ABSTRACT
We explore the safety, and therapeutic benefit of intrathecal injection of ex-vivo expanded autologous bone marrow derived mesenchymal stem cells (BM-MSCs) in 10 patients with advanced multiple sclerosis (MS). Patients were assessed at 3, 6 and 12 months. Assessment at 3-6 months revealed Expanded Disability Scale Score (EDSS) improvement in 5/7, stabilization in 1/7, and worsening in 1/7 patients. MRI at 3 months revealed new or enlarging lesions in 5/7 and Gadolinium (Gd+) enhancing lesions in 3/7 patients. Vision and low contrast sensitivity testing at 3 months showed improvement in 5/6 and worsening in 1/6 patients. Early results show hints of clinical but not radiological efficacy and evidence of safety with no serious adverse events.
Subject(s)
Bone Marrow Transplantation/immunology , Mesenchymal Stem Cell Transplantation/methods , Multiple Sclerosis/pathology , Multiple Sclerosis/surgery , Adult , Bone Marrow Transplantation/adverse effects , Bone Marrow Transplantation/pathology , Cells, Cultured , Feasibility Studies , Female , Follow-Up Studies , Humans , Injections, Spinal , Male , Mesenchymal Stem Cell Transplantation/adverse effects , Middle Aged , Pilot Projects , Transplantation, Autologous , Treatment OutcomeSubject(s)
Adenocarcinoma/complications , Breast Neoplasms/complications , Paralysis/etiology , Paraneoplastic Syndromes, Nervous System/physiopathology , Phrenic Nerve/pathology , Adenocarcinoma/therapy , Antibodies, Monoclonal/administration & dosage , Antibodies, Monoclonal, Humanized , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/therapy , Cyclophosphamide/administration & dosage , Docetaxel , Doxorubicin/administration & dosage , Female , Fluorouracil/administration & dosage , Humans , Middle Aged , Neoadjuvant Therapy , Paraneoplastic Syndromes, Nervous System/etiology , Respiratory Insufficiency/etiology , Taxoids/administration & dosage , Trastuzumab , Vinblastine/administration & dosage , Vinblastine/analogs & derivatives , VinorelbineABSTRACT
The occurrence of tension pneumocephalus following ventriculoperitoneal (v.p.) shunt insertion is extremely rare, and is usually of delayed onset. We report a patient who developed an acute subdural tension pneumocephalus within 1 day following placement of a v.p. shunt for normal pressure hydrocephalus as a complication from shunt surgery.
Subject(s)
Hydrocephalus, Normal Pressure/surgery , Pneumocephalus/etiology , Ventriculoperitoneal Shunt/adverse effects , Aged , Female , Humans , Magnetic Resonance Imaging , Neurosurgical Procedures , Pneumocephalus/diagnostic imaging , Pneumocephalus/physiopathology , Subdural Space/pathology , Time Factors , Tomography, X-Ray ComputedABSTRACT
A 7-year-old, right-handed girl started to have seizures at age 1 year 4 months. She developed normally until age 4 when she had worsening of seizures with auditory verbal agnosia, complete aphasia, and a behavioral disorder fulfilling the diagnostic criteria of autism. Medical therapy failed. MRI revealed a right temporal tumor. Video/EEG monitoring at age 7 showed contralateral electrical status epilepticus in wakefulness and sleep and ipsilateral onset of seizures. Resection (ganglioglioma with excessive inflammation) resulted in seizure freedom and marked reduction of the autistic features. This case is unique for being, to our knowledge, (1) the first in which a lesion located in the right, rather than left, temporal lobe resulted in secondary falsely localizing left temporal lobe electrical status epilepticus with a clinical picture of Landau-Kleffner syndrome and autism, and (2) the fourth reported patient with lesional Landau-Kleffner syndrome to respond to resective surgery.
Subject(s)
Autistic Disorder/complications , Brain Neoplasms/complications , Epilepsy, Complex Partial/complications , Ganglioglioma/complications , Landau-Kleffner Syndrome/complications , Status Epilepticus/complications , Temporal Lobe/pathology , Child , Electroencephalography , Female , Humans , Magnetic Resonance Imaging , Video RecordingABSTRACT
Dimethylsulfoxide (DMSO) is a solvent commonly used for the cryopreservation of autologous peripheral blood stem cells (APBSC). Side effects upon infusion of DMSO-cryopreserved APBSC mainly consist of nausea, emesis, chills, rigors, and cardiovascular events, such as bradyarrhythmia or hypotension. We report the case of a patient who received DMSO-cryopreserved APBSC after myeloablative chemotherapy for a relapsing lymphoma. The patient developed a rare reaction during the infusion manifesting as transient global amnesia. The clinical course during the reaction is described and an explanation of the possible causes is discussed. This observation underlines the need for an adequate DMSO depletion to limit neurotoxicity or other adverse manifestations.
