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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

A Rare Case of Churg Strauss Syndrome Associated with Cervical Spine and Brain Involvement (P4.037)
CONCLUSIONS:This patient meets four major criteria for diagnosis of CSS ( presence of sinusitis, histologic evidence of eosinophilic vasculitis, peripheral eosinophilia and pulmonary infiltrates). CSS associated with spine vasculitis is a rare but potentially serious clinical entity that may also lead to vascular/granulomatous compressive complications leading to permanent neurological damage. This may be only the second case of spinal cord non-hemorrhagic myelitis associated with CSS.Study Supported by:Disclosure: Dr. Mittal has nothing to disclose. Dr. Acsadi has received personal compensation for activities with Talecri...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Mittal, S., Acsadi, A., Cruz, L., Aglio, T., Ek, K., Lakshminarayanan, S., Logee, K. Tags: General Neurology III Source Type: research

Do Not Forget Susac Syndrome in Patients with Unexplained Acute Confusion (P6.303)
CONCLUSIONS: We report two patients evaluated within one month of each other who presented with acute confusion associated with MRI and CSF abnormalities and were eventually diagnosed with Susac syndrome. Susac syndrome remains under-diagnosed and should be included in the differential diagnosis of patients with unexplained confusional state associated with CSF pleocytosis/proteinorrachia and MRI callosal abnormalities.Disclosure: Dr. Star has nothing to disclose. Dr. Bruzzone has nothing to disclose. Dr. De Alba has nothing to disclose. Dr. Gill has nothing to disclose. Dr. Schneck has received personal compensation in an...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Star, M., Bruzzone, M., De Alba, F., Gill, R., Schneck, M., Biller, J. Tags: Neuro-ophthalmology/Neuro-otology II Source Type: research

Rapidly Fatal Internal Carotid Artery Mycotic Aneurysm Rupture in a Rheumatoid Patient Taking a TNF-α Inhibitor: Case Report and Literature Review
Conclusions Although fungal mycotic aneurysms of the ICA are rare, their incidence may increase with the expanded use of immunosuppressive medications. Patients with rheumatoid arthritis who take potent immunosuppression regimens may be prime candidates for mycotic aneurysms because they often have two favoring conditions: atherosclerosis and immunosuppression. These ICA aneurysms carry a high mortality rate, so early diagnosis and aggressive therapy, potentially by endovascular trapping/vessel occlusion coupled with long-term antifungal therapy, is essential.[...]Georg Thieme Verlag KG Stuttgart · New YorkArticle in Th...
Source: Journal of Neurological Surgery Part A: Central European Neurosurgery - July 21, 2014 Category: Neurosurgery Authors: Bowers, Christian A.Saad, DanyClegg, Daniel O.Ng, PerryClayton, FredericHaydoura, SouhaSchmidt, Richard H. Tags: Case Report Source Type: research

Spinal Cord Infarction as the Initial Presentation of Systemic Lupus Erythematosus (P2.077)
CONCLUSIONS:Aggressive therapy with high dose corticosteroids and intravenous cyclophosphamide followed by oral therapy may be a successful therapeutic approach to spinal cord infarcts secondary to systemic lupus erythematosus. Study Supported by: N/ADisclosure: Dr. Michael has nothing to disclose. Dr. Hayat has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Michael, A., Hayat, G. Tags: Neurological Consequences of Autoimmune Disease Source Type: research

Primary Angiitis of the Central Nervous System (PACNS) Presenting with Intracerebral Hemorrhage (P2.293)
Conclusion: Primary CNS vasculitis should be suspected even in patients presenting initially with intracerebral hemorrhage in association with only moderate headaches.Disclosure: Dr. Alkhalifah has nothing to disclose. Dr. Fayad has received research support from the National Institute of Neurological Disorders and Stroke and St. Jude Medical. Dr. Omojola has nothing to disclose. Dr. Hearth-Holmes has nothing to disclose. Dr. McComb has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Alkhalifah, M., Fayad, P., Omojola, M., Hearth-Holmes, M., McComb, R. Tags: Cerebrovascular Disease and Interventional Neurology: Inflammation and Immunology Source Type: research

Primary Angiitis of the Central Nervous System (PACNS) presenting with intracerebral hemorrhage (ICH): three cases associated with chronic use of over-the-counter vasoconstrictive drugs (P7.128)
CONCLUSIONS: While the FDA withdrew phenylpropanolamine due to its association with ICH, other vasoconstrictive agents remain ingredients of nasal decongestants/diet pills. These may induce chronic vasoconstriction leading to secondary inflammation and arterial rupture, culminating in atypical PACNS presentations such as multifocal ICH or ICH with acute infarcts (patients 1,2).Disclosure: Dr. Jha has nothing to disclose. Dr. George has nothing to disclose. Dr. Singhal has received personal compensation for activities as a medicolegal expert witness. Dr. Singhal's spouse holds stock and/or stock options in Biogen Idec.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Jha, R., George, J., Singhal, A. Tags: Cerebrovascular Disease and Interventional Neurology: Stroke in Young Source Type: research

