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1.
Rev. habanera cienc. méd ; 21(3): e4710, mayo.-jun. 2022. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1409482

ABSTRACT

RESUMEN Introducción: El SARS-CoV-2 afecta principalmente al sistema respiratorio, pero el daño producido por este virus también se extiende a otros sistemas, incluido el sistema nervioso, y los mecanismos de infección neurológica pueden ser directos o indirectos. Objetivo: Determinar la relación entre las manifestaciones neurológicas y la severidad de la enfermedad en pacientes sintomáticos positivos a la COVID-19. Hospital San Vicente de Paúl. 2021. Material y Métodos: Estudio observacional de corte transversal, empleando el registro de historias clínicas de los pacientes hospitalizados con la COVID-19 y manifestaciones neurológicas, las cuales se clasificaron en manifestaciones del sistema nervioso central y manifestaciones del sistema nervioso periférico. Resultados: 74,1 % pacientes presentaron manifestaciones neurológicas, el mayor porcentaje se concentró en pacientes que desarrollaron enfermedad grave (15 [60 %], SNC; 91 [77,1 %], SNP; 125 [65,4 %], SNC y SNP). La presencia conjunta de manifestaciones neurológicas centrales y periféricas se asoció significativamente con la COVID-19 crítica (P valor= 0,011; OR: 2,005). El índice de mortalidad alcanzó 2,69 %. Conclusiones: Las manifestaciones neurológicas en pacientes hospitalizados con la COVID-19 son muy frecuentes, y la COVID-19 crítica tiene mayor probabilidad de presentar manifestaciones neurológicas.


ABSTRACT Introduction: SARS-CoV-2 mainly affects the respiratory system, but the damage caused by this virus also extends to other systems, including the nervous system, and the mechanisms of neurological infection can be direct or indirect. Objective: To determine the relationship between neurological manifestations and disease severity in symptomatic COVID-19 positive patients at San Vicente de Paul Hospital in 2021. Material and Methods: A cross-sectional observational study was conducted using medical records of patients hospitalized with COVID-19 and neurological manifestations, which were classified into manifestations of the central nervous system and manifestations of the peripheral nervous system. Results: The results show that 74,1 % of patients presented neurological manifestations; the highest percentage was concentrated in patients who developed severe disease (15 [60 %], CNS; 91 [77,1 %], PNS; 125 [65,4 %], CNS and PNS). The joint presence of central and peripheral neurological manifestations was significantly associated with critical COVID-19 (P value= 0,011; OR: 2,005). The mortality rate reached 2,69 %. Conclusions: Neurological manifestations in hospitalized COVID-19 patients are very common, and critical COVID-19 is more likely to have neurological manifestations.


Subject(s)
Humans , Severity of Illness Index , Central Nervous System , Catastrophic Illness , COVID-19 , Neurologic Manifestations
3.
Rev. méd. Minas Gerais ; 32: 32404, 2022.
Article in English, Portuguese | LILACS | ID: biblio-1391280

ABSTRACT

A doença infecciosa emergente COVID-19, causada pelo novo coronavírus SARS-CoV-2, tem sido descrita como potencialmente multissistêmica. Apesar de sua apresentação sindrômica predominantemente respiratória, uma série de manifestações extrapulmonares, incluindo neurológicas, têm sido documentadas. Este relato se refere a um homem de 61 anos, atendido em regime ambulatorial para controle de comorbidades crônicas, com queixas de congestão nasal, vertigem e com PCR SARS-CoV-2 positivo à avaliação inicial e por até 21 dias após início dos sintomas. Não houve sinais de gravidade durante o curso de doença e a resolução completa dos sintomas ocorreu em aproximadamente dois meses após apresentação clínica inicial.


Emerging infectious disease COVID-19 is caused by the new coronavirus SARS-CoV-2 and it has been described as potentially multisystemic. Despite its predominantly respiratory syndromic presentation, a series of extra-pulmonary manifestations, including neurological ones, have been documented. This report refers to a 61-year-old male patient assisted in ambulatory regime for control of chronic comorbidities. This patient presented complaints of nasal congestion, vertigo and had positive RT-PCR for SARS-CoV-2 at the initial evaluation, remaining positive 21 days after symptoms onset. There were no aggravation signs during the course of the disease and complete resolution of symptoms occurred approximately two months after initial clinical presentation.


Subject(s)
Humans , Male , Middle Aged , Vertigo , COVID-19 , Neurologic Manifestations
4.
Repert. med. cir ; 31(Suplemento): 19-27, 2022. ilus.
Article in English, Spanish | LILACS, COLNAL | ID: biblio-1367319

ABSTRACT

El síndrome respiratorio agudo severo causado por coronavirus 2 (SARS-CoV-2) es responsable de la propagación mundial de la enfermedad por coronavirus (COVID-19). Nuestro conocimiento hasta el momento del impacto de este virus en el sistema nervioso es limitado. El propósito de este artículo es revisar el espectro de los diversos hallazgos en neuroimágenes asi como la fisiopatología en los pacientes con COVID-19. Se necesitan estudios futuros que examinen el impacto de los síntomas y su correlación con las neuroimágenes durante el curso de la enfermedad, para aclarar y evaluar aún más el vínculo entre las complicaciones neurológicas y el resultado clínico, así como limitar las consecuencias a largo plazo.


Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the global spread of coronavirus disease (COVID-19). Our understanding, so far, of the impact this virus has on the nervous system is limited. Our article aims to review the spectrum of neuroimaging findings in patients with COVID 19, as well as, their underlying pathophysiology. Future studies examining the impact of symptoms and their correlation with neuroimaging findings duirng the course of the disease are needed to further clarify and evaluate the association between neurological complications and clinical outcome, as well as to limit long-term consequences.


