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Neurosarcoidosis Presenting with Prominent Periventricular White-Matter Lesions during Steroid Treatment for Autoimmune Hepatitis
A 63-year-old woman under treatment of autoimmune hepatitis presented with headache, memory loss, and somnolence. Three months before admission, the patient experienced liver inflammation relapse after prednisolone (PSL) cessation. Consequently, PSL was resumed and then tapered. Cerebrospinal fluid (CSF) examination showed lymphocytic pleocytosis with remarkably reduced glucose and elevated angiotensin-converting enzyme and soluble interleukin-2 receptor levels. Magnetic resonance imaging (MRI) revealed prominent bilateral periventricular white-matter lesions, hydrocephalus, ischemic stroke with gadolinium enhancement of f...
Source: Case Reports in Neurology - August 19, 2022 Category: Neurology Source Type: research

What Causes Facial Nerve Palsy?
Discussion Facial nerve palsy has been known for centuries, but in 1821 unilateral facial nerve paralysis was described by Sir Charles Bell. Bell’s palsy (BP) is a unilateral, acute facial paralysis that is clinically diagnosed after other etiologies have been excluded by appropriate history, physical examination and/or laboratory testing or imaging. Symptoms include abnormal movement of facial nerve. It can be associated with changes in facial sensation, hearing, taste or excessive tearing. The right and left sides are equally affected but bilateral BP is rare (0.3%). Paralysis can be complete or incomplete at prese...
Source: PediatricEducation.org - June 3, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news

Case presentation: the dancing man from sierra leone
Discussion Making this diagnosis is challenging, as brain imaging often shows non specific changes and blood results are usually normal. CSF may reveal raised proteins and WBCs. A high index of suspicion is required to arrange a brain biopsy as this confirms the diagnosis.
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: Al-Rifai, M. S., Salek-Haddadi, A. Tags: Immunology (including allergy), Neuroimaging, Stroke, Radiology, Drugs: musculoskeletal and joint diseases, Vascularitis, Surgical diagnostic tests ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research

Progress in pediatrics in 2015: choices in allergy, endocrinology, gastroenterology, genetics, haematology, infectious diseases, neonatology, nephrology, neurology, nutrition, oncology and pulmonology
AbstractThis review focuses key advances in different pediatric fields that were published in Italian Journal of Pediatrics and in international journals in 2015. Weaning studies continue to show promise for preventing food allergy. New diagnostic tools are available for identifying the allergic origin of allergic-like symptoms. Advances have been reported in obesity, short stature and autoimmune endocrine disorders. New molecules are offered to reduce weight gain and insulin-resistance in obese children. Regional investigations may provide suggestions for preventing short stature. Epidemiological studies have evidenced th...
Source: Italian Journal of Pediatrics - August 26, 2016 Category: Pediatrics Source Type: research

Lupus patients 'at higher risk of developing other health conditions'
People with lupus are at a greater risk of developing other health conditions than members of the general population.This is according to a new study conducted by the University of Nottingham and the Arthritis Research UK Primary Care Centre at Keele University, which examined the frequency of comorbidities associated with systemic lupus erythematosus in the UK between 1999 and 2012.A broad UK study Published in the medical journal Arthritis Care & Research, the study drew upon data from the UK Clinical Practice Research Datalink, identifying cases of lupus and matching each one by age, gender and practice to four heal...
Source: Arthritis Research UK - May 26, 2016 Category: Rheumatology Source Type: news

Efficacy of Extracranial–Intracranial Bypass for Progressive Middle Cerebral Artery Occlusion Associated with Active Sjögren's Syndrome: Case Report
Sjögren syndrome affecting the major cerebral arteries is rare, and an optimal therapeutic strategy to counteract such a lesion has not yet been established. We herein report a case of a 39-year-old woman with a history of primary Sjögren syndrome, which had previously been treated with immunosuppressive therapy, manifesting with a crescendo transient ischemic attack because of left middle cerebral artery stenosis. Despite the administration of high doses of prednisolone and azathioprine for active Sjögren syndrome, the frequency of crescendo transient ischemic attacks increased with the progression of stenosis and magn...
Source: Journal of Stroke and Cerebrovascular Diseases - August 4, 2014 Category: Neurology Authors: Hiroyuki Sakata, Miki Fujimura, Kenichi Sato, Hiroaki Shimizu, Teiji Tominaga Tags: Case Reports Source Type: research

Teaching NeuroImages: Macaroni sign
A 35-year-old patient with previously diagnosed and currently untreated Takayasu arteritis presented with motor aphasia. The symptom had started 24 hours before presentation and ceased after another 12 hours. Cranial MRI and magnetic resonance angiography were normal. Plasma concentration of C-reactive protein was elevated (9.1 mg/dL). Duplex ultrasonography showed hypoechoic, homogeneous thickening of the intima–media complex of the left common carotid artery (figure). This finding, also referred to as "macaroni sign," has been reported in Takayasu arteritis.1,2 The patient was transferred to the rheumatologic depar...
Source: Neurology - June 30, 2014 Category: Neurology Authors: Siepmann, T., Bodechtel, U. Tags: Ultrasound, Autoimmune diseases, Vasculitis, All Cerebrovascular disease/Stroke RESIDENT AND FELLOW SECTION Source Type: research

Anti glutamic acid decarboxylase antibody mediated encephalopathy while on etanercept in a patient with multiple autoimmune diseases
A 39 year old lady presented with an altered mental state and unsteadiness of gait. She had a history of juvenile idiopathic arthritis, autoimmune thyroiditis and alopecia, protein S deficiency with vena cava thrombosis, previous excision of ovarian mass and vasculitic rash. There was a previous history of ovarian mass and her immunomodulatory therapy for arthritis over the previous year was Etanercept. She used recreational cannabis but denied any other illicit drug usage. Her affect was variable and at times inappropriate with frequent laughter. She would spit regularly. There was anxiety and a prevailing sensation of do...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: MacDougall, N., Waddell, B., O'Riordan, J. I. Tags: Immunology (including allergy), Brain stem / cerebellum, Drugs: CNS (not psychiatric), Epilepsy and seizures, Infection (neurology), Stroke, Drugs misuse (including addiction), Connective tissue disease, Musculoskeletal syndromes Association of British Source Type: research