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https://read.qxmd.com/read/30806821/treatment-of-neurological-manifestations-of-gluten-sensitivity-and-coeliac-disease
#1
REVIEW
Panagiotis Zis, Marios Hadjivassiliou
PURPOSE OF REVIEW: The aim of this paper was to overview the current literature in order to establish the available treatment options for the neurological manifestations of gluten-related disorders (serologically confirmed gluten sensitivity and coeliac disease). RECENT FINDINGS: A range of debilitating neurological manifestations is increasingly being recognized in patients with gluten sensitivity with and without enteropathy even in the absence of gastrointestinal symptoms...
February 26, 2019: Current Treatment Options in Neurology
https://read.qxmd.com/read/30800553/scedosporium-apiospermum-a-rare-cause-of-aggressive-orbital-apex-syndrome
#2
Ui Lyn Loh, Pih Yih Tai, Adil Hussein, Fazilawati A Qamarruddin
Orbital apex syndrome (OAS) is a localized orbital cellulitis at the orbital apex that can cause vision loss from optic neuropathy and ophthalmoplegia involving multiple cranial nerves. Herein, we report a rare and rapidly progressive case of OAS secondary to fungal pansinusitis caused by Scedosporium apiospermum in an immunocompromised patient following the extraction of abscessed teeth. A 48-year-old man with diabetes mellitus who had failed to adhere to his treatment presented with complaints of a right-sided headache and toothache for two weeks, with nausea and vomiting for two days prior to presentation...
December 17, 2018: Curēus
https://read.qxmd.com/read/30772800/effect-of-diabetes-on-neurological-adverse-effects-and-chemotherapy-induced-peripheral-neuropathy-in-advanced-colorectal-cancer-patients-treated-with-different-folfox-regimens
#3
Nusrat Bano, Rahila Ikram
This retrospective study reports impact of diabetes on incidence rate of dose limiting symptoms of neurological toxicity and chemotherapy induced peripheral neuropathy (CIPN). Post-surgical colorectal cancer (CRC) patients with metastatic disease, treated with four different schedules of FOLFOX were included in this study. Neurological adverse effects were assessed by CTC v2.0. The incidence rate of adverse neurological symptoms in CRC patients, clinically diagnosed with diabetes (n=6) were compared with non-diabetic CRC patients (n=32)...
January 2019: Pakistan Journal of Pharmaceutical Sciences
https://read.qxmd.com/read/30771770/outcomes-of-decompressive-surgery-for-cavernous-sinus-meningiomas-long-term-follow-up-in-50-patients
#4
Yair M Gozal, Gmaan Alzhrani, Hussam Abou-Al-Shaar, Mohammed A Azab, Michael T Walsh, William T Couldwell
OBJECTIVECavernous sinus meningiomas are complex tumors that offer a perpetual challenge to skull base surgeons. The senior author has employed a management strategy for these lesions aimed at maximizing tumor control while minimizing neurological morbidity. This approach emphasizes combining "safe" tumor resection and direct decompression of the roof and lateral wall of the cavernous sinus as well as the optic nerve. Here, the authors review their experience with the application of this technique for the management of cavernous sinus meningiomas over the past 15 years...
February 15, 2019: Journal of Neurosurgery
https://read.qxmd.com/read/30718027/a-case-of-accidental-mercury-intoxication
#5
Olivia L Kamensky, Destiny Horton, Donald P Kingsley, Christy C Bridges
BACKGROUND: Mercury poisoning is an uncommon diagnosis in the United States, but it is a differential diagnosis that physicians should consider because it can lead to potentially fatal complications if untreated. Due to the nonspecific presentation of mercury poisoning, which includes symptoms such as fever, nausea, vomiting, and abdominal pain, misdiagnosis may occur unless a proper history is taken. CASE REPORT: In the present case, a white female patient was misdiagnosed repeatedly with a viral illness and sent home from the local hospital...
February 1, 2019: Journal of Emergency Medicine
https://read.qxmd.com/read/30717761/safety-of-thalidomide-and-bevacizumab-in-patients-with-hereditary-hemorrhagic-telangiectasia
#6
Elisabetta Buscarini, Luisa Maria Botella, Urban Geisthoff, Anette D Kjeldsen, Hans Jurgen Mager, Fabio Pagella, Patrizia Suppressa, Roberto Zarrabeitia, Sophie Dupuis-Girod, Claire L Shovlin
BACKGROUND: Hereditary hemorrhagic telangiectasia (HHT) is a multisystemic inherited vascular dysplasia that leads to nosebleeds and visceral arteriovenous malformations (AVMs). Anti-angiogenic drugs thalidomide and bevacizumab have been increasingly used off-label with variable results. The HHT working group within the ERN for Rare Multisystemic Vascular Diseases (VASCERN), developed a questionnaire-based retrospective capture of adverse events (AEs) classified using the Common Terminology Criteria for Adverse Events...
