Glial Fibrillary Acidic Protein Autoimmunity After Aseptic Meningitis: A Report of 2 Cases
This study involved a retrospective chart review. Results Two female patients, 45 and 55 years of age, developed aseptic meningoencephalomyelitis or meningitis; in one patient, it was likely caused by herpes simplex virus 2. The patients were recovering from the infectious condition when they, 51 and 5 days after onset, had new symptoms with detection of GFAP antibodies in the CSF; CSF and serum samples from the initial lumbar punctures had been negative for GFAP antibodies. Both patients recovered with steroid treatment (in one case, plus rituximab; in the other, plus azathioprine) including resolution of MRI and CSF abn...
Source: Neurology Neuroimmunology and Neuroinflammation - November 10, 2023 Category: Neurology Authors: Bien, C. G., Büttner, T., Reichen, I. C., Thomas, A., Vlad, B., Woermann, F., Bien, C. I., Jelcic, I. Tags: Autoimmune diseases, Meningitis, All Clinical Neurology Clinical/Scientific Note Source Type: research

Guillain-Barr é syndrome following varicella-zoster virus infection: a case report and systematic review
CONCLUSION: GBS is a rare neurological complication of primary infection with VZV. However, the authors should suspect this syndrome when a patient develops ascending weakness, regardless of the absence of areflexia and albuminocytological dissociation. Drug therapy with IIVIg ensures a gradual improvement for the patient over a period of weeks to several months.PMID:37915710 | PMC:PMC10617928 | DOI:10.1097/MS9.0000000000001370 (Source: Annals of Medicine)
Source: Annals of Medicine - November 2, 2023 Category: Internal Medicine Authors: Yaman Nerabani Abd Alazeez Atli Ola Hamdan Abdulkader Hajjar Mwaffak Noor Al Hoda Haj Hammadh Hiba Marstawi Soma Hora Nouri Alabd Source Type: research

Changes in Cerebrospinal Fluid, Liver and Intima-media-thickness Biomarkers in Patients with HIV-associated Neurocognitive Disorders Randomized to a Less Neurotoxic Treatment Regimen
AbstractThe prevalence of neurocognitive impairment in people living with HIV is estimated between 30 and 50%. The pathogenesis of HIV-associated neurocognitive disorders is complex and multifactorial. Aim of the study was to measure the change in CSF biomarkers, Fibroscan and IMT measurements in PLWH with HAND randomized to a less neurotoxic regimen, or continuing their treatment.  Adult patients with HAND were screened and enrolled if presenting no major resistance associated mutations, no HIV viral replication, not on efavirenz or darunavir, with R5-tropic HIV and without major confounding conditions. Lumbar puncture, ...
Source: Journal of NeuroImmune Pharmacology - October 31, 2023 Category: Drugs & Pharmacology Source Type: research

Using a novel virtual-reality simulator to assess performance in lumbar puncture: a validation study
A lumbar puncture procedure ’s success depends on a competent physician minimizing the risk of failing to get a sample and avoiding complications such as post-dural headache. A new virtual-reality simulator mig... (Source: BMC Medical Education)
Source: BMC Medical Education - October 30, 2023 Category: Universities & Medical Training Authors: Sujun Xie, S øren Grimstrup, Leizl Joy Nayahangan, Zheng Wang, Xing Wan and Lars Konge Tags: Research Source Type: research

Clinical and radiological predictors of tuberculous meningitis
Conclusion: Our study emphasizes the importance of performing a MRI brain in suspected TBM. (Source: European Respiratory Journal)
Source: European Respiratory Journal - October 27, 2023 Category: Respiratory Medicine Authors: Young, R., Skyllberg, E., Sharma, A., White, V., Tiberi, S., Dart, S., Kunst, H. Tags: Tuberculosis and non-tuberculous mycobacterial diseases Source Type: research

