ABSTRACT
Imaging modalities frequently utilize iodinated-based contrast agents (IBCAs) to assist professionals in deficit identification and improve clinical outcomes for patients. However, they are not without risk. In patients with post-radiological neurological deficits, contrast-induced neurotoxicity (CIN) should be among the top differentials. In this case report, we present the case of a 61-year-old female who experienced classical signs and symptoms of neurotoxicity after a cerebral angiogram. The patient's clinical detriments stemming from iodinated contrast resolved after a multi-day treatment of high-dose steroid use.
ABSTRACT
Bell's palsy is a mononeuropathy of the facial nerve that typically causes unilateral facial paralysis. The incidence of unilateral Bell's palsy is not uncommon, but sequential or simultaneous bilateral Bell's palsy is exceedingly rare. While unilateral Bell's palsy is oftentimes idiopathic, bilateral Bell's palsy is almost exclusively explained by an identifiable trigger. In pre-clinical trials, Bell's palsy cases were recorded at higher rates in the vaccine cohort than the placebo cohort. Herein, we present a case of isolated sequential bilateral Bell's palsy that after an extensive workup, proved to be idiopathic. Notably, in the setting of a recent coronavirus disease 2019 (COVID-19) vaccine and absence of identifiable etiology, our case highlights a potential correlation of the COVID-19 vaccine and bilateral Bell's palsy.
ABSTRACT
BACKGROUND: Fatigue affects 40% to 50% of all PD patients and is a leading cause of disability, with no clearly established or efficacious established treatments. METHODS: In this double-blinded, placebo-controlled, pilot trial, we investigated whether rasagiline improved fatigue among PD patients. Subjects were randomized to 1 mg daily of rasagiline or placebo for 12 weeks. The primary endpoint was a change in the Modified Fatigue Impact Scale from baseline to week 12. RESULTS: Thirty PD subjects (16 men), with Modified Fatigue Impact Scale baseline score of 67 ± 15, were randomized (16 to rasagiline vs. 14 to placebo). Significant improvement was noted in the mean Modified Fatigue Impact Scale score of the rasagiline group (12 points) as compared to placebo (8.5 points) from baseline to week 12 (P = 0.003). CONCLUSION: In this pilot study, rasagiline at a dose of 1 mg per day improved fatigue. Larger randomized studies are needed to confirm this finding.
Subject(s)
Fatigue/drug therapy , Fatigue/etiology , Indans/therapeutic use , Neuroprotective Agents/therapeutic use , Parkinson Disease/complications , Adult , Aged , Aged, 80 and over , Double-Blind Method , Female , Follow-Up Studies , Humans , Male , Middle Aged , Pilot Projects , Severity of Illness Index , Statistics, Nonparametric , Treatment OutcomeABSTRACT
Intravascular lymphoma (IVL) is a rare variant of non-Hodgkin's lymphoma characterised by neoplastic lymphoid cells growing inside the lumina of medium and small vessels. The diversity of clinical presentation owing to the possibility of its occurrence in any organ often makes it a challenging diagnosis. We present an intriguing case of intravascular large B-cell central nervous system (CNS) lymphoma in which the patient presented with a non-specific neurological symptom and had no systemic symptoms or dermatological manifestations. The patient deteriorated rapidly after presentation and succumbed to multi-organ failure within 2 weeks of admission.
