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[PMID]: 28452700
[Au] Autor:Ghadersohi S; Ference EH; Detwiller K; Kern RC
[Ad] Address:Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
[Ti] Title:Presentation, workup, and management of penetrating transorbital and transnasal injuries: A case report and systematic review.
[So] Source:Am J Rhinol Allergy;31(2):29-34, 2017 Mar 01.
[Is] ISSN:1945-8932
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: A foreign body (FB) penetrating intracranially after passing transorbitally or transnasally is a rare occurrence. However, otolaryngologists are increasingly being asked to participate in the care of these patients for both endoscopic removal of the object and repair of any skull base defects. OBJECTIVE: To assess the presentation, workup, and management of transnasal or transorbital penetrating FB injury. METHODS: Systematic review of the presentation, workup, and management of transnasal or transorbital penetrating FB injury; plus, a case report of a 53-year-old woman with a transorbital penetrating rose bush branch. We searched medical literature data bases, which resulted in 215 total titles, which were then narrowed based on inclusion and exclusion criteria. RESULTS: Thirty-five cases of transorbital or transnasal low-velocity trauma that involved the paranasal sinuses were reviewed from 33 articles. The average age was 30 years, 40% of the objects were made of wood. Fifty-seven percent of the cases were transorbital, whereas 43% were transnasal. Forty-six percent of the surgical interventions were completed endoscopically or with endoscopic assistance. Complications of injury were common, with 66% of patients experiencing cerebrospinal fluid leaks; 23%, permanent blindness; 17%, meningitis; 14%, ophthalmoplegia; 9%, decreased visual acuity; and 3%, brain abscess. Our patient presented with a traumatic cerebrospinal fluid leak, and recovered well after transorbital and endoscopic removal of the branch, skull base repair, and a prolonged course of antibiotics and antifungal medications. CONCLUSIONS: Transnasal and transorbital penetrating FB injuries are a relatively uncommon occurrence but when they do occur require rapid workup and interdisciplinary management to prevent acute and delayed complications.
[Mh] MeSH terms primary: Cerebrospinal Fluid Leak/epidemiology
Craniocerebral Trauma/epidemiology
Endoscopy
Eye Injuries/epidemiology
Head Injuries, Penetrating/epidemiology
Orbit/surgery
Paranasal Sinuses/surgery
Postoperative Complications/epidemiology
[Mh] MeSH terms secundary: Cerebrospinal Fluid Leak/etiology
Craniocerebral Trauma/surgery
Eye Injuries/surgery
Female
Foreign Bodies
Head Injuries, Penetrating/surgery
Humans
Middle Aged
Skull Base/surgery
United States/epidemiology
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Js] Journal subset:IM
[Da] Date of entry for processing:170429
[St] Status:MEDLINE
[do] DOI:10.2500/ajra.2017.31.4421

  2 / 17344 MEDLINE  
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[PMID]: 29450710
[Au] Autor:Jabarin B; Eviatar E; Israel O; Marom T; Gavriel H
[Ad] Address:Department of Otolaryngology-Head and Neck Surgery, Assaf Harofeh Medical Center, Tel Aviv University Sackler School of Medicine, 70300, Zerifin, Israel.
[Ti] Title:Indicators for imaging in periorbital cellulitis secondary to rhinosinusitis.
[So] Source:Eur Arch Otorhinolaryngol;275(4):943-948, 2018 Apr.
[Is] ISSN:1434-4726
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:PURPOSE: Our objective was to identify the clinical indicators for subperiosteal orbital abscess (SPOA) among patients who present with periorbital cellulitis secondary to rhinosinusitis, and to evaluate the need for performing a computerized tomography (CT) scan. METHODS: A retrospective cohort study of all patients admitted to our tertiary care emergency department between 2006 and 2014 was conducted. Included were healthy patients with acute periorbital cellulitis secondary to rhinosinusitis. Variables analyzed included age, gender, duration of symptoms, previous antibiotic therapy, highest recorded temperature, physical examination findings, ophthalmologist's examination results, laboratory results, and interpretation of imaging studies, when performed. RESULTS: Of the 123 identified patients, 78 (63%) were males, with a mean age of 4 years (range 1-70). 68 patients were categorized as Chandler's 1 disease, 2 as Chandler's 2, and 53 as Chandler's 3. 68 patients underwent a CT scan, of those 53 had SPOA. Proptosis and ophthalmoplegia were strongly associated with the presence of an abscess (P < 0.001). However, 14 patients with no ophthalmoplegia or proptosis who underwent a CT scan were older (mean age, 10 years; P < 0.028), and had higher neutrophil count of 78 versus 59% (P = 0.01). This group of patients had a clinically rapidly progressive disease, receiving wider broad-spectrum antibiotics or had their antibiotic treatment replaced to broader spectrum antibiotics through their course of treatment (48.2% compared to only 6.1%). CONCLUSIONS: We confirmed that patients with proptosis and/or limitation of extraocular movements are at high risk for developing SPOA, yet many do not have these predictors. Other features can identify patients who do not have proptosis and/or limitation of extraocular movements but do have significant risk of SPOA, and in these cases performing an imaging study is strongly suggested.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Process
[do] DOI:10.1007/s00405-018-4897-4

