chil. radiol ; 25(1): 5-18, mar. 2019. tab, ilus
Article in Spanish | LILACS | ID: biblio-1003745

ABSTRACT

La esclerosis múltiple (EM) es la enfermedad inflamatorio-desmielinizante del Sistema nervioso central más prevalente en adultos. La resonancia magnética (RM) juega un rol cada vez más importante en el estudio de esta patología, en especial en su diagnóstico precoz, por lo que la diferenciación imagenológica de variantes frecuentes e infrecuentes de EM con otras patologías de sustancia blanca que comprometen encéfalo y médula espinal es esencial. Mediante una revisión pictórica se ilustrarán características típicas en RM del compromiso por EM y de variantes menos habituales de lesión desmielinizante, y se ilustrarán hallazgos característicos de lesiones relacionadas a vasculopatías inflamatorias y no inflamatorias, encefalomielitis diseminada aguda (ADEM), neuromielitis óptica (NMO) y enfermedades vasculares de la médula espinal que pueden simular EM, con énfasis en el diagnóstico diferencial radiológico.


Multiple sclerosis (MS) is the most prevalent inflammatory-demyelinating disease of the central nervous system in adult population. Magnetic resonance imaging (MRI) has an increasingly important role, especially in early diagnosis, so the imaging differentiation of frequent and infrequent variants of MS with other white matter diseases of brain and spinal cord is essential. Through a pictorial essay we show typical MR features of MS and more infrequent variants of demyelinating lesions and illustrate characteristic imaging findings of inflammatory and non-inflammatory vasculopathies, acute disseminated encephalomyelitis (ADEM), neuromyelitis optica (NMO) and vascular diseases of spinal cord that may simulate MS, with emphasis on imaging differential diagnosis.


Subject(s)
Humans , Multiple Sclerosis/diagnostic imaging , Magnetic Resonance Imaging , Tomography, X-Ray Computed , Neuromyelitis Optica/diagnostic imaging , Diagnosis, Differential , Encephalomyelitis, Acute Disseminated/diagnostic imaging , Susac Syndrome/diagnostic imaging
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