Subject(s)
Humans , Male , Female , SARS-CoV-2 , COVID-19 , Neurologic Manifestations , Magnetic Resonance Imaging , Cerebral Hemorrhage , Review , Coronavirus Infections
5.
Yenagoa Medical Journal ; 4(2): 10-19, April 2022. Tables
Article in English | AIM | ID: biblio-1392471

ABSTRACT

To determine the pattern of neurological disorders managed in some neurology clinics in Kano, Nigeria. Materials and Methods: A five-year retrospective descriptive survey (2016-2020) of patients with neurological disorders attending neurology out-patient clinics at three selected hospitals in Kano metropolis. A research proforma was used to collect information on socio-demographic and health characteristics of the participants. Case folders and outpatient registers were used as a source of information about the patients. Data obtained was analyzed using IBM Statistical package for social science (SPSS) version 20 and results presented using descriptive statistics of frequency and percentage. Results: Out of the 433 cases with neurological disorders surveyed, 58% were adult and 42% were pediatric. Males (54.3%) were found to be more affected. Majority (83.4%) of the participants were from an urban area, with married (79.7%) individuals mostly affected. Stroke was the most prevalent (33.7%) neurological disorder. Hypokinesia (5.1%) and hyperkinesia(3%) as a primary and secondary movement disorder respectively were the most prevalent forms of movement disorder. Psychotic symptoms, weakness, paresthesia, fever, vomiting and convulsion were the most common manifestations that comes with the neurological disorders. Of the common neurological disorders, stroke was most associated with motor (56.2%), sensory (36.4%) and psychiatric (43.5%) manifestations. Conclusion: Paediatric age group contributed close to half of neurological disorders. Stroke was the most prevalent form of neurological disorder and most associated with motor, sensory and psychiatric manifestations. Hypokinesia and hyperkinesia had close prevalence and were the most common primary and secondary movement disorders respectively.


Subject(s)
Prevalence , Stroke , Nervous System Diseases , Neurologic Manifestations
6.
Rev. Méd. Inst. Mex. Seguro Soc ; 59(6): 545-550, dic. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1357564

ABSTRACT

Introducción: la enfermedad por SARS-CoV-2 denominada COVID-19 originada en China adquirió dimensiones pandémicas. De acuerdo con el reporte situacional de la OMS al 15 de marzo de 2021, la tasa de letalidad global es del 2.2%; en México se han confirmado alrededor de 194 944 defunciones por COVID-19. Estudios en China identificaron que los pacientes con COVID-19 severo, al compararlos con aquellos que cursaron con COVID-19 no severo, presentaron manifestaciones neurológicas más graves. Objetivo: determinar la frecuencia de síntomas y manifestaciones neurológicas en pacientes con COVID-19 severo en un centro de tercer nivel de atención. Material y métodos: estudio transversal, observacional y analítico, llevado a cabo en el Hospital de Especialidades del Centro Médico Nacional Siglo XXI, en pacientes hospitalizados con COVID-19 severo. Resultados: se analizaron 183 casos, de los cuales 130 eran hombres (71%). La mediana de edad fue de 55 años (RIC: 44-65). Los síntomas neurológicos fueron: cefalea, anosmia y disgeusia. Las manifestaciones neurológicas se presentaron en 27 pacientes, la más frecuente fue la enfermedad vascular cerebral tipo isquémica (EVC) en 12 pacientes (44%) en pacientes con mayor edad, 76.5 frente a 54 años (p = 0.000), y con antecedente de enfermedad cardiovascular. Conclusiones: los síntomas neurológicos más frecuentes fueron cefalea, anosmia y disgeusia. La manifestación neurológica más frecuente fue la EVC isquémica que se presentó en pacientes con COVID-19 severo de mayor edad y con antecedente de enfermedad cardiovascular.


Background: The SARS-CoV-2 disease, called COVID-19, emerged in China has acquired pandemic dimensions. According to the WHO situational report of March 15, 2021, the global fatality rate is 2.2%; in Mexico, around 194 944 deaths have been confirmed by COVID-19. Studies in China identified that patients with severe COVID-19, when compared with those who had non-severe COVID-19, presented more severe neurological manifestations. Objective: To determine the frequency of neurological symptoms and manifestations in patients with severe COVID-19 in a tertiary care center. Material and methods: A cross-sectional, observational and analytical study was carried out at the Hospital de Especialidades del Centro Médico Nacional Siglo XXI, in patients hospitalized with severe COVID-19. Results: 183 cases were analyzed, of which 130 were men (71%). The median age was 55 years (IQR: 44-65). The neurological symptoms were: headache, anosmia and dysgeusia. Neurological manifestations occurred in 27 patients (16%), the most frequent was ischemic-type cerebrovascular disease (CVD) in 12 (44%), in patients older than 76.5 years vs. 54 years (p = 0.000), with history of cardiovascular disease. Conclusions: The most frequent neurological symptoms were headache, anosmia and dysgeusia. The most frequent neurological manifestation was ischemic CVD that appeared in older patients with severe COVID-19 with a history of cardiovascular disease.