Varicella Zoster viral encephalitis without herpes: diagnosis by metagenomic next-generation sequencing of  cerebrospinal fluid
Future Microbiol. 2023 Oct 26. doi: 10.2217/fmb-2023-0107. Online ahead of print.ABSTRACTAcute Varicella Zoster viral encephalitis in immunocompetent adult patients without cutaneous herpes has rarely been reported. A 24-year-old female was hospitalized for a headache with a fever but without other obvious symptoms. Multiple routine examinations showed no abnormalities. Lumbar puncture indicated intracranial hypertension. The examination of cerebrospinal fluid by metagenomic next-generation sequencing demonstrated acute Varicella Zoster viral encephalitis. The patient's condition improved by treatment with acyclovir for an...
Source: Herpes - October 26, 2023 Category: Infectious Diseases Authors: Xin Hong Youqi Ji Mengyuan Chen Fang Su Yongze Zhu Yumei Ge Source Type: research

Cerebral venous thrombosis caused by spontaneous intracranial hypotension due to spontaneous spinal cerebrospinal fluid leakage in the high cervical region: a case report
This report proposes a diagnostic procedure for detecting rare cases of SIH-induced CVT, thereby preventing future misdiagnoses and delayed treatment. When a patient presenting with CVT in conjunction with intracranial hypotension has no history of trauma or piercing, SIH caused by spontaneous spinal CSF leakage should be considered as a potential cause of secondary low intracranial pressure. For detection of CSF leaks at rare sites, an MRI of the whole spine rather than a localized MRI of the spine needs to be performed to avoid misdiagnosis. An epidural blood patch should be performed as soon as possible as it may shorte...
Source: Frontiers in Neurology - October 26, 2023 Category: Neurology Source Type: research

Human African Trypanosomiasis (Sleeping Sickness) —Epidemiology, Clinical Manifestations, Diagnosis, Treatment, and Prevention
AbstractPurpose of ReviewHuman African Trypanosomiasis (HAT), also known as sleeping sickness, is a vector-borne parasitic neglected tropical disease (NTD) endemic in sub-Saharan Africa. This review aims to enhance our understanding of HAT and provide valuable insights to combat this significant public health issue by synthesizing the latest research and evidence.Recent FindingsHAT has reached a historical< 1000 cases in 2018. In patients without neurologic symptoms and signs, the likelihood of a severe meningoencephalitic stage is deemed low, obviating the need for a lumbar puncture to guide treatment decisions using f...
Source: Current Tropical Medicine Reports - October 25, 2023 Category: Tropical Medicine Source Type: research

Positioning for lumbar puncture in newborn infants
CONCLUSIONS: When compared to sitting position, lateral decubitus position may result in little to no difference in successful lumbar puncture procedure at first attempt. None of the included studies reported the total number of lumbar puncture attempts. Furthermore, infants in a lateral decubitus position likely experience more episodes of bradycardia and oxygen desaturation, and there may be little to no difference in episodes of apnea. The evidence is very uncertain regarding time to perform lumbar puncture. Pain intensity during and after the procedure was reported using a pain scale that was not included in our prespe...
Source: Cochrane Database of Systematic Reviews - October 23, 2023 Category: General Medicine Authors: Sara Pessano Matteo Bruschettini Marcus Glenton Prescott Olga Romantsik Source Type: research

Persistent headaches one year after bacterial meningitis: prevalence, determinants and impact on quality of life
ConclusionPersistent headaches are frequent one year after meningitis and are associated with quality of life alteration.Clinical trialNCT01730690. (Source: European Journal of Clinical Microbiology and Infectious Diseases)
Source: European Journal of Clinical Microbiology and Infectious Diseases - October 23, 2023 Category: Microbiology Source Type: research

