H. Ueno, Narumi Ohno, Miharuka Yokosaki, Tatsuya Ohtani, Kazuki Kimoto, Chika Matsuoka, Mayumi Giga, T. Kono, D. Agari, E. Nomura
A 74yearold woman presented with a 1year history of progressive weakness and pain in the right leg. Despite L4L5 laminoplasty performed at another hospital 2 months before admission, her clinical manifestations had deteriorated and she was referred and admitted to our hospital. Diffusionweighted wholebody imaging with background body signal suppression (DWIBS) showed diffusion restrictions in the L2 and L3 nerve roots, femoral nerve, and uterus (Figure 1A). Uterine needle biopsy revealed diffuse large Bcell lymphoma. These findings indicated a diagnosis of secondary neurolymphomatosis. Wholebody 18Ffluorodeoxyglucosepositron
{"title":"Diagnostic usefulness of whole‐body diffusion‐weighted imaging in neurolymphomatosis without FDG uptake","authors":"H. Ueno, Narumi Ohno, Miharuka Yokosaki, Tatsuya Ohtani, Kazuki Kimoto, Chika Matsuoka, Mayumi Giga, T. Kono, D. Agari, E. Nomura","doi":"10.1111/ncn3.12713","DOIUrl":"https://doi.org/10.1111/ncn3.12713","url":null,"abstract":"A 74yearold woman presented with a 1year history of progressive weakness and pain in the right leg. Despite L4L5 laminoplasty performed at another hospital 2 months before admission, her clinical manifestations had deteriorated and she was referred and admitted to our hospital. Diffusionweighted wholebody imaging with background body signal suppression (DWIBS) showed diffusion restrictions in the L2 and L3 nerve roots, femoral nerve, and uterus (Figure 1A). Uterine needle biopsy revealed diffuse large Bcell lymphoma. These findings indicated a diagnosis of secondary neurolymphomatosis. Wholebody 18Ffluorodeoxyglucosepositron","PeriodicalId":19154,"journal":{"name":"Neurology and Clinical Neuroscience","volume":"11 1","pages":"251 - 252"},"PeriodicalIF":0.4,"publicationDate":"2023-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47883492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Keisuke Mizutani, T. Oguri, K. Sakurai, H. Yuasa, K. Takada
Bilateral medial medullary infarction (MMI) is a rare form of ischemic stroke, mainly caused by vertebral artery atherosclerosis or small penetrating artery disease. We report a case of bilateral MMI due to varicella‐zoster virus (VZV) vasculopathy. An 81‐year‐old man presented with altered consciousness and right hemiplegia during disseminated herpes zoster. Polymerase chain reaction analysis of his cerebrospinal fluid detected positive VZV‐DNA, and magnetic resonance imaging revealed ischemic infarction localized to the ventral part of the bilateral medial medulla and enhancement of the left vertebral artery. After initiating intravenous acyclovir administration, his consciousness, skin rashes, and general condition improved gradually, whereas pyramidal symptoms deteriorated into quadriplegia. This case demonstrates that VZV vasculopathy may cause bilateral MMI.
{"title":"Bilateral medial medullary infarction due to varicella‐zoster virus vasculopathy: A case report","authors":"Keisuke Mizutani, T. Oguri, K. Sakurai, H. Yuasa, K. Takada","doi":"10.1111/ncn3.12712","DOIUrl":"https://doi.org/10.1111/ncn3.12712","url":null,"abstract":"Bilateral medial medullary infarction (MMI) is a rare form of ischemic stroke, mainly caused by vertebral artery atherosclerosis or small penetrating artery disease. We report a case of bilateral MMI due to varicella‐zoster virus (VZV) vasculopathy. An 81‐year‐old man presented with altered consciousness and right hemiplegia during disseminated herpes zoster. Polymerase chain reaction analysis of his cerebrospinal fluid detected positive VZV‐DNA, and magnetic resonance imaging revealed ischemic infarction localized to the ventral part of the bilateral medial medulla and enhancement of the left vertebral artery. After initiating intravenous acyclovir administration, his consciousness, skin rashes, and general condition improved gradually, whereas pyramidal symptoms deteriorated into quadriplegia. This case demonstrates that VZV vasculopathy may cause bilateral MMI.","PeriodicalId":19154,"journal":{"name":"Neurology and Clinical Neuroscience","volume":"11 1","pages":"245 - 247"},"PeriodicalIF":0.4,"publicationDate":"2023-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42428917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Asuka Suzuki, Yuka Nakaya, Koji Hayashi, M. Ueda, Rei Asano, Yudai Tanaka, H. Hayashi, Toyoaki Miura, K. Hayashi, K. Fujita, Kaori Kawabata, Yasutaka Kobayashi, Mamiko Sato
{"title":"Bálint syndrome by cerebral septic embolism","authors":"Asuka Suzuki, Yuka Nakaya, Koji Hayashi, M. Ueda, Rei Asano, Yudai Tanaka, H. Hayashi, Toyoaki Miura, K. Hayashi, K. Fujita, Kaori Kawabata, Yasutaka Kobayashi, Mamiko Sato","doi":"10.1111/ncn3.12711","DOIUrl":"https://doi.org/10.1111/ncn3.12711","url":null,"abstract":"","PeriodicalId":19154,"journal":{"name":"Neurology and Clinical Neuroscience","volume":"11 1","pages":"176 - 177"},"PeriodicalIF":0.4,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48569429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Shiraishi, T. Kamo, R. Kumazawa, N. Sasaki, K. Isahaya, H. Akiyama, Y. Furusawa, Reiko Onodera, Jovelle L Fernandez, Masaru Otsuka, Y. Yamano
As motor symptoms of Parkinson's disease (PD) progress, visits to medical clinics for patients and caregivers become burdensome.