Subject(s)
Humans , Male , Female , Tertiary Healthcare , Cerebrovascular Disorders , COVID-19 , Neurologic Manifestations , Tertiary Healthcare , Headache
7.
Alerta (San Salvador) ; 4(2): 61-72, may. 26, 2021. ilus, graf
Article in Spanish | LILACS, BISSAL | ID: biblio-1247335

ABSTRACT

El nuevo coronavirus, denominado COVID-19, es un betacoronavirus asociado a síntomas respiratorios que van desde un cuadro respiratorio leve hasta cuadros severos, que implican compromiso de varios órganos blanco como los sistemas pulmonar, renal, cardiovascular, nervioso, de la coagulación y se asocian a diversas complicaciones que ensombrecen el pronóstico. El órgano blanco afectado está determinado por la expresión de receptores para angiotensina II, que además se encuentran en el tejido nervioso, presentes en estructuras vitales en el control cardiorespiratorio. Es así como se han descrito manifestaciones neurológicas en estudios publicados alrededor del mundo que aún no son concluyentes, donde se asocian a una afección directa de las estructuras nerviosas o producto de complicaciones sistémicas


The new coronavirus, called COVID-19, is a beta-coronavirus associated with respiratory symptoms that range from mild to severe respiratory symptoms, which involve involvement of various target organs such as the pulmonary, renal, cardiovascular, nervous, coagulation systems and se associated with various complications that cloud the prognosis. The target organ affected is determined by the expression of receptors for angiotensin II, which are also found in nervous tissue, present in vital structures in cardiorespiratory control. This is how neurological manifestations have been described in studies published around the world that are not yet conclusive, where they are associated with a direct affection of the nervous structures or the product of systemic complications


Subject(s)
Humans , Coronavirus Infections , Neurologic Manifestations , Organs at Risk , Betacoronavirus
8.
Arch. argent. pediatr ; 119(2): e142-e148, abril 2021. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1152045

ABSTRACT

La gripe se asocia al aparato respiratorio, especialmente en invierno, y puede causar complicaciones neurológicas. Se evaluó a pacientes pediátricos con manifestaciones neurológicas graves por gripe desde septiembre de 2018 hasta febrero de 2019 para determinar características clínicas, neuroimagenología, tratamiento y resultados. El objetivo fue evaluar la encefalitis asociada a la gripe y destacar diferentes manifestaciones neurológicas y cambios de neuroimagenología. El estudio incluyó a 13 pacientes. Los síntomas neurológicos ocurrieron tras los síntomas típicos de la gripe. Los cambios de neuroimagenología incluyen alteraciones de señal de la sustancia blanca cortical y subcortical, edema localizado o generalizado y lesiones multifocales simétricas bilaterales en el tálamo y la médula del cerebelo. Las opciones terapéuticas incluyen metilprednisolona en inyección intravenosa, inmunoglobulina intravenosa, plasmaféresis y oseltamivir. Es fundamental considerar la encefalitis asociada a la gripe en pacientes con convulsiones, la encefalopatía con hallazgos radiológicos compatibles, e iniciar el tratamiento lo antes posible


Influenza is mostly associated with the respiratory tract system, especially in the winter season. Various neurological complications could occur due to influenza infection. Pediatric patients who had severe neurological manifestations due to influenza infection from September 2018 to February 2019 were evaluated for clinical characteristics, neuroimaging studies, treatment, and outcome. We aimed to assess Influenza-associated encephalitis in children, emphasize different neurological manifestations and neuroimaging changes. Thirteen patients were included in the study. Neurological symptoms occurred after flu-like symptoms. Neuroimaging changes of influenza-associated encephalitis/encephalopathy include cortical and subcortical white matter signal alterations, localized or generalized edema, and bilateral symmetrical multifocal lesions on the thalamus and cerebellar medulla. Pulse methylprednisolone, intravenous immunoglobulin, plasma exchange, and oseltamivir are the therapy choices. It is essential to consider influenza-associated encephalitis in patients with seizures, encephalopathy with supporting radiological findings, especially during the influenza season and starting treatment as fast as possible for better outcomes.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Brain Diseases/diagnostic imaging , Encephalitis/diagnostic imaging , Influenza, Human/complications , Turkey/epidemiology , Brain Diseases/therapy , Encephalitis/therapy , Neuroimaging , Neurologic Manifestations
9.
Rev. argent. neurocir ; 35(1): 12-27, mar. 2021. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1397339

ABSTRACT

Las lesiones selares son una patología con una incidencia de 3,2 a 4 / 100,000 y una prevalencia de 78 a 94 / 100,000. Un 10% son incidentalomas en la población adulta. Se cree que su prevalencia en el orden mundial actualmente va en aumento.En relación a las manifestaciones clínicas, cabe destacar que es una de las pocas enfermedades que pueden manifestarse tanto por signos y síntomas neurológicos (por ejemplo: hemianopsia bitemporal, síndrome de hipertensión endocraneana debido a hidrocefalia, entre otros), como también por síndromes endocrinológicos (por ejemplo: síndrome de Cushing, acromegalia, amenorrea-galactorrea, infertilidad).Todo paciente debe presentar un estudio clínico-radiológico completo, lo que permitirá un correcto diagnóstico y categorización del mismo.El objetivo del presente trabajo es proporcionar al neurocirujano en formación los conceptos claves que servirán de sustento para el manejo preoperatorio de un paciente con adenoma hipofisario.


Sellar lesions are a pathology with an incidence of 3.2 to 4 / 100.000 and a prevalence of 78 to 94 / 100.000. Normally, 10% of them are incidentalomas and adult patients are in the highest risk group. Because it ́s prevalence in the world is currently increasing, it is of extremely importance to study and understand this pathology. In relation to the clinical manifestations, it should be noted that it is one of the few diseases that can manifest through neurological signs and symptoms like bitemporal hemianopsia, endocranial hypertension syndrome due to hydrocephalus, as well as endocrinological syndromes like Cushing's, acromegaly, amenorrhea-galactorrhea and infertility. One of the most important things to notice is that the treatment success in this pathology comes with the correct diagnosis and characterization of it, for what all patients should have a complete clinical-radiological evaluation.In this study, we establish a guide with concepts and key tools to support the medical personal during a pre-surgical preparation of patients with pituitary adenoma.