  3 / 17344 MEDLINE  
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[PMID]: 29516491
[Au] Autor:Jarholm JA; Faiz KW; Nysted T; Zarnovicky S; Kristoffersen ES
[Ad] Address:Department of Neurology, Akershus University Hospital, Lørenskog, Norway.
[Ti] Title:Orbital Pain, Ophthalmoplegia, and Oligoclonal Bands in the Cerebrospinal Fluid: A Case Report of Tolosa-Hunt Syndrome.
[So] Source:Headache;, 2018 Mar 08.
[Is] ISSN:1526-4610
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:LETTER
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1111/head.13283

  4 / 17344 MEDLINE  
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[PMID]: 29398297
[Au] Autor:Bacalhau M; Simões M; Rocha MC; Hardy SA; Vincent AE; Durães J; Macário MC; Santos MJ; Rebelo O; Lopes C; Pratas J; Mendes C; Zuzarte M; Rego AC; Girão H; Wong LC; Taylor RW; Grazina M
[Ad] Address:FMUC - Faculty of Medicine, University of Coimbra, Coimbra, Portugal; CNC - Center for Neuroscience and Cell Biology, Laboratory of Biochemical Genetics, University of Coimbra, Coimbra, Portugal.
[Ti] Title:Disclosing the functional changes of two genetic alterations in a patient with Chronic Progressive External Ophthalmoplegia: Report of the novel mtDNA m.7486G>A variant.
[So] Source:Neuromuscul Disord;, 2017 Nov 23.
[Is] ISSN:1873-2364
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Chronic Progressive External Ophthalmoplegia (CPEO) is characterized by ptosis and ophthalmoplegia and is usually caused by mitochondrial DNA (mtDNA) deletions or mt-tRNA mutations. The aim of the present work was to clarify the genetic defect in a patient presenting with CPEO and elucidate the underlying pathogenic mechanism. This 62-year-old female first developed ptosis of the right eye at the age of 12 and subsequently the left eye at 45 years, and was found to have external ophthalmoplegia at the age of 55 years. Histopathological abnormalities were detected in the patient's muscle, including ragged-red fibres, a mosaic pattern of COX-deficient muscle fibres and combined deficiency of respiratory chain complexes I and IV. Genetic investigation revealed the "common deletion" in the patient's muscle and fibroblasts. Moreover, a novel, heteroplasmic mt-tRNA variant (m.7486G>A) in the anticodon loop was detected in muscle homogenate (50%), fibroblasts (11%) and blood (4%). Single-fibre analysis showed segregation with COX-deficient fibres for both genetic alterations. Assembly defects of mtDNA-encoded complexes were demonstrated in fibroblasts. Functional analyses showed significant bioenergetic dysfunction, reduction in respiration rate and ATP production and mitochondrial depolarization. Multilamellar bodies were detected by electron microscopy, suggesting disturbance in autophagy. In conclusion, we report a CPEO patient with two possible genetic origins, both segregating with biochemical and histochemical defect. The "common mtDNA deletion" is the most likely cause, yet the potential pathogenic effect of a novel mt-tRNA variant cannot be fully excluded.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:Publisher