随着帕金森病（PD）运动症状的发展，患者和护理人员去诊所就诊变得繁重。
{"title":"A multicenter, prospective, observational study to assess the satisfaction of an integrated digital platform of online medical care and remote patient monitoring in Parkinson's disease","authors":"M. Shiraishi, T. Kamo, R. Kumazawa, N. Sasaki, K. Isahaya, H. Akiyama, Y. Furusawa, Reiko Onodera, Jovelle L Fernandez, Masaru Otsuka, Y. Yamano","doi":"10.1111/ncn3.12709","DOIUrl":"https://doi.org/10.1111/ncn3.12709","url":null,"abstract":"As motor symptoms of Parkinson's disease (PD) progress, visits to medical clinics for patients and caregivers become burdensome.","PeriodicalId":19154,"journal":{"name":"Neurology and Clinical Neuroscience","volume":"11 1","pages":"152 - 163"},"PeriodicalIF":0.4,"publicationDate":"2023-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41475217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Klavansky, Jorge A. Roa, John W Liang, C. Kellner, S. Tsetsou
A 44‐year‐old female underwent cranioplasty 6 months after a malignant right MCA stroke. Three hours later, she became unresponsive, with new left‐gaze deviation and right‐side hemiparesis. CT head showed new right MCA hypodensity and diffuse edema. After aggressive medical management, she returned to baseline. A brain MRI showed no stroke. Malignant cerebral edema after uneventful cranioplasty is a rare and often fatal complication related to sudden intracranial negative pressure and altered cerebral autoregulation. This is a rare case in which a patient developed malignant cerebral edema and status epilepticus after cranioplasty and survived.
{"title":"Reversible Malignant Cerebral Edema Following Cranioplasty","authors":"D. Klavansky, Jorge A. Roa, John W Liang, C. Kellner, S. Tsetsou","doi":"10.1111/ncn3.12708","DOIUrl":"https://doi.org/10.1111/ncn3.12708","url":null,"abstract":"A 44‐year‐old female underwent cranioplasty 6 months after a malignant right MCA stroke. Three hours later, she became unresponsive, with new left‐gaze deviation and right‐side hemiparesis. CT head showed new right MCA hypodensity and diffuse edema. After aggressive medical management, she returned to baseline. A brain MRI showed no stroke. Malignant cerebral edema after uneventful cranioplasty is a rare and often fatal complication related to sudden intracranial negative pressure and altered cerebral autoregulation. This is a rare case in which a patient developed malignant cerebral edema and status epilepticus after cranioplasty and survived.","PeriodicalId":19154,"journal":{"name":"Neurology and Clinical Neuroscience","volume":"11 1","pages":"242 - 244"},"PeriodicalIF":0.4,"publicationDate":"2023-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43770144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Komagamine, Reika Aoki‐Kawabata, Mai Hamaguchi, Keisuke Suzuki, N. Kokubun
Nerve hypertrophy is one of the characteristic features of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). The brachial plexus runs along the gap between the anterior and medial scalene muscles (interscalene gap), and its enlargement sometimes appears as widening of the interscalene gap on conventional axial cervical spine MRI.
{"title":"Chunky yarn sign: A screening marker for brachial plexus hypertrophy on axial cervical spine MRI","authors":"T. Komagamine, Reika Aoki‐Kawabata, Mai Hamaguchi, Keisuke Suzuki, N. Kokubun","doi":"10.1111/ncn3.12710","DOIUrl":"https://doi.org/10.1111/ncn3.12710","url":null,"abstract":"Nerve hypertrophy is one of the characteristic features of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). The brachial plexus runs along the gap between the anterior and medial scalene muscles (interscalene gap), and its enlargement sometimes appears as widening of the interscalene gap on conventional axial cervical spine MRI.","PeriodicalId":19154,"journal":{"name":"Neurology and Clinical Neuroscience","volume":"200 3","pages":"226 - 230"},"PeriodicalIF":0.4,"publicationDate":"2023-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41283447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Autoimmunity to Voltage‐gated Calcium Channels","authors":"M. Motomura, S. Yoshimura, H. Shiraishi","doi":"10.1111/ncn3.12707","DOIUrl":"https://doi.org/10.1111/ncn3.12707","url":null,"abstract":"","PeriodicalId":19154,"journal":{"name":"Neurology and Clinical Neuroscience","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46958510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vagus nerve stimulation (VNS) has rarely been used in adult patients with status epilepticus (SE). Although evidence for VNS's effect on consciousness is largely lacking, VNS implantation may be considered an option in a prolonged unconscious state after SE. Here, we present the case of a woman with prolonged SE whose consciousness incompletely recovered after seizure cessation with conventional therapy but fully recovered after activation of VNS.