Subject(s)
Adenoma , Pituitary Neoplasms , Prolactin , Growth Hormone , Hydrocephalus , Neurologic Manifestations , Neurosurgery
10.
Coluna/Columna ; 20(1): 42-46, Jan.-Mar. 2021. tab, graf
Article in English | LILACS | ID: biblio-1154024

ABSTRACT

ABSTRACT Objective: To evaluate the clinical and radiological results of posterior vertebral column resection (PVCR) for the treatment of kyphosis from spinal tuberculosis. Methods: Retrospective study of a series of 14 cases, 9 female and 5 male, with a mean age of 28 years (1 to 64) at the time of surgery, with spinal tuberculosis with mean kyphosis of 56.42° (2° to 95°). Results: All patients underwent surgical treatment with PVCR, with a mean number of 2.57 (1 to 6) resected vertebrae and a mean number of instrumented vertebrae of 6.14 (4 to 8). The mean kyphosis correction was 64% after up to one year of follow-up. Prior to surgery, eight patients had signs of spinal cord impairment (ASIA score ranging from A to D), and six did not present any deficit of strength or sensory function (ASIA E). There was no neurological worsening and everyone with deficits improved by at least one degree on the scale. In the postoperative follow-up, bone consolidation was observed in all patients, except one. Among the intra- and postoperative complications, pleurotomy was the most prevalent. Conclusion: Posterior vertebral column resection has proven to be a safe and effective option for the treatment of kyphotic deformity from spinal tuberculosis. Level of evidence IV; Therapeutic studies - Investigation of treatment results.


RESUMO Objetivo: Avaliação dos resultados clínicos e radiológicos da ressecção da coluna vertebral por via posterior (RCVP) no tratamento da cifose por tuberculose vertebral. Métodos: Estudo retrospectivo de uma série de 14 casos, sendo 9 do sexo feminino e 5 do sexo masculino, com média de idade de 28 anos (1 a 64) à época da cirurgia, portadores de tuberculose vertebral, com média de cifose de 56,42° (2° a 95°). Resultados: Todos os pacientes foram submetidos ao tratamento cirúrgico com RCVP, com número médio de 2,57 (1 a 6) vértebras ressecadas e número médio de vértebras instrumentadas de 6,14 (4 a 8). A média de correção da cifose foi de 64%, com até um ano de seguimento. Antes da cirurgia, oito pacientes apresentavam sinais de sofrimento medular (escore ASIA variando de A a D) e outros seis não apresentavam déficit de força ou sensibilidade (ASIA E). Não houve piora neurológica, e todos os que tinham déficits melhoraram no mínimo um grau na escala. No seguimento pós-operatório, foi evidenciada consolidação óssea em todos os pacientes, exceto um. Dentre as complicações intra e pós-operatórias, a pleurotomia foi a mais prevalente. Conclusões: A ressecção por via posterior mostrou ser uma opção segura e eficaz no tratamento da cifose por tuberculose vertebral. Nível de evidência IV; Estudos terapêuticos - Investigação dos resultados do tratamento.


RESUMEN Objetivo: Evaluación de los resultados clínicos y radiológicos de la resección de la columna vertebral por vía posterior (RCVP) en el tratamiento de la cifosis por tuberculosis vertebral. Métodos: Estudio retrospectivo de una serie de 14 casos, 9 del sexo femenino y 5 del sexo masculino, con promedio de edad de 28 años (1 a 64) en el momento de la cirugía, portadores de tuberculosis vertebral con promedio de cifosis de 56,42° (2º a 95°). Resultados: Todos los pacientes fueron sometidos a tratamiento quirúrgico con RCVP, con número promedio de 2,57 (1 a 6) vértebras resecadas y número promedio de vértebras instrumentadas de 6,14 (4 a 8). El promedio de corrección de la cifosis fue de 64%, con hasta un año de seguimiento. Antes de la cirugía, ocho pacientes presentaban señales de sufrimiento medular (puntuación ASIA variando de A a D), y otros seis no presentaban déficit de fuerza o sensibilidad (ASIA E). No hubo empeoramiento neurológico, y todos los que tenían déficit mejoraron al menos un grado en la escala. En el seguimiento postoperatorio, fue evidenciada consolidación ósea en todos los pacientes, excepto en uno. Entre las complicaciones intra y postoperatorias, la pleurotomía fue la más prevalente. Conclusiones: La resección por vía posterior mostró ser una opción segura y eficaz en el tratamiento de la cifosis por tuberculosis vertebral. Nivel de evidencia IV; Estudios terapéuticos: investigación de los resultados del tratamiento.