Sphenopalatine ganglion blocks for post-dural puncture headache: A case report in a 3-year-old child
Paediatr Anaesth. 2023 Oct 20. doi: 10.1111/pan.14785. Online ahead of print.ABSTRACTPost-dural puncture headache is a distressing complication that may occur after lumbar puncture or unintentional dural puncture. Risk factors in the pediatric population have not been well elicited, and the true incidence is unknown. Conservative management includes conservative physical measures and medical therapies. Epidural blood patch remains the gold standard for managing severe refractory headache, but greater occipital nerve blocks and sphenopalatine ganglion blocks have been used with success. Sphenopalatine ganglion blocks are ea...
Source: Paediatric Anaesthesia - October 21, 2023 Category: Anesthesiology Authors: Anisa Bhettay Roxanne Burger Source Type: research

Sphenopalatine ganglion blocks for post-dural puncture headache: A case report in a 3-year-old child
Paediatr Anaesth. 2023 Oct 20. doi: 10.1111/pan.14785. Online ahead of print.ABSTRACTPost-dural puncture headache is a distressing complication that may occur after lumbar puncture or unintentional dural puncture. Risk factors in the pediatric population have not been well elicited, and the true incidence is unknown. Conservative management includes conservative physical measures and medical therapies. Epidural blood patch remains the gold standard for managing severe refractory headache, but greater occipital nerve blocks and sphenopalatine ganglion blocks have been used with success. Sphenopalatine ganglion blocks are ea...
Source: Paediatric Anaesthesia - October 21, 2023 Category: Anesthesiology Authors: Anisa Bhettay Roxanne Burger Source Type: research

Sphenopalatine ganglion blocks for post-dural puncture headache: A case report in a 3-year-old child
Paediatr Anaesth. 2023 Oct 20. doi: 10.1111/pan.14785. Online ahead of print.ABSTRACTPost-dural puncture headache is a distressing complication that may occur after lumbar puncture or unintentional dural puncture. Risk factors in the pediatric population have not been well elicited, and the true incidence is unknown. Conservative management includes conservative physical measures and medical therapies. Epidural blood patch remains the gold standard for managing severe refractory headache, but greater occipital nerve blocks and sphenopalatine ganglion blocks have been used with success. Sphenopalatine ganglion blocks are ea...
Source: Paediatric Anaesthesia - October 21, 2023 Category: Anesthesiology Authors: Anisa Bhettay Roxanne Burger Source Type: research

Sphenopalatine ganglion blocks for post-dural puncture headache: A case report in a 3-year-old child
Paediatr Anaesth. 2023 Oct 20. doi: 10.1111/pan.14785. Online ahead of print.ABSTRACTPost-dural puncture headache is a distressing complication that may occur after lumbar puncture or unintentional dural puncture. Risk factors in the pediatric population have not been well elicited, and the true incidence is unknown. Conservative management includes conservative physical measures and medical therapies. Epidural blood patch remains the gold standard for managing severe refractory headache, but greater occipital nerve blocks and sphenopalatine ganglion blocks have been used with success. Sphenopalatine ganglion blocks are ea...
Source: Paediatric Anaesthesia - October 21, 2023 Category: Anesthesiology Authors: Anisa Bhettay Roxanne Burger Source Type: research

Sphenopalatine ganglion blocks for post-dural puncture headache: A case report in a 3-year-old child
Paediatr Anaesth. 2023 Oct 20. doi: 10.1111/pan.14785. Online ahead of print.ABSTRACTPost-dural puncture headache is a distressing complication that may occur after lumbar puncture or unintentional dural puncture. Risk factors in the pediatric population have not been well elicited, and the true incidence is unknown. Conservative management includes conservative physical measures and medical therapies. Epidural blood patch remains the gold standard for managing severe refractory headache, but greater occipital nerve blocks and sphenopalatine ganglion blocks have been used with success. Sphenopalatine ganglion blocks are ea...
Source: Paediatric Anaesthesia - October 21, 2023 Category: Anesthesiology Authors: Anisa Bhettay Roxanne Burger Source Type: research