Introduction. Cerebrovascular accident is defined as rapidly developing symptoms or signs of focal and global loss of cerebral function lasting for 24 hours or more with no apparent cause other than that of vascular origin. Stroke is the fifth leading cause of death in the United States and it is one of the most disabling cause of neurological disorders. The attack of cerebrovascular accident begins abruptly, the focal neurologic deficit either fully evolved at the onset or it progress over minutes to hours or within days. Electroencephalogram (EEG) is used to detect electrical activity in the brain for various neurologic disorders like epilepsy, encephalopathy, prion diseases (CJD), Alzheimer disease and also stroke. Objective. To determine the frequency of abnormal EEG for detecting acute ischemic stroke. Methods. This was a cross sectional study conducted at Department of Medicine, Dow University of Health Sciences Karachi OJHA Campus, Dow International Medical College (DIMC), and Duration of study was 06 month from 1st October 2020 to 30th March 2021. Non-probability consecutive sampling technique was used. A total of 460 patients of acute ischemic stroke were included in this study. Patients were diagnosed on the basis of CT scan brain or diffusion weighted imaging. Within 24 hours the EEG was done in all admitted patients. The potentials recorded by EEG were cumulated excitatory and inhibitory postsynaptic potentials in neuronal dendrites, usually in most superficial regions of cerebral cortex. All data was entered and analyzed using SPSS v25.0. Data were stratified for age, gender, BMI and duration of stroke to address the effect modifiers. Post-stratification, Chi-square test was used by taking p-value ≤0.05 as significant. Results. 460 patients were selected for this study. Mean age was 40.04±9.1 years. Among cases, there were 276 (60%) males and 184 (40%) females. 235 patients (51.08%) had abnormal EEG. By stratification of abnormal EEG, it was found that duration of acute stroke had significant effect having abnormal EEG (p = 0.000001). Conclusions. The role of complexity of abnormal Electro Encephalogram is useful following acute ischemic stroke. The various parameters of EEG help to evaluate the large ischemic stroke.
{"title":"The frequency of abnormal electroencephalography for detecting acute ischemic stroke","authors":"Samar Iltaf, Sahar-u-Nissa Pechuho","doi":"10.37897/rjn.2021.4.12","DOIUrl":"https://doi.org/10.37897/rjn.2021.4.12","url":null,"abstract":"Introduction. Cerebrovascular accident is defined as rapidly developing symptoms or signs of focal and global loss of cerebral function lasting for 24 hours or more with no apparent cause other than that of vascular origin. Stroke is the fifth leading cause of death in the United States and it is one of the most disabling cause of neurological disorders. The attack of cerebrovascular accident begins abruptly, the focal neurologic deficit either fully evolved at the onset or it progress over minutes to hours or within days. Electroencephalogram (EEG) is used to detect electrical activity in the brain for various neurologic disorders like epilepsy, encephalopathy, prion diseases (CJD), Alzheimer disease and also stroke. Objective. To determine the frequency of abnormal EEG for detecting acute ischemic stroke. Methods. This was a cross sectional study conducted at Department of Medicine, Dow University of Health Sciences Karachi OJHA Campus, Dow International Medical College (DIMC), and Duration of study was 06 month from 1st October 2020 to 30th March 2021. Non-probability consecutive sampling technique was used. A total of 460 patients of acute ischemic stroke were included in this study. Patients were diagnosed on the basis of CT scan brain or diffusion weighted imaging. Within 24 hours the EEG was done in all admitted patients. The potentials recorded by EEG were cumulated excitatory and inhibitory postsynaptic potentials in neuronal dendrites, usually in most superficial regions of cerebral cortex. All data was entered and analyzed using SPSS v25.0. Data were stratified for age, gender, BMI and duration of stroke to address the effect modifiers. Post-stratification, Chi-square test was used by taking p-value ≤0.05 as significant. Results. 460 patients were selected for this study. Mean age was 40.04±9.1 years. Among cases, there were 276 (60%) males and 184 (40%) females. 235 patients (51.08%) had abnormal EEG. By stratification of abnormal EEG, it was found that duration of acute stroke had significant effect having abnormal EEG (p = 0.000001). Conclusions. The role of complexity of abnormal Electro Encephalogram is useful following acute ischemic stroke. The various parameters of EEG help to evaluate the large ischemic stroke.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41602649","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}
Baclofen was previously known for its efficacy to treat spasticity but this agent has been studied and reported to have several other uses including its role in central hyperthermia. Central hyperthermia is associated with increased morbidity, mortality, and the impact of neuronal damage on the central nervous system. Until now there is no established guideline for the management of central hyperthermia which generally does not respond to standard antipyretic therapy. In this literature review, we will discuss the basic concepts of central hyperthermia and the role and mechanism of action of baclofen as an option for central hyperthermia therapy.
