ABSTRACT
SUNCT has been reported in association with abnormalities of the brainstem and pituitary region. We present a patient with a history of left optic nerve hypoplasia, mild hypothalamic-pituitary dysfunction, and SUNCT starting in adolescence. SUNCT with an early age of onset may be associated with congenital abnormality of the hypothalamic-pituitary axis.
Subject(s)
Optic Nerve Diseases/complications , Optic Nerve/abnormalities , SUNCT Syndrome/complications , Adolescent , Adult , Age of Onset , Cysts/complications , Female , Galactorrhea , Humans , Hyperprolactinemia/complications , Magnetic Resonance Imaging , Menstruation Disturbances/complications , Optic Nerve Diseases/congenital , Pituitary Diseases/complicationsSubject(s)
Brain Neoplasms/complications , Diabetes Mellitus, Type 1/complications , Melanoma/complications , Melanosis/complications , Neurocutaneous Syndromes/complications , Anticonvulsants , Antineoplastic Agents , Autoantibodies/immunology , Brain/pathology , Brain/physiopathology , Brain Neoplasms/diagnosis , Brain Neoplasms/physiopathology , Child , Diabetes Mellitus, Type 1/immunology , Diabetes Mellitus, Type 1/physiopathology , Disease Progression , Fatal Outcome , Glutamate Decarboxylase/immunology , Humans , Male , Melanoma/diagnosis , Melanoma/physiopathology , Melanosis/diagnosis , Melanosis/physiopathology , Meningeal Neoplasms/pathology , Meninges/pathology , Neurocutaneous Syndromes/diagnosis , Neurocutaneous Syndromes/physiopathology , Nevus, Pigmented/etiology , Radiotherapy , Seizures/etiology , Treatment FailureABSTRACT
This article reviews the current and most neurologic uses of botulinum neurotoxin type A (BoNT-A), beginning with relevant historical data, neurochemical mechanism at the neuromuscular junction. Current commercial preparations of BoNT-A are reviewed, as are immunologic issues relating to secondary failure of BoNT-A therapy. Clinical uses are summarized with an emphasis on controlled clinical trials (as appropriate), including facial movement disorders, focal neck and limb dystonias, spasticity, hypersecretory syndromes, and pain.
Subject(s)
Multiple Sclerosis/diagnosis , Adjuvants, Immunologic/administration & dosage , Adolescent , Female , Humans , Interferon beta-1a , Interferon-beta/administration & dosage , Methylprednisolone/administration & dosage , Multiple Sclerosis/complications , Multiple Sclerosis/drug therapy , Neuroprotective Agents/administration & dosageABSTRACT
Anticonvulsants, neuroleptics, and antispasticity agents are used with increasing frequency in the pediatric population. Each of the drugs discussed in this article has serious but potentially reversible adverse effects. Pediatric primary care providers must be aware of the potential emergencies associated with the use of these neurologic medications to provide prompt and effective treatment.
