ABSTRACT
Valproate is a commonly prescribed anticonvulsant drug. It has a potential to cause hyperammonemia even in the presence of normal liver function tests. This hyperammonemic state can lead to encephalopathy referred as Valproate induced hyperammonemic encephalopathy (VHE). Here we present a case of valproate induced hyperammonemic encephalopathy in a young male caused by initiation of valproate therapy.
Subject(s)
Brain Diseases , Hyperammonemia , Neurotoxicity Syndromes , Male , Humans , Valproic Acid/adverse effects , Anticonvulsants/adverse effects , Brain Diseases/chemically induced , Neurotoxicity Syndromes/etiology , Neurotoxicity Syndromes/drug therapy , Hyperammonemia/chemically induced , Hyperammonemia/drug therapyABSTRACT
Systemic lupus erythematosus (SLE) usually affects young females and its presentation with haemorrhage is unusual. Intracerebral bleed (ICB) has been described in a few case reports, but massive haematuria has not been reported in the literature so far. Here, we present a case of a 56 year-old-lady who presented with expanding lobar bleed and massive haematuria as the first presentation of SLE secondary to vasculitis. Lupus vasculitis usually presents with thrombosis-related complications and although bleeding in this context is rare, it can lead to catastrophic consequences. Hence, vasculitis-related bleeding should be taken under consideration in a challenging situation like ours.
ABSTRACT
Oromandibular dystonia is defined as a focal dystonia that manifests as forceful contractions of the face, jaw, and/or tongue. Lingual dystonia is a rare subtype of oromandibular dystonia that specifically affects the tongue. Multiple etiologies are thought to attribute to oromandibular dystonia, including brain damage, the use of neuroleptic medications, neurodegenerative disorders, metabolic disorders, neurodevelopmental disorders, and viral infections. Idiopathic cases of isolated lingual dystonia are rare and seldom reported in the literature. This report describes a 35-year-old female patient with lingual dystonia that was present at rest and aggravated during speech. Despite detailed history taking and a thorough examination, along with multiple imaging and laboratory studies, no cause could be established and her case was classified as being that of an idiopathic etiology.