An Update of the Mayo Clinic Cohort of Patients With Adult Primary Central Nervous System Vasculitis: Description of 163 Patients
This study is based on a cohort of 163 consecutive patients with PCNSV who were examined at the Mayo Clinic over a 29-year period from 1983 to 2011. The aim of the study was to define the characteristics of these patients, which represents the largest series in adults reported to date. A total of 105 patients were diagnosed by angiographic findings and 58 by biopsy results. The patients diagnosed by biopsy more frequently had at presentation cognitive dysfunction, greater cerebrospinal fluid total protein concentrations, less frequent cerebral infarcts, and more frequent leptomeningeal gadolinium-enhanced lesions on magnet...
Source: Medicine - May 1, 2015 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Can Quantitative Muscle Strength and Functional Motor Ability Differentiate the Influence of Age and Corticosteroids in Ambulatory Boys with Duchenne Muscular Dystrophy?
Conclusion The baseline data analysis of this natural history study indicates that the outcomes measures utilized in this study were sensitive to the age related differences in strength and motor function that are characteristic of disease progression boys with DMD; however treatment effects were less likely to be identified. These findings reflect the difficulty inherent in obtaining the statistical power needed to substantiate intervention efficacy in the small, heterogeneous samples sizes that are characteristic of DMD clinical studies. Isokinetic dynamometry revealed variability in the muscles affected, which has been ...
Source: PLOS Currents Muscular Dystrophy - July 8, 2016 Category: Neurology Authors: cbuckon Source Type: research

Safety of long-term exposure to abiraterone acetate in patients with castration-resistant prostate cancer and concomitant cardiovascular risk factors
Conclusions: Long-term abiraterone treatment was well tolerated in mCRPC patients with controlled cardiovascular comorbidities/risk factors, with no apparent worsening of cardiovascular conditions from baseline over an extended observation period.
Source: Therapeutic Advances in Medical Oncology - August 7, 2016 Category: Cancer & Oncology Authors: Verzoni, E., Grassi, P., Ratta, R., Niger, M., De Braud, F., Valdagni, R., Procopio, G. Tags: Original Research Source Type: research

Seizure syndrome as a first manifestation of solitary tumor-like mass lesion of PACNS: Two case reports
Rationale: Primary angiitis of the central nervous system (PACNS) is an inflammatory disease involving cerebrovascular and parenchymal, and solitary tumor-like mass lesion of PACNS (TLML-PACNS) is frequently misdiagnosed as neoplastic or other inflammatory diseases. However, seizure syndrome as a first manifestation of TLML-PACNS has rarely reported before. Patient concerns: Here, we report 2 cases of seizure syndrome, which was the first sign that presented prior to the diagnosis of TLML-PACNS by brain biopsy. Diagnoses: A mass lesion in the white and gray matters was detected by magnetic resonance imaging. The patholog...
Source: Medicine - March 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Deadly Respiratory Distress Mimic
Medic 534, staffed by a paramedic and EMT, is dispatched to a nursing home for a 78-year-old female in respiratory distress. On arrival, the crew finds the patient in a chair accompanied by two nurses and the administrator on call. The patient is in obvious distress showing fatigue and an increased work of breathing. She is alert to voice, but diaphoretic, lethargic, and unable to speak due to rapid, shallow breathing. A nurse is administering a nebulizer containing 3 mL of albuterol sulfate/ipratropium. A second nurse states that the patient has been in increasing distress for the last 45 minutes. The nurse also says that...
Source: JEMS Patient Care - July 17, 2018 Category: Emergency Medicine Authors: Brenton Faber, PhD, NRP Tags: Airway & Respiratory Patient Care Source Type: news

Bilateral thalamic and mesencephalic infarctions with hypopituitarism as long-term complications postradiotherapy: A case report
Conclusion: To our knowledge, this is the first report of bilateral thalamic and mesencephalic infarction together with hypopituitarism following radiotherapy for NPC.
Source: Medicine - August 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Intravascular large B-cell lymphoma presenting as multiple stroke: A case report
Conclusion: IVLBCL is an aggressive disease with high mortality. Timely diagnosis and treatment can be lifesaving.
Source: Medicine - October 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Deadly Respiratory Distress Mimic
Conclusion It’s important for prehospital providers to be able to differentiate metabolic disturbances in the setting of respiratory distress and not be fooled into thinking tachypnea always has a respiratory cause. The physical exam and adjuncts such as end-tidal capnography can assist in the prehospital diagnosis. A COPD exacerbation generally presents as diminished lung sounds, wheezing on exhalation, and a prolonged expiratory phase. Here, a patient will attempt to compensate for the inflammation and mucus accumulation associated with the destruction and narrowing of peripheral airways and a subsequent lack of availa...
Source: JEMS Special Topics - July 17, 2018 Category: Emergency Medicine Authors: Brenton Faber, PhD, NRP Tags: Airway & Respiratory Exclusive Articles Patient Care Source Type: news