Subject(s)
Humans , Osteotomy , Tuberculosis, Spinal , Neurologic Manifestations
11.
Rev. cuba. oftalmol ; 34(1): e957, 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1289533

ABSTRACT

La enfermedad cerebrovascular isquémica tiene una elevada incidencia y prevalencia en Cuba, y constituye la tercera causa de muerte en el país. Existen diferencias anatómicas y clínicas entre el infarto de la circulación anterior y la posterior. En ocasiones, los elementos distintivos que ayudan al diagnóstico topográfico de la enfermedad cerebrovascular isquémica son las manifestaciones neuroftalmológicas. Con el objetivo de profundizar en el conocimiento actual sobre las alteraciones neuroftalmológicas que se asocian a la enfermedad cerebrovascular isquémica, se realizó una revisión bibliográfica, donde se consultaron un total de 69 fuentes de información digital de los últimos 5 años. La circulación cerebral se divide de manera general en anterior y posterior. Los síntomas y signos principales del ictus que afecta la circulación anterior son la desviación conjugada de la mirada, la afectación de las sácadas, la hemianopsia homónima, la heminegligencia y la apraxia de la apertura ocular; mientras que las alteraciones asociadas a la afectación de la circulación posterior son el nistagmo, las anormalidades en la alineación y los movimientos oculares, así como la hemianopsia homónima con conservación macular. Se concluye que en la enfermedad cerebrovascular isquémica aparecen síntomas y signos como consecuencia de la afectación, tanto de la vía visual aferente, como de la eferente. La hemianopsia homónima es el signo más frecuente reportado(AU)


Ischemic cerebrovascular disease has a high incidence and prevalence in Cuba, and it is the third cause of death in the country. A number of anatomical and clinical differences distinguish anterior from posterior circulation infarction. On certain occasions the distinguishing elements that aid in the topographic diagnosis of ischemic cerebrovascular disease are its neuro-ophthalmological manifestations. With the purpose of gaining insight into the current knowledge about the neuro-ophthalmological alterations associated to ischemic cerebrovascular disease, a bibliographic review was conducted based on the analysis of 69 digital information sources from the last five years. Cerebral circulation is generally divided into anterior and posterior. The main symptoms and signs of the stroke that affects anterior circulation are conjugate gaze deviation, altered saccades, homonymous hemianopsia, heminegligence and eyelid opening apraxia, whereas the alterations associated to posterior circulation involvement are nystagmus, eye movement and alignment abnormalities, and homonymous hemianopsia with macular preservation. It is concluded that ischemic cerebrovascular disease presents symptoms and signs related to both the afferent and the efferent visual pathways. Homonymous hemianopsia is the most common sign reported(AU)


Subject(s)
Humans , Cerebrovascular Circulation , Cerebrovascular Disorders/epidemiology , Hemianopsia/etiology , Review Literature as Topic , Neurologic Manifestations
12.
Autops. Case Rep ; 11: e2021334, 2021. tab, graf
Article in English | LILACS | ID: biblio-1345352

ABSTRACT

Leigh syndrome is an inherited neurodegenerative disorder of infancy that typically manifests between 3 and 12 months of age. The common neurological manifestations are developmental delay or regression, progressive cognitive decline, dystonia, ataxia, brainstem dysfunction, epileptic seizures, and respiratory dysfunction. Although the disorder is clinically and genetically heterogeneous, the histopathological and radiological features characteristically show focal and bilaterally symmetrical, necrotic lesions in the basal ganglia and brainstem. The syndrome has a characteristic histopathological signature that helps in clinching the diagnosis. We discuss these unique findings on autopsy and radiology in a young infant who succumbed to a subacute, progressive neurological illness suggestive of Leigh syndrome. Our case highlights that Leigh syndrome should be considered in the differential diagnosis of infantile-onset, subacute neuroregression with dystonia and seizures, a high anion gap metabolic acidosis, normal ketones, elevated lactates in blood, brain, and urine, and bilateral basal ganglia involvement.


Subject(s)
Humans , Male , Infant , Leigh Disease/pathology , Autopsy , Basal Ganglia/abnormalities , Brain Damage, Chronic/pathology , Neurodegenerative Diseases , Diagnosis, Differential , Neurologic Manifestations
13.
Psicol. ciênc. prof ; 41(spe3): e193951, 2021. tab
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1340447

ABSTRACT

A microcefalia é uma condição neurológica que afeta o tamanho do perímetro cefálico. Nesta pesquisa qualitativa e descritiva, buscou-se avaliar como a mãe lida com o bebê real, identificando processos de reconstrução das idealizações maternas. Os instrumentos utilizados foram questionário sociodemográfico e entrevista semiestruturada gravada. A coleta foi realizada em três municípios do interior da Paraíba, nos domicílios de seis mães de microcéfalos com até um ano de idade. Os dados coletados no conteúdo emergente na fala das entrevistadas passaram pela análise temático categorial com suporte teórico psicanalítico. Foram identificadas nove categorias: a) reações ao diagnóstico; b) luto do bebê idealizado; c) elaboração do luto e mecanismos de enfrentamento; d) formas de lidar com o bebê e maternagem; e) dinâmica familiar após a descoberta da microcefalia; f) preconceito; g) atendimento focado em aspectos biológicos e físicos; h) acompanhamento psicológico e acolhimento; i) e suporte social. A mãe é abalada nos aspectos psicológicos e sociais. Os resultados mostram que a espiritualidade, o apoio familiar e de outras mães que vivenciam a mesma situação são formas de enfrentamento. O suporte social mais significativo é exercido pelas mães de outras crianças com microcefalia, com as quais as entrevistadas passaram a conviver em meio ao tratamento interdisciplinar dos filhos. O profissional de psicologia tem um papel fundamental na família que enfrenta a microcefalia, fortalecendo a maternagem, potencializando as forças da mãe para lidar com a desilusão e auxiliando-a na reorganização e adaptação a esse bebê com deficiências múltiplas, o que proporciona a reconstrução de suas idealizações.(AU)