  5 / 17344 MEDLINE  
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[PMID]: 29491292
[Au] Autor:Ueno T; Kimura R; Kon T; Haga R; Nishijima H; Nunomura JI; Tomiyama M
[Ad] Address:Department of Neurology, Aomori Prefectural Central Hospital, Japan.
[Ti] Title:The Differential Diagnosis of Acute Onset Truncal Ataxia: The Importance of Dysgeusia in Miller Fisher Syndrome.
[So] Source:Intern Med;, 2018 Feb 28.
[Is] ISSN:1349-7235
[Cp] Country of publication:Japan
[La] Language:eng
[Ab] Abstract:Miller Fisher syndrome (MFS) can be difficult to diagnose, particularly in mild cases where some of the standard triad of symptoms (external ophthalmoplegia, ataxia, and loss of deep tendon reflex) are absent. We herein report a case of the incomplete form of MFS diagnosed in a 54-year-old Japanese man who presented only with ataxia symptoms and was positive for the anti-GQ1b antibody. However, the patient also suffered from dysgeusia, a significant impairment of taste perception. We propose that dysgeusia in acute-onset ataxia cases may constitute an important clinical feature to aid in the diagnosis of the incomplete form of MFS.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[St] Status:Publisher
[do] DOI:10.2169/internalmedicine.0313-17

  6 / 17344 MEDLINE  
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[PMID]: 29390338
[Au] Autor:Han J; Ji Y; Cao D; Kang Z; Zhu J
[Ad] Address:Department of Neurology, Harrison International Peace Hospital.
[Ti] Title:Miller Fisher syndrome with acute angle-closure glaucoma as the first manifestation: A case report.
[So] Source:Medicine (Baltimore);96(50):e9201, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: There were no reports of Miller Fisher syndrome (MFS) with acute angle-closure glaucoma as the first manifestation. PATIENT CONCERNS: A 78-year-old female patient was admitted to our hospital with pain in her left eye, blurred vision along with nausea, and vomiting for 2 days. It was extremely rare that ophthalmoplegia, loss of tendon reflexes, and ataxia, did not occur in the early stages of MFS, and initial presentation was only dilated pupis and an increase in intraocular pressure. DIAGNOSES: The final diagnosis of the patient was MFS. INTERVENTIONS: Intravenous immunoglobulins were administered. OUTCOMES: Ophthalmoplegia, walking instability, and ataxia gradually improved. At 3 months follow-up, there was no neurological deficit, and the patient could completely self-care. LESSONS: This is the first report of MFS patient with acute angle closure glaucoma as the first manifestation. Consideration should be given to the possibility of incorporating autonomic nervous system dysfunction, or even MFS, in patients with acute angle-closure glaucoma in order to reduce missed diagnosis rate.
[Mh] MeSH terms primary: Glaucoma, Angle-Closure/diagnosis
Glaucoma, Angle-Closure/drug therapy
Immunoglobulins, Intravenous/therapeutic use
Miller Fisher Syndrome/diagnosis
Miller Fisher Syndrome/drug therapy
[Mh] MeSH terms secundary: Acute Disease
Aged
Diagnosis, Differential
Female
Humans
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Nm] Name of substance:0 (Immunoglobulins, Intravenous)
[Em] Entry month:1802
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009201