{"title":"Effect of vagus nerve stimulation in patient with prolonged postictal encephalopathy","authors":"Mi‐Ri Kang, K. Ji","doi":"10.1111/ncn3.12706","DOIUrl":"https://doi.org/10.1111/ncn3.12706","url":null,"abstract":"Vagus nerve stimulation (VNS) has rarely been used in adult patients with status epilepticus (SE). Although evidence for VNS's effect on consciousness is largely lacking, VNS implantation may be considered an option in a prolonged unconscious state after SE. Here, we present the case of a woman with prolonged SE whose consciousness incompletely recovered after seizure cessation with conventional therapy but fully recovered after activation of VNS.","PeriodicalId":19154,"journal":{"name":"Neurology and Clinical Neuroscience","volume":"11 1","pages":"170 - 172"},"PeriodicalIF":0.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45569038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yasuyuki Takai, Y. Warabi, Y. Sunami, Natsuki Miyakoshi, Kazushi Takahashi
A 61year old male, who had had a motorbike accident 30 years ago and slowly progressed paralysis of bilateral upper extremities, subacutely developed spastic paraplegia, numbness under inferior thoracic level, and bladderintestinal dysfunction. Spinal magnetic resonance imaging (MRI) revealed intramedullary lesions from the C2 to the L2 vertebral level with leptomeningeal gadorium (Gd)enhancement, and ventral intraspinal fluid collection with hemosiderin deposition (Figure 1A– H). Brain MRI revealed Gdenhancement and hemosiderin deposition around the cerebellum and brainstem (Figure 1K– N). Laboratory tests showed no evidence of collagen disease, infection, and malignant tumor, and negative results for antiaquapolin4 antibody and antimyelin oligodendrocyte glycoprotein antibody. Although the pathological findings were not confirmed, neurosarcoidosis accompanying duropathy was suspected on the basis of elevated soluble interleukin2 receptor and lysozyme (normal angiotensinconverting enzyme level), lymphocytes with xanthochromia in CSF, enlarged hilar lymph nodes with positive gallium scintigraphy (Figure 1I, J), and elevated CD4/CD8 ratio in bronchoalveolar lavage.1 Corticosteroid treatment was effective, and remission was maintained with methotrexate, but the upper extremity paralysis did not improve. This case presented longitudinally extensive transverse myelitis. We have reported that neurosarcoidosis had asymptomatic cerebral microbleeds,2 but conversely, stimulation of hemosiderin by exogenous hemorrhages, such as superficial siderosis,3 may lead to more severe neurosarcoidosis.
{"title":"Longitudinally extensive transverse myelitis as neurosarcoidosis accompanying duropathy","authors":"Yasuyuki Takai, Y. Warabi, Y. Sunami, Natsuki Miyakoshi, Kazushi Takahashi","doi":"10.1111/ncn3.12705","DOIUrl":"https://doi.org/10.1111/ncn3.12705","url":null,"abstract":"A 61year old male, who had had a motorbike accident 30 years ago and slowly progressed paralysis of bilateral upper extremities, subacutely developed spastic paraplegia, numbness under inferior thoracic level, and bladderintestinal dysfunction. Spinal magnetic resonance imaging (MRI) revealed intramedullary lesions from the C2 to the L2 vertebral level with leptomeningeal gadorium (Gd)enhancement, and ventral intraspinal fluid collection with hemosiderin deposition (Figure 1A– H). Brain MRI revealed Gdenhancement and hemosiderin deposition around the cerebellum and brainstem (Figure 1K– N). Laboratory tests showed no evidence of collagen disease, infection, and malignant tumor, and negative results for antiaquapolin4 antibody and antimyelin oligodendrocyte glycoprotein antibody. Although the pathological findings were not confirmed, neurosarcoidosis accompanying duropathy was suspected on the basis of elevated soluble interleukin2 receptor and lysozyme (normal angiotensinconverting enzyme level), lymphocytes with xanthochromia in CSF, enlarged hilar lymph nodes with positive gallium scintigraphy (Figure 1I, J), and elevated CD4/CD8 ratio in bronchoalveolar lavage.1 Corticosteroid treatment was effective, and remission was maintained with methotrexate, but the upper extremity paralysis did not improve. This case presented longitudinally extensive transverse myelitis. We have reported that neurosarcoidosis had asymptomatic cerebral microbleeds,2 but conversely, stimulation of hemosiderin by exogenous hemorrhages, such as superficial siderosis,3 may lead to more severe neurosarcoidosis.","PeriodicalId":19154,"journal":{"name":"Neurology and Clinical Neuroscience","volume":"11 1","pages":"173 - 175"},"PeriodicalIF":0.4,"publicationDate":"2023-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41775182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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