Microcephaly is a neurological condition that affects child's head circumference. This qualitative descriptive research sought to evaluate how mothers of child with microcephaly deal with the real baby, identifying reconstruction processes of maternal idealizations. A sociodemographic questionnaire and a recorded semi-structured interview were conducted with the mothers of six babies born with microcephaly of up to one year of age from three municipalities of the countryside of Paraíba. With psychoanalytical theoretical support, data underwent categorical thematic analysis and resulted in nine categories: a) reactions to diagnosis; b) grief over the idealized baby; c) grief elaboration and coping mechanisms; d) ways of dealing with the baby and mothering bond; e) family dynamics after microcephaly diagnosis; f) prejudice; g) care focused on biological and physical aspects; h) psychological support and welcoming; and i) social support. The results indicate that mothers' psychological and social aspects are affected by the situation, with spirituality, family support, and contact with other mothers who experienced the same situation being coping strategies. According to the reports, the most significant social support was provided by the mothers of other children with microcephaly, whom the interviewees got to know and spend time with during the interdisciplinary treatment of their children. Psychologists also offered significant support for the family facing microcephaly, helping to strengthen motherhood, empower the mother to cope with disillusionment, reorganize and adapt to this baby with multiple disabilities, and enable the mother to be rebuilt idealizations.(AU)


La microcefalia es una afección neurológica que afecta el tamaño de la circunferencia de la cabeza. En esta investigación cualitativa y descriptiva, buscamos evaluar cómo la madre trata el bebé real, identificando los procesos de reconstrucción de idealizaciones maternas. Los instrumentos utilizados fueron el cuestionario sociodemográfico y la entrevista semiestructurada grabada. La recolección se realizó en tres municipios del interior de Paraíba (Brasil), en los hogares de seis madres de bebés con microcefalia de hasta un año de edad. Los datos recopilados en el discurso de las entrevistadas pasaron por el análisis temático categórico utilizando el apoyo teórico psicoanalítico. Se identificaron nueve categorías: a) reacciones al diagnóstico; b) duelo del bebé idealizado; c) elaboración del duelo y mecanismos de afrontamiento; d) formas de tratar el bebé y la maternidad; e) dinámica familiar después del descubrimiento de la microcefalia; f) prejuicio; g) atención centrada en aspectos biológicos y físicos; h) acompañamiento psicológico y acogedor; i) apoyo social. Los aspectos psicológicos y sociales de la madre son afectados. Los resultados muestran que las formas de afrontamiento son la espiritualidad, el apoyo familiar y otras madres que vivencian la misma situación. El apoyo social más significativo lo brindan las madres de otros niños con microcefalia, con quienes las entrevistadas comenzaron a convivir en medio del tratamiento interdisciplinario de sus hijos. El psicólogo desempeña un papel clave en la microcefalia que enfrenta la familia, incluido el fortalecimiento de la maternidad, el empoderamiento de las fuerzas de la madre para hacer frente a la desilusión, ayudarla a reorganizarse y adaptarse a este bebé con múltiples discapacidades, y permitir que sea reconstruida sus idealizaciones.(AU)


Subject(s)
Humans , Female , Pregnancy , Adult , Zika Virus , Maternal Behavior , Microcephaly , Mother-Child Relations , Prejudice , Psychology , Social Support , Bereavement , Adaptation, Psychological , Surveys and Questionnaires , Affect , User Embracement , Family Relations , Psychological Distress , Mothers , Neurologic Manifestations
14.
Autops. Case Rep ; 11: e2021261, 2021. tab, graf
Article in English | LILACS | ID: biblio-1285410

ABSTRACT

Immune-mediated encephalitis as an adverse event due to checkpoint inhibitors is very rare. We describe herein the case of a 38-year-old woman with metastatic triple-negative breast cancer who developed seizures and somnolence twelve days after receiving the first dose of Atezolizumab. Work up ruled out all infectious etiologies, and the patient was eventually diagnosed with immune-mediated meningoencephalitis. Symptoms recovered with a high-dose of steroids, and she was found to have an excellent response on follow-up imaging, which raised the question of whether a relationship exists between the occurrence, and severity of the adverse event and the response to treatment. Only a few other cases of atezolizumab-related encephalitis have been published. Early recognition and treatment are crucial; the reason why we are describing this case along with a review of the literature and a review on all the neurological immune-related adverse events due to the different checkpoint inhibitors.


Subject(s)
Humans , Female , Adult , Adenocarcinoma , Triple Negative Breast Neoplasms/pathology , Antineoplastic Agents, Immunological/adverse effects , Meningoencephalitis/pathology , Drug-Related Side Effects and Adverse Reactions , Immunotherapy/adverse effects , Neurologic Manifestations
15.
Rev. enferm. UFSM ; 11: e72, 2021. tab
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1342112

ABSTRACT

Objetivo: identificar os danos neurológicos prevalentes em pacientes internados em Unidade de Terapia Intensiva e a relação destes com as características sociais e clínicas, os cuidados e o desfecho clínico. Método: estudo transversal com análise de 83 prontuários de pacientes com danos neurológicos e internados no período de 2016 a 2018. Resultados: predomínio do Acidente Vascular Encefálico Hemorrágico (55,4%). O Traumatismo Cranioencefálico acometeu apenas homens (16,9%). A Hipertensão Arterial Sistêmica foi a principal comorbidade evidenciada (51,8%). A alteração da força muscular foi o principal sinal de dano neurológico grave (36,2%). A analgesia prevaleceu entre os cuidados intensivos dedicados aos pacientes com danos neurológicos graves (95,1%). Predomínio do óbito como desfecho clínico (85,6%). Conclusão: predomina o Acidente Vascular Encefálico Hemorrágico, especialmente em mulheres. A analgesia é o principal cuidado evidenciado, e a taxa de mortalidade foi superior à dos índices encontrados na literatura.