  7 / 17344 MEDLINE  
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[PMID]: 29384560
[Au] Autor:Avila A; Liu J; Kohen MC
[Ti] Title:Horner Syndrome After Epidural Catheter Placement in a 4-Month-Old Child.
[So] Source:J Pediatr Ophthalmol Strabismus;55:e1-e3, 2018 Jan 31.
[Is] ISSN:1938-2405
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Although there are reports of iatrogenic Horner syndrome in the adult population, pediatric cases are rare. The current report presents a case of acquired Horner syndrome that occurred after an epidural catheter was placed for pain control. Horner syndrome completely resolved after removing the catheter and no imaging or further work-up was necessary. [J Pediatr Ophthalmol Strabismus. 2018;55:e1-e3.].
[Mh] MeSH terms primary: Anesthesia, Epidural/adverse effects
Catheterization/adverse effects
Catheters/adverse effects
Horner Syndrome/etiology
Pneumothorax/therapy
[Mh] MeSH terms secundary: Anesthesia, Epidural/instrumentation
Child, Preschool
Device Removal
Female
Horner Syndrome/diagnosis
Horner Syndrome/therapy
Humans
Iatrogenic Disease
Recovery of Function
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180228
[Lr] Last revision date:180228
[Js] Journal subset:IM
[Da] Date of entry for processing:180201
[St] Status:MEDLINE
[do] DOI:10.3928/01913913-20170907-02

  8 / 17344 MEDLINE  
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[PMID]: 29190634
[Au] Autor:Narumi K; Mishima E; Akiyama Y; Matsuhashi T; Nakamichi T; Kisu K; Nishiyama S; Ikenouchi H; Kikuchi A; Izumi R; Miyazaki M; Abe T; Sato H; Ito S
[Ad] Address:Division of Nephrology, Endocrinology, and Vascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
[Ti] Title:Focal Segmental Glomerulosclerosis Associated with Chronic Progressive External Ophthalmoplegia and Mitochondrial DNA A3243G Mutation.
[So] Source:Nephron;138(3):243-248, 2018.
[Is] ISSN:2235-3186
[Cp] Country of publication:Switzerland
[La] Language:eng
[Ab] Abstract:Focal segmental glomerulosclerosis (FSGS) is caused by various etiologies, with mitochondrial dysfunction being one of the causes. FSGS is known to be associated with mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS), which is a subclass of mitochondrial disease. However, it has rarely been reported in other mitochondrial disease subclasses. Here, we reported a 20-year-old man diagnosed with FSGS associated with chronic progressive external ophthalmoplegia (CPEO) due to mitochondrial DNA (mtDNA) 3243A>G mutation. He presented with left ptosis, short stature, mild sensorineural deafness, and cardiac conduction block. A renal biopsy sample showed segmental sclerosis and adhesions between capillaries and Bowman's capsule, indicating FSGS. Electron microscopy demonstrated abnormal aggregated mitochondria in podocytes, and the basement membrane and epithelial cells of Bowman's capsule. Skeletal muscle biopsy also showed accumulation of abnormal mitochondria. mtDNA analysis identified heteroplasmic mtDNA 3243A>G mutation with no large-scale deletions. From these findings, we diagnosed the case as CPEO with multi-organ involvement including FSGS. Our report demonstrates that CPEO, as well as MELAS, can be associated with FSGS. Because mitochondrial disease presents with a variety of clinical symptoms, atypical cases with non-classical manifestations are observed. Thus, mitochondrial disease should be considered as an underlying cause of FSGS with systemic manifestations even with atypical phenotypes.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180228
[Lr] Last revision date:180228
[St] Status:In-Data-Review
[do] DOI:10.1159/000485109