{"title":"A review of the role and mechanisms of action of baclofen in the management of central hyperthermia","authors":"Wayan Widyantara, V. T. Dewi","doi":"10.37897/rjn.2021.4.4","DOIUrl":"https://doi.org/10.37897/rjn.2021.4.4","url":null,"abstract":"Baclofen was previously known for its efficacy to treat spasticity but this agent has been studied and reported to have several other uses including its role in central hyperthermia. Central hyperthermia is associated with increased morbidity, mortality, and the impact of neuronal damage on the central nervous system. Until now there is no established guideline for the management of central hyperthermia which generally does not respond to standard antipyretic therapy. In this literature review, we will discuss the basic concepts of central hyperthermia and the role and mechanism of action of baclofen as an option for central hyperthermia therapy.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45094296","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}
Z. Bajko, S. Maier, Anca Moţăţăianu, R. Filep, A. Stoian, L. Bărcuţean, Sebastian Andone, R. Bălaşa
Dissection of the cervical arteries is the leading cause of stroke in young adults, yet the etiology and pathogenesis of this event remain unclear. However, a growing number of data in the literature support the potential implications of immunological mechanisms in the pathogenesis. Several large patient groups and multicentre cohorts have reported significant associations with recent infections and elevated inflammatory markers. There are also several case reports and case series suggesting an association with various autoimmune disorders and viral infections. Some case reports have also detailed cervical artery dissections linked to the use of biological therapies for other pathologies. In the present case, a 38-year-old female patient with triple spontaneous cervical artery dissection presented multiple potential trigger factors as recent infection, autoimmune thyroid disease, primary thrombophilia and hyperhomocysteinemia. This report sought first presents this case, and then reviews the existing relevant literature data regarding the potential immunological mechanisms implicated in the pathogenesis of cervical artery dissection.
{"title":"Immunological mechanisms in multiple spontaneous cervical artery dissection: An illustrative case and review of the literature","authors":"Z. Bajko, S. Maier, Anca Moţăţăianu, R. Filep, A. Stoian, L. Bărcuţean, Sebastian Andone, R. Bălaşa","doi":"10.37897/rjn.2021.4.19","DOIUrl":"https://doi.org/10.37897/rjn.2021.4.19","url":null,"abstract":"Dissection of the cervical arteries is the leading cause of stroke in young adults, yet the etiology and pathogenesis of this event remain unclear. However, a growing number of data in the literature support the potential implications of immunological mechanisms in the pathogenesis. Several large patient groups and multicentre cohorts have reported significant associations with recent infections and elevated inflammatory markers. There are also several case reports and case series suggesting an association with various autoimmune disorders and viral infections. Some case reports have also detailed cervical artery dissections linked to the use of biological therapies for other pathologies. In the present case, a 38-year-old female patient with triple spontaneous cervical artery dissection presented multiple potential trigger factors as recent infection, autoimmune thyroid disease, primary thrombophilia and hyperhomocysteinemia. This report sought first presents this case, and then reviews the existing relevant literature data regarding the potential immunological mechanisms implicated in the pathogenesis of cervical artery dissection.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44083393","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}
Introduction. Malignant glioma is resistant brain tumor to treatment and considered by aggressiveness that fails successful resection. Molecular pathways including PTEN related with tumor behavior. Materials and methods. We studied the immunohistochemical expression of PTEN in 32 brain surgical resection specimens with different histologic grades. All samples were from pathology department of Sina hospital in Tehran-Iran from 2020-2021. Results. From 32 patients, 21 (65.6%) had no PTEN staining. There was significant relationship between high age and no PTEN expression and average age with no PTEN staining was 54.05±14.01 years (P value: 0.044). There was significant relationship between necrosis in histopathologic evaluation with no PTEN staining (P value: 0.016). Also, there was no significant relationship between sex, tumor’s size, Tumor’s site, tumor’s grade, and primary or secondary type of tumor with PTEN staining (P value > 0.05). Conclusion. PTEN expression related to histopathologic features such as necrosis and age. PTEN can be introduced as an important prognostic indicator in high grade.