Objective: to identify the prevalent neurological damage in patients admitted to an Intensive Care Unit and their relationship with social and clinical characteristics, care, and clinical outcome. Method: cross-sectional study with analysis of 83 medical records of patients with neurological damage and hospitalized in the period from 2016 to 2018. Results: predominance of Hemorrhagic Stroke (55.4%). Traumatic Brain Injury affected only men (16.9%). Systemic Arterial Hypertension was the main comorbidity evidenced (51.8%). Altered muscle strength was the main sign of severe neurological damage (36.2%). Analgesia prevailed among intensive care dedicated to patients with severe neurological damage (95.1%). Death as clinical outcome predominated (85.6%). Conclusion: Hemorrhagic stroke predominates, especially in women. Analgesia is the main care evidenced, and the mortality rate was higher than the rates found in the literature.


Objetivo: identificar el daño neurológico prevalente en los pacientes ingresados en una Unidad de Cuidados Intensivos y su relación con las características sociales y clínicas, los cuidados y el resultado clínico. Método: estudio transversal con análisis de 83 historias clínicas de pacientes con daño neurológico e ingresados en el periodo de 2016 a 2018. Resultados: predominio del Ictus Hemorrágico (55,4%). El traumatismo craneoencefálico sólo afectaba a los hombres (16,9%). La hipertensión arterial sistémica fue la principal comorbilidad evidenciada (51,8%). La alteración de la fuerza muscular fue el principal signo de daño neurológico grave (36,2%). La analgesia prevaleció entre los cuidados intensivos dedicados a los pacientes con daño neurológico grave (95,1%). Predominó la muerte como resultado clínico (85,6%). Conclusión: Predomina el ictus hemorrágico, especialmente en las mujeres. La analgesia es el principal cuidado evidenciado, y la tasa de mortalidad fue superior a las tasas encontradas en la literatura.


Subject(s)
Humans , Health Profile , Adult , Intensive Care Units , Nervous System Diseases , Neurologic Manifestations
16.
S. Afr. med. j. (Online) ; 111(11): 1046-1049, 2021. figures
Article in English | AIM | ID: biblio-1344518

ABSTRACT

South Africa has experienced three deadly waves of the COVID-19 pandemic with devastating consequences, but little is known about the experiences in small-town hospitals in the country. Between May 2020 and June 2021, author GC treated ~100 confirmed COVID-19 cases. This retrospective case series report describes 10 of these cases, 7 with unusual complications and 3 with sudden death.


Subject(s)
Pneumonia , Hospitals, Urban , Comorbidity , COVID-19 , Neurologic Manifestations , Diabetes Mellitus, Type 2 , Dyspnea , Infarction
17.
Arq. bras. neurocir ; 39(4): 294-299, 15/12/2020.
Article in English | LILACS | ID: biblio-1362338

ABSTRACT

Introduction Spinal cord injury (SCI) is common in polytrauma patients. The standard exam for the initial evaluation is computed tomography (CT), due to its higher sensitivity and specificity when compared with plain radiographs. However, CT is insufficient for themanagement of some cases, especially to evaluate ligamentous and spinal cord injuries. The objective of the present study is to describe clinical scenarios in which the CT scan was insufficient to guide the treatment of SCIs. Methods We present the cases of four polytrauma patients with normal CT scans at admission and with unstable or surgically-treated lesions. Discussion The cases reported evidence the need for ongoing neurological surveillance with serial physical examination and magnetic resonance imaging (MRI) in cases of neurological injury not explained by CT or occult instability. Conclusion Computed tomography is not always sufficient to determine the management of SCIs. A comprehensive evaluation of the clinical data, CT findings and, occasionally, MRI findings is crucial in order to choose the best conduct.


Subject(s)
Humans , Male , Female , Adult , Spinal Cord Injuries/surgery , Spinal Cord Injuries/diagnostic imaging , Magnetic Resonance Spectroscopy/methods , Tomography, X-Ray Computed/methods , Multiple Trauma/complications , Neurologic Manifestations
18.
Rev. colomb. reumatol ; 27(supl.2): 166-170, oct.-dic. 2020. tab, graf
Article in English | LILACS | ID: biblio-1341351

ABSTRACT

ABSTRACT Sjögren syndrome (SS) is an autoimmune disease, rarely affecting the central nervous system. The case is reported on a 68-year-old male patient who presented with keratocon-junctivitis sicca and xerostomia, during neuropsychological evaluation showed moderate to severe multidomain cognitive impairment. The magnetic resonance showed evidence of hypertrophic pachymeningitis. The CSF study showed pleocytosis, mild proteinuria, and negative cultures. The immune positive profile, Anti SS-A, SS-B and salivary gland biopsy was compatible with SS. The treatment was started with methylprednisolone pulses at a dose of 1g every 24 h for three days, and controlled with maintenance therapy, showing a favorable response. Chronic meningitis is a diagnostic challenge; among the less common causes is hypertrophic pachymeningitis in SS, and less frequently in male patients (1/9). Non-specific neurological manifestations should be considered, such as headaches or neuropsychiatric symptoms, as on some occasions rare cases may be encountered, such as the one described.


RESUMEN El síndrome de Sjögren (SS) es una enfermedad autoinmune que rara vez afecta al sistema nervioso central. En este informe de caso describimos a un paciente varón, de 68 años, que presentó queratoconjuntivitis seca y xerostomía, y a la evaluación neuropsicológica mostró deterioro cognitivo multidominio en grado de moderado a grave. La resonancia magnética mostró evidencia de paquimeningitis hipertrófica. El estudio del LCR mostró pleocitosis, proteinuria leve y cultivos negativos; el perfil inmunológico positivo anti SS-A, SS-B y la biopsia de la glándula salival compatible con SS. El tratamiento se inició con pulsos de metilprednisolona a una dosis de 1 g/cada 24 h/durante 3 días, control con terapia de mantenimiento, mostrando una respuesta favorable. La meningitis crónica es un desafío para el diagnóstico, entre las causas menos frecuentes está la paquimeningitis hipertrófica en el SS, y con menor frecuencia en los pacientes varones (1/9). Se deben considerar manifestaciones neurológicas inespecíficas, como dolores de cabeza o síntomas neuropsiquiátricos, ya que en algunas ocasiones podemos enfrentarnos a casos raros como el descrito.


