ABSTRACT
We report a retrospective analysis of 15 cases of neurobrucellosis. Initial clinical manifestations consisted of meningoencephalitis in 5 patients, acute and subacute meningitis in 4, intracranial hypertension in 2, polyradiculoneuritis with albumin-cell dissociation in 2 (one with cerebral and subarachnoid hemorrhage), and transverse myelitis and lumbar epidural abcess with root involvement in 1 each. Cranial nerve involvement was noted in 5 patients. Fever was absent in 3. Transient clinical manifestations mimicking transient ischemic attacks were noted in 3 patients. Unusual central nervous system demyelinating lesions were observed on the MRI in 1 of the patients with meningoencephalitis. Cerebrospinal fluid Wright titers and culture were rarely helpful. Most patients responded favorably with minor neurological sequelae. The most commonly used antibiotics were rifampin, doxycycline, and trimethoprim-sulphamethoxazole, in various combinations for at least 3 months. The differential diagnosis of neurobrucellosis is wide. However, in endemic areas, the disease should be ruled out in all patients who develop unexplained neurological symptoms.
Subject(s)
Brucellosis/diagnosis , Brucellosis/drug therapy , Central Nervous System Bacterial Infections/diagnosis , Central Nervous System Bacterial Infections/drug therapy , Adolescent , Adult , Female , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
Lafora's disease is a form of progressive myoclonic epilepsy characterized by seizures, myoclonus and dementia. We present the case of a 12-year-old girl who is complaining of epilepsy and myoclonic jerks starting a year ago, with deterioration of school performance, and abnormal EEG. The axillary skin biopsy showed PAS-positive inclusions in the cells of sweat glands, typical of Lafora's disease.
Subject(s)
Lafora Disease/diagnosis , Skin/pathology , Axilla , Child , Diagnosis, Differential , Electroencephalography , Female , Humans , Lafora Disease/pathologyABSTRACT
We present a family with six children of first cousin parents, in which three present with microcephaly, hypertelorism, down-slanting palpebral fissures, ptosis, a broad nasal tip, a short webbed neck, mental retardation and seizures. Two differential diagnosis, the Noonan and the Baraitser-Winter syndrome are discussed. The possibility of the description of a new MCA/MR syndrome is raised.
Subject(s)
Abnormalities, Multiple/genetics , Blepharoptosis/genetics , Face/abnormalities , Hypertelorism/genetics , Intellectual Disability/genetics , Astigmatism/genetics , Brain/abnormalities , Child , Child, Preschool , Consanguinity , Female , Genes, Recessive , Humans , Male , Neck/abnormalities , Nose/abnormalities , Nystagmus, Pathologic/congenital , Nystagmus, Pathologic/genetics , Pedigree , Seizures/genetics , SyndromeABSTRACT
Dural fistulas of the cavernous sinus represent a relatively unknown etiology for diplopia. The authors report on a case where combination of MR and transcranial Doppler (especially transocular) helped in diagnostic and therapeutic approach. They propose a new algorithm for the management of diplopia.