{"title":"Relationship between phosphatase and tensin homolog (PTEN) expression in high grade glioma and histopathologic findings","authors":"Nasim Hayati, H. Tabriz, E. Nazar, R. Gorji","doi":"10.37897/rjn.2021.4.7","DOIUrl":"https://doi.org/10.37897/rjn.2021.4.7","url":null,"abstract":"Introduction. Malignant glioma is resistant brain tumor to treatment and considered by aggressiveness that fails successful resection. Molecular pathways including PTEN related with tumor behavior. Materials and methods. We studied the immunohistochemical expression of PTEN in 32 brain surgical resection specimens with different histologic grades. All samples were from pathology department of Sina hospital in Tehran-Iran from 2020-2021. Results. From 32 patients, 21 (65.6%) had no PTEN staining. There was significant relationship between high age and no PTEN expression and average age with no PTEN staining was 54.05±14.01 years (P value: 0.044). There was significant relationship between necrosis in histopathologic evaluation with no PTEN staining (P value: 0.016). Also, there was no significant relationship between sex, tumor’s size, Tumor’s site, tumor’s grade, and primary or secondary type of tumor with PTEN staining (P value > 0.05). Conclusion. PTEN expression related to histopathologic features such as necrosis and age. PTEN can be introduced as an important prognostic indicator in high grade.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43765449","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}
E. Tedyanto, N. Susilawathi, Anak Agung Sagung Ngurah Indradewi
HSVE (Herpes simplex virus encephalitis) is an infection caused by herpes simplex virus type 1 (HSV-1) or type 2 that produces neurologic problems. HSVE is associated with significant morbidity and mortality in adults even with antiviral medication, and it is a fatal disease in babies and children regardless of treatment. The most likely pathways include retrograde transmission through the olfactory or trigeminal nerves, as well as hematogenous spread. The most common presenting symptoms are encephalopathy, fever, convulsions, headache, and regional neurologic dysfunction. An accurate history and physical examination are required to identify Herpes simplex virus encephalitis (HSVE), and a prompt assessment is advised after the diagnosis has been established. HSVE is a neurodegenerative disease that may be fatal. Rapid diagnostic work-up and early diagnosis in all suspected or confirmed cases will result in early initiation of intravenous acyclovir, which may decrease morbidity and death.
{"title":"Herpes simplex virus encephalitis: A literature review","authors":"E. Tedyanto, N. Susilawathi, Anak Agung Sagung Ngurah Indradewi","doi":"10.37897/rjn.2021.4.5","DOIUrl":"https://doi.org/10.37897/rjn.2021.4.5","url":null,"abstract":"HSVE (Herpes simplex virus encephalitis) is an infection caused by herpes simplex virus type 1 (HSV-1) or type 2 that produces neurologic problems. HSVE is associated with significant morbidity and mortality in adults even with antiviral medication, and it is a fatal disease in babies and children regardless of treatment. The most likely pathways include retrograde transmission through the olfactory or trigeminal nerves, as well as hematogenous spread. The most common presenting symptoms are encephalopathy, fever, convulsions, headache, and regional neurologic dysfunction. An accurate history and physical examination are required to identify Herpes simplex virus encephalitis (HSVE), and a prompt assessment is advised after the diagnosis has been established. HSVE is a neurodegenerative disease that may be fatal. Rapid diagnostic work-up and early diagnosis in all suspected or confirmed cases will result in early initiation of intravenous acyclovir, which may decrease morbidity and death.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48416764","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}
Background, aim. Fahr’s disease is a rare neurodegenerative disease caused by intracranial classifications. This case report aims to accentuate the importance of considering rare disease like Fahr’s disease as the differential diagnosis of neuropsychiatric deficits, especially in patients with a history of thyroidectomy. Case presentation. A 50-year-old female who underwent thyroidectomy 5 years previously presented with incoherent speech, behavioral problems, and hand stiffness. On evaluation, several neurobehavioral deficits and carpopedal spasms were observed, along with low Mini-Mental State Examination (MMSE), Hachinski, Activities of Daily Living (ADL), and Instrumental Activities of Daily Living Scale (IADL) score of 22, 4, 13, and 12, respectively. Clinically significant laboratory abnormalities include low serum calcium of 4.7 mg/dl, low thyroid stimulating hormone (TSH) level of 0.113 mIU/l, and low parathyroid hormone (PTH) level of 1.2 pg/ml. In addition, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) reverse transcription-polymerase chain reaction (RT-PCR) test showed a positive result. Meanwhile, brain computerized tomography (CT)-scan results showed multiple bilateral calcifications in the basal ganglia, bilateral cortical-subcortical calcifications in the frontal lobe, and subcortical calcification in the left frontal lobe. Results. The patient was diagnosed with Fahr’s disease secondary to post-thyroidectomy hypoparathyroidism and coronavirus disease 2019 (COVID-19). The patient was treated with calcium lactate, levothyroxine, donepezil, favipiravir for COVID’s infection, vitamin B1, B6, and B12. Conclusions. Fahr’s disease should be considered in patients with neuropsychiatric deficits and spasm disorders, especially in patients with a history of thyroidectomy. Routine follow-up CT-scans after thyroidectomy are recommended.