Subject(s)
Humans , Male , Aged , Sjogren's Syndrome , Meningitis , Signs and Symptoms , Causality , Diagnosis , Neurologic Manifestations
19.
Rev. Ciênc. Méd. Biol. (Impr.) ; 19(1): 144-146, jun 17, 2020.
Article in Portuguese | LILACS | ID: biblio-1358987

ABSTRACT

Introdução: A doença de Behçet (DB), também chamada síndrome de Behçet, é uma doença crônica, multissistêmica com remissões e exacerbações e evolução imprevisível. Objetivo: Descrever as manifestações neurológicas da doença de Behçet. Metodologia: Revisão narrativa da literatura utilizando o Pubmed como banco de dados. Resultados: Envolvimento neurológico em pacientes com DB conhecido como Neuro-Behcet (NB) apresenta uma prevalência variável de 2.2-5%. O diagnóstico de NB e baseado na presença de síndromes neurológicas em pacientes com achados sistêmicos de DB. Achados de neuroimagem e achados de líquor são uteis para excluir diagnósticos diferenciais, principalmente quadros infecciosos. Conclusão: Ainda que a DB seja rara na pratica neurológica rotineira, esta e comumente mencionada no diagnostico diferencial de doenças inflamatórias e/ou desmielinizantes do SNC.


Introductino: Behçet's disease (BD), also called Behçet's syndrome, is a chronic, multisystemic disease with remissions and exacerbations and unpredictable evolution. Objective: To describe neurological manifestations of BD. Metodology: Narrative review of the literature using Pubmed database. Results: Neurological involvement in patients with BD known as Neuro-Behcet (NB) has a variable prevalence of 2.2-5%. The diagnosis of NB is based on the presence of neurological syndromes in patients with systemic BD findings. Neuroimaging findings and cerebrospinal fluid findings are useful to exclude deferential diagnoses, especially infectious conditions. Conclusion: Although BD is rare in routine neurological practice, it is commonly mentioned in the differential diagnosis of inflammatory and / or demyelinating diseases of the CNS.


Subject(s)
Vasculitis , Behcet Syndrome , Neurologic Manifestations , Database
20.
Arq. bras. med. vet. zootec. (Online) ; 72(3): 778-786, May-June, 2020. tab
Article in Portuguese | LILACS, VETINDEX | ID: biblio-1129176

ABSTRACT

O perfil epizootiológico da cinomose canina em Belo Horizonte é desatualizado e não alberga algumas características relevantes. Uma análise recente da distribuição do vírus em relação às características do hospedeiro e do meio ambiente associada aos principais sinais clínicos e achados laboratoriais são importantes para se adotarem medidas estratégicas para o controle da enfermidade. Objetivou-se, assim, determinar as características epizootiológicas da infecção pelo vírus da cinomose canina associada à variedade de sinais clínico-neurológicos e laboratoriais em Belo Horizonte, auxiliando no diagnóstico precoce da infecção e na diminuição das taxas de morbidade e mortalidade da doença. A avaliação do perfil epizootiológico de 90 cães revelou que a doença é mais frequente em animais adultos (um a seis anos de idade) e que não receberam vacinas conforme recomendado pelos protocolos. Os sinais clínicos extraneurais e neurais foram variados, com predomínio para manifestações gastrentérica e respiratória, mioclonia e déficit motor, respectivamente. O exame do fluido cérebro-espinhal demonstrou predomínio de proteinorraquia associada à pleocitose linfocítica. O teste de imunocromatografia para pesquisa de antígeno com amostras do fluido cerebroespinhal foi eficaz para identificar a doença em pacientes com sinais neurológicos, diferentemente das amostras do swab conjuntival, que não devem ser utilizadas.(AU)


The epizootiology profile of canine distemper in Belo Horizonte is outdated and does not harbor some important characteristics. A recent analysis of the virus distribution in relation to host and environmental characteristics associated with the main clinical signs and laboratory findings are important for adopting strategic measures to control the disease. The aim of this study was to determine the epizootiology characteristics of canine distemper virus infection associated with a variety of clinical and neurologic signs and laboratory findings in Belo Horizonte, helping to detect early infection and reduce morbidity and mortality rates. The evaluation of the epizootiology profile of 90 dogs revealed that the disease is more frequent in adult animals (1-6 years of age) and did not receive vaccines as recommended by the protocols. Extra neural and neural clinical signs were varied, with predominance for gastrointestinal and respiratory manifestations and myoclonus and motor deficit, respectively. Examination of the cerebrospinal fluid of 16 dogs showed a predominance of increase protein associated with lymphocytic pleocytosis. The immunochromatography test for antigen screening with samples of cerebrospinal fluid in 76 animals with neurological signs was effective in identifying the disease, unlike conjunctival swab samples, which should not be used.(AU)


Subject(s)
Animals , Dogs , Distemper/epidemiology , Distemper Virus, Canine/isolation & purification , Myoclonus/veterinary , Neurologic Manifestations , Chromatography, Affinity/veterinary , Motor Skills Disorders/virology , Lymphocytosis/veterinary
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