  9 / 17344 MEDLINE  
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[PMID]: 29269696
[Au] Autor:Yokoi K; Ando T; Kawakami O
[Ad] Address:Department of Neurology, Anjo Kosei Hospital.
[Ti] Title:[Case of posterior reversible encephalopathy syndrome caused by Fisher syndrome].
[So] Source:Rinsho Shinkeigaku;58(1):45-48, 2018 Jan 26.
[Is] ISSN:1882-0654
[Cp] Country of publication:Japan
[La] Language:jpn
[Ab] Abstract:This report presents a case of a 71-year-old woman with Fisher syndrome who had posterior reversible encephalopathy syndrome (PRES) before the initiation of intravenous immunoglobulin (IVIg) treatment. She had symptoms of common cold 2 weeks before the onset of PRES. On the day of the onset, she began to stagger while walking. On day 2, she developed hypertension, vision impairment, and limb weakness and was admitted to the hospital. On day 3, she was provided steroid pulse therapy. On day 4, she developed convulsions and right imperfection single paralysis and was transferred to the our hospital. During the transfer, the patient was conscious. Her blood pressure was high at 198/107 mmHg. She had mild weakness in her limbs and face, light perception in both eyes, dilation of both pupils, total external ophthalmoplegia, no tendon reflexes, and limb and trunk ataxia. We diagnosed PRES because of the high signal intensities observed on T -weighted MRI on both sides of the parietal and occipital lobes. We also diagnosed Fisher syndrome because of a positive anti-GQ1b immunoglobulin G antibody test and albuminocytologic dissociation in the cerebrospinal fluid. PRES showed prompt improvement with antihypertensive therapy, whereas Fisher syndrome slowly improved over a course of 2 months. This case is the first report of PRES without IVIg suggesting that Fisher syndrome induces hypertension and causes PRES.
[Mh] MeSH terms primary: Miller Fisher Syndrome/complications
Posterior Leukoencephalopathy Syndrome/etiology
[Mh] MeSH terms secundary: Aged
Antihypertensive Agents/administration & dosage
Biomarkers/blood
Biomarkers/cerebrospinal fluid
Cerebrospinal Fluid Proteins/cerebrospinal fluid
Diltiazem/administration & dosage
Female
Gangliosides/immunology
Humans
Immunoglobulin G/blood
Immunoglobulins, Intravenous
Magnetic Resonance Imaging
Miller Fisher Syndrome/diagnosis
Neuroimaging
Posterior Leukoencephalopathy Syndrome/diagnostic imaging
Posterior Leukoencephalopathy Syndrome/drug therapy
Treatment Outcome
Valsartan/administration & dosage
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Nm] Name of substance:0 (Antihypertensive Agents); 0 (Biomarkers); 0 (Cerebrospinal Fluid Proteins); 0 (Gangliosides); 0 (Immunoglobulin G); 0 (Immunoglobulins, Intravenous); 68652-37-9 (GQ1b ganglioside); 80M03YXJ7I (Valsartan); EE92BBP03H (Diltiazem)
[Em] Entry month:1802
[Cu] Class update date: 180227
[Lr] Last revision date:180227
[Js] Journal subset:IM
[Da] Date of entry for processing:171223
[St] Status:MEDLINE
[do] DOI:10.5692/clinicalneurol.cn-001089

  10 / 17344 MEDLINE  
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[PMID]: 29459060
[Au] Autor:Fong CY; Aung HWW; Khairani A; Gan CS; Shahrizaila N; Goh KJ
[Ad] Address:Division of Paediatric Neurology, Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. Electronic address: cyfong@ummc.edu.my.
[Ti] Title:Bickerstaff's brainstem encephalitis with overlapping Guillain-Barre' syndrome: Usefulness of sequential nerve conduction studies.
[So] Source:Brain Dev;, 2018 Feb 16.
[Is] ISSN:1872-7131
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:Bickerstaff's brainstem encephalitis (BBE) is a rare immune-mediated disorder characterized by ophthalmoplegia, ataxia and disturbance of consciousness, which may overlap with Guillain-Barré syndrome (GBS) if there is additional limb weakness. We report a 7-month-old boy presented with ophthalmoplegia followed by a rapidly ascending paralysis of all four limbs and disturbance of consciousness. The initial impression was BBE with overlapping GBS. This was supported by sequential nerve conduction study (NCS) findings compatible with an acute inflammatory demyelinating polyneuropathy (AIDP). He received intravenous pulse methylprednisolone, intravenous immunoglobulin and plasmapharesis with complete clinical recovery after 6 weeks of illness and improved NCS findings from week 16. This is the first case of paediatric BBE with overlapping GBS with an AIDP subtype of GBS. It expands the clinical spectrum of this condition in children. Our case highlights the importance of sequential NCS in paediatric BBE with overlapping GBS for accurate electrophysiological diagnosis and prognosis particularly if the first NCS findings are not informative.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180220
[Lr] Last revision date:180220
[St] Status:Publisher


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