{"title":"Secondary Fahr’s disease: A differential to be considered in a COVID-19 pneumonia patient with neuropsychiatric presentations","authors":"Felisitas Farica Sutantoyo, Paulus Sugianto","doi":"10.37897/RJN.2021.4.17","DOIUrl":"https://doi.org/10.37897/RJN.2021.4.17","url":null,"abstract":"Background, aim. Fahr’s disease is a rare neurodegenerative disease caused by intracranial classifications. This case report aims to accentuate the importance of considering rare disease like Fahr’s disease as the differential diagnosis of neuropsychiatric deficits, especially in patients with a history of thyroidectomy. Case presentation. A 50-year-old female who underwent thyroidectomy 5 years previously presented with incoherent speech, behavioral problems, and hand stiffness. On evaluation, several neurobehavioral deficits and carpopedal spasms were observed, along with low Mini-Mental State Examination (MMSE), Hachinski, Activities of Daily Living (ADL), and Instrumental Activities of Daily Living Scale (IADL) score of 22, 4, 13, and 12, respectively. Clinically significant laboratory abnormalities include low serum calcium of 4.7 mg/dl, low thyroid stimulating hormone (TSH) level of 0.113 mIU/l, and low parathyroid hormone (PTH) level of 1.2 pg/ml. In addition, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) reverse transcription-polymerase chain reaction (RT-PCR) test showed a positive result. Meanwhile, brain computerized tomography (CT)-scan results showed multiple bilateral calcifications in the basal ganglia, bilateral cortical-subcortical calcifications in the frontal lobe, and subcortical calcification in the left frontal lobe. Results. The patient was diagnosed with Fahr’s disease secondary to post-thyroidectomy hypoparathyroidism and coronavirus disease 2019 (COVID-19). The patient was treated with calcium lactate, levothyroxine, donepezil, favipiravir for COVID’s infection, vitamin B1, B6, and B12. Conclusions. Fahr’s disease should be considered in patients with neuropsychiatric deficits and spasm disorders, especially in patients with a history of thyroidectomy. Routine follow-up CT-scans after thyroidectomy are recommended.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48560289","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}
Made Bagus Adipermana, I. Wibhuti, Olivia Saraswati, N. Sari
Background. Aortic dissection is one of the leading causes of death in cardiovascular disease. The clinical course of aortic dissection is often atypical and can mimic a variety of clinical manifestations. Stroke is one of the conditions that can make the management of aortic dissection becoming more complex. Case presentation. A 55-year-old female patient came with complaints of severe chest pain. The patient was diagnosed with Stanford aortic dissection, De Bakey type II, hypertension heart disease, mild mitral regurgitation, mild circumferential pericardial effusion. After the second day of treatment, the patient also complained of sudden slurred speech and weakness on right extremities. The administration of antiplatelet were postponed in consideration of the current patient with aortic dissection. On the 7th day of treatment, the patient experienced a worsening motor strength on the right extremities. We decided to continue antihypertensive therapy on acute phase of ischemic stroke with the consideration that aortic dissection can cause higher mortality. Conclusions. The management of ischemic stroke in a patient with aortic dissection is challenging. In ischemic stroke patient with aortic dissection, anti-hypertensives need to be given to reduce the stress on the aortic wall and prevent expansion of the dissection which has a higher mortality rate.
