Assuntos
Levodopa , Doença de Parkinson , Ubiquitina-Proteína Ligases , Humanos , Doença de Parkinson/tratamento farmacológico , Doença de Parkinson/genética , Levodopa/uso terapêutico , Ubiquitina-Proteína Ligases/genética , Ubiquitina-Proteína Ligases/metabolismo , Distonia/genética , Distonia/tratamento farmacológico , Distonia/induzido quimicamente , Masculino , Feminino , Antiparkinsonianos/uso terapêutico , Antiparkinsonianos/farmacologia , Adulto , Marcha/efeitos dos fármacos , Transtornos Neurológicos da Marcha/genética , Transtornos Neurológicos da Marcha/etiologia , Transtornos Neurológicos da Marcha/tratamento farmacológicoRESUMO
Seizures are not common in cases with chronic liver disease. Overall seizures have been reported in 20-30% of cases in chronic liver disease associated with hepatic encephalopathy. We report two cases of chronic liver disease patients who presented with new-onset refractory focal status epilepticus (SE). Both patients had encephalitis and seizures which responded only when acyclovir was added to the treatment with antiepileptic medication. Herpes encephalitis should be considered as a possible diagnosis in new-onset focal seizures or focal SE in patients with chronic liver disease with or without hepatic encephalopathy, pending further investigations.
RESUMO
Optic disc edema may be caused by a number of conditions. A commonly ignored but important aspect is the presence of "infiltration" of disc; that may closely mimic disc edema. Disc edema, optic nerve dysfunction and a normal appearing disc in any combination may occur in infiltrative optic neuropathies. Identifying disc infiltration can aid in diagnosis of many sinister pathologies even in the absence of other specific clinical features. We describe two patients presenting with optic nerve dysfunction and infiltrated disc appearance, which on investigations were found to have underlying malignancies thereby underscoring the importance of detecting infiltrative optic neurpathies.