{"title":"Ischemic stroke as a comorbidity in a patient with Stanford A aortic dissection: A case report","authors":"Made Bagus Adipermana, I. Wibhuti, Olivia Saraswati, N. Sari","doi":"10.37897/rjn.2021.4.23","DOIUrl":"https://doi.org/10.37897/rjn.2021.4.23","url":null,"abstract":"Background. Aortic dissection is one of the leading causes of death in cardiovascular disease. The clinical course of aortic dissection is often atypical and can mimic a variety of clinical manifestations. Stroke is one of the conditions that can make the management of aortic dissection becoming more complex. Case presentation. A 55-year-old female patient came with complaints of severe chest pain. The patient was diagnosed with Stanford aortic dissection, De Bakey type II, hypertension heart disease, mild mitral regurgitation, mild circumferential pericardial effusion. After the second day of treatment, the patient also complained of sudden slurred speech and weakness on right extremities. The administration of antiplatelet were postponed in consideration of the current patient with aortic dissection. On the 7th day of treatment, the patient experienced a worsening motor strength on the right extremities. We decided to continue antihypertensive therapy on acute phase of ischemic stroke with the consideration that aortic dissection can cause higher mortality. Conclusions. The management of ischemic stroke in a patient with aortic dissection is challenging. In ischemic stroke patient with aortic dissection, anti-hypertensives need to be given to reduce the stress on the aortic wall and prevent expansion of the dissection which has a higher mortality rate.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47755065","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}
Background and objectives. COVID-19 is a respiratory infection caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2). The COVID-19 associates multi-clinical symptoms such as neurological manifestations with mild to advanced progression. This study aimed to determine the clinical neurological characteristics of geriatric patients with COVID-19. Methods. The study was an observational and descriptive study on 27 geriatric patients with COVID-19. All patients’ age was over 60 years old who treated in the in-patient department of Sanglah General Hospital, Denpasar on July 2020 to January 2021. The data were taken from medical records. Outcomes. The mean age of all patients was 70.41 (± 8.902) years, and dominated by the males (51.9%). The majority of manifestations in this study were fever in 13 people (48.1%), unconsciousness in 10 people (37%), hemiparesis in 10 people (37%) and cough in 9 people (33.3%). Conclusions. The clinical neurology characteristics of geriatric patients with COVID-19 vary, which may involve general and neurological manifestations. Promptly accurate diagnosis is necessary for further management.
{"title":"Clinical neurological characteristics of geriatric patients with COVID-19 in Sanglah General Hospital from 2020 to 2021","authors":"A. Yolanda, A. Laksmidewi, A. Meidiary","doi":"10.37897/RJN.2021.4.11","DOIUrl":"https://doi.org/10.37897/RJN.2021.4.11","url":null,"abstract":"Background and objectives. COVID-19 is a respiratory infection caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2). The COVID-19 associates multi-clinical symptoms such as neurological manifestations with mild to advanced progression. This study aimed to determine the clinical neurological characteristics of geriatric patients with COVID-19. Methods. The study was an observational and descriptive study on 27 geriatric patients with COVID-19. All patients’ age was over 60 years old who treated in the in-patient department of Sanglah General Hospital, Denpasar on July 2020 to January 2021. The data were taken from medical records. Outcomes. The mean age of all patients was 70.41 (± 8.902) years, and dominated by the males (51.9%). The majority of manifestations in this study were fever in 13 people (48.1%), unconsciousness in 10 people (37%), hemiparesis in 10 people (37%) and cough in 9 people (33.3%). Conclusions. The clinical neurology characteristics of geriatric patients with COVID-19 vary, which may involve general and neurological manifestations. Promptly accurate diagnosis is necessary for further management.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43303983","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}
Intracerebral calcifications are one of the essential parameters in the diagnosis of some neurological diseases. Fahr group is a rare pathologic entity presenting with basal ganglion calcifications. Symmetrical basal ganglion calcifications and an etiologic reason (metabolic, hormonal, or infectious) constitute the main picture of Fahr syndrome. This syndrome usually begins at the third and fourth decade and is often with accompanying neuropsychiatric symptoms. We presented the case of a 7 years old child who was admitted to the hospital with an atypical tonic-clonic epileptic seizure. Bilateral basal ganglion calcifications were detected at the level of globus pallidus. Clinical and laboratory findings were compatible with secondary hyperparathyroidism.
{"title":"An unexpected diagnosis in early pediatric age group: Fahr syndrome manifested with epileptic seizure","authors":"E. Doğan","doi":"10.37897/rjn.2021.4.18","DOIUrl":"https://doi.org/10.37897/rjn.2021.4.18","url":null,"abstract":"Intracerebral calcifications are one of the essential parameters in the diagnosis of some neurological diseases. Fahr group is a rare pathologic entity presenting with basal ganglion calcifications. Symmetrical basal ganglion calcifications and an etiologic reason (metabolic, hormonal, or infectious) constitute the main picture of Fahr syndrome. This syndrome usually begins at the third and fourth decade and is often with accompanying neuropsychiatric symptoms. We presented the case of a 7 years old child who was admitted to the hospital with an atypical tonic-clonic epileptic seizure. Bilateral basal ganglion calcifications were detected at the level of globus pallidus. Clinical and laboratory findings were compatible with secondary hyperparathyroidism.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46784743","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}
Background. Guillain-Barré syndrome (GBS), the most common cause of flaccid motor deficit with acute or subacute onset, is associated in approximately 2/3 of cases with a history of microbial, predominantly viral, infection. In the context of the current COVID-19 pandemic, the presence of patients with both peripheral nervous system pathology and SARS-CoV-2 viral infection raised questions among researchers whether there may be a possible link between the two entities. Thus, this narrative review aims to provide a clearer perspective on this topic, addressing several issues. Methods. The authors performed independent research of the available literature in the most important electronic databases (PubMed, Google Scholar, and Science Direct). After applying the exclusion criteria, the reviewers focused on the most relevant articles published during the last 18 months, focusing on epidemiological and pathophysiological data regarding GBS and COVID-19. Results. In the first part, a summary of the most important results from the literature on the epidemiological situation in different parts of the world was conducted. Subsequently, possible immunological theories are presented in order to explain the epidemiological association between GBS and COVID-19 infection. Finally, the authors propose new research directions on the topic, discussing the issue of the COVID-19 vaccine, with its short and long term effects, and possible correlations with peripheral nerve pathology. Conclusion. Neurological manifestation in COVID-19 may represent a challenge for the clinician, and with growing numbers of unprecedented cases of peripheral nerve pathology associated with the SARS-CoV-2 virus being reported, further research is urgently needed.
{"title":"SARS-CoV-2 and the Guillain-Barré syndrome – features for a complex association","authors":"T. Schreiner, O. Schreiner","doi":"10.37897/RJN.2021.4.1","DOIUrl":"https://doi.org/10.37897/RJN.2021.4.1","url":null,"abstract":"Background. Guillain-Barré syndrome (GBS), the most common cause of flaccid motor deficit with acute or subacute onset, is associated in approximately 2/3 of cases with a history of microbial, predominantly viral, infection. In the context of the current COVID-19 pandemic, the presence of patients with both peripheral nervous system pathology and SARS-CoV-2 viral infection raised questions among researchers whether there may be a possible link between the two entities. Thus, this narrative review aims to provide a clearer perspective on this topic, addressing several issues. Methods. The authors performed independent research of the available literature in the most important electronic databases (PubMed, Google Scholar, and Science Direct). After applying the exclusion criteria, the reviewers focused on the most relevant articles published during the last 18 months, focusing on epidemiological and pathophysiological data regarding GBS and COVID-19. Results. In the first part, a summary of the most important results from the literature on the epidemiological situation in different parts of the world was conducted. Subsequently, possible immunological theories are presented in order to explain the epidemiological association between GBS and COVID-19 infection. Finally, the authors propose new research directions on the topic, discussing the issue of the COVID-19 vaccine, with its short and long term effects, and possible correlations with peripheral nerve pathology. Conclusion. Neurological manifestation in COVID-19 may represent a challenge for the clinician, and with growing numbers of unprecedented cases of peripheral nerve pathology associated with the SARS-CoV-2 virus being reported, further research is urgently needed.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47345013","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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