February 4, 2019: Orphanet Journal of Rare Diseases
https://read.qxmd.com/read/30656098/surgical-therapy-of-temporal-triggered-migraine-headache
#7
Nicolò Bertozzi, Francesco Simonacci, GianLuigi Lago, Chiara Bordin, Edoardo Raposio
Background: The auriculotemporal and zygomaticotemporal nerves are the 2 primary trigger points in the temporal area of migraine headache. Different surgical approaches are described in literature, either open or endoscopic ones. Methods: We described and delineated the currently adopted strategies to treat temporal trigger points in migraine headache. Furthermore, we reported our personal experience in the field. Results: Regardless of the type of approach, outcomes observed were similar and ranged from 89% to 67% elimination / >50% reduction rates...
December 2018: Plastic and Reconstructive Surgery. Global Open
https://read.qxmd.com/read/30643465/helical-tomotherapy-in-patients-with-leptomeningeal-metastases
#8
Sanziana Ri Schiopu, Gregor Habl, Matthias Haefner, Sonja Katayama, Klaus Herfarth, Juergen Debus, Florian Sterzing
Purpose: Leptomeningeal metastasis (LM) is an increasingly common complication of late-stage systemic cancer, for which there is no standard treatment. We analyzed outcome and toxicity in patients with LM undergoing craniospinal irradiation via helical tomotherapy (HT-CSI) at our institution. Patients and methods: The charts of 15 patients diagnosed with LM and undergoing HT-CSI between 2006 and 2014 were retrospectively assessed. Main neoplasms included breast cancer, lung cancer, and lymphoma...
2019: Cancer Management and Research
https://read.qxmd.com/read/30562773/-multidisciplinary-classification-of-magnetic-resonance-imaging-features-of-neuropsychiatric-lupus
#9
J Y Chang, M Zheng, Y Liu, R Liu, J F Zhang, X L Deng
OBJECTIVE: To investigate the clinical correlation between the manifestations of neuropsychiatric lupus (NPSLE) and brain magnetic resonance imaging (MRI). METHODS: Retrospective analysis of 65 neuropsychiatric lupus patients with brain MRI and clinical data from Peking University Third Hospital from January 2006 to October 2016, which was classified by rheumatologist, neurologists, and radiologists based on their brain MRI findings. The correlation between brain MRI findings and clinical manifestations was analyzed...
December 18, 2018: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://read.qxmd.com/read/30483455/extrapyramidal-symptoms-with-administration-of-lenalidomide-maintenance-therapy-for-multiple-myeloma
#10
Fnu Sagar, Saad Ullah Malik, Supranee Soontornprueksa, Awais Ijaz, Muhammad Usman, Ali Younas Khan, Pavan Tenneti, Mohammad A Fraz, Faiz Anwer
Lenalidomide is commonly used as induction or maintenance therapy in multiple myeloma. We report a case of 71-year-old female presenting with tardive dyskinesia-like symptoms one month after starting her lenalidomide maintenance therapy after high-dose chemotherapy and autologous hematopoietic stem cell rescue. Her symptoms evolved over days to pronounced uncontrollable limb movements, tongue smacking, lip-smacking, abnormal sounds, and tongue biting. The patient categorically denied any exposure to other drugs which are known to cause symptoms of tardive dyskinesia...
September 24, 2018: Curēus
https://read.qxmd.com/read/30482825/diagnosis-and-management-of-immune-checkpoint-inhibitor-associated-neurologic-toxicity-illustrative-case-and-review-of-the-literature
#11
Kerry L Reynolds, Amanda C Guidon
Immune checkpoint inhibitors (ICIs) initiate antitumor immunity by blocking the action of immune inhibitor-signaled cytotoxic proteins, such as cytotoxic T-lymphocyte-associated protein 4, programmed cell death protein 1, and programmed cell death ligand 1. However, in rare cases (∼1%-12% of patients), ICI treatment causes neurologic immune-related adverse events (irAEs). These include, but are not limited to, headache, encephalitis, neuropathies, myasthenia gravis, and myositis. The symptoms associated with irAEs can range from mild (grade 1-2) to severe (grade 3-4); however, they are often challenging to diagnose because they may present as generalized symptoms, such as fatigue and weakness, that can also be caused by the cancer itself...
November 27, 2018: Oncologist
https://read.qxmd.com/read/30478703/autonomic-dysfunction-and-hpv-immunization-an-overview
#12
Svetlana Blitshteyn, Louise Brinth, Jeanne E Hendrickson, Manuel Martinez-Lavin
This article reviews the case series reported from several countries describing patients with suspected severe side effects to the HPV vaccines. The described symptom clusters are remarkably similar and include disabling fatigue, headache, widespread pain, fainting, gastrointestinal dysmotility, limb weakness, memory impairment episodes of altered awareness, and abnormal movements. This constellation of symptoms and signs has been labeled with different diagnoses such as complex regional pain syndrome (CRPS), postural orthostatic tachycardia syndrome (POTS), small fiber neuropathy (SFN), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), or fibromyalgia...
November 27, 2018: Immunologic Research
https://read.qxmd.com/read/30473736/successful-rituximab-treatment-of-granulomatosis-with-polyangiitis-with-cranial-neuropathies
#13
Maho Nakazawa, Katsuya Suzuki, Hidekata Yasuoka, Kunihiro Yamaoka, Tsutomu Takeuchi
Background: In granulomatosis with polyangiitis (GPA), peripheral nerve involvement is common but central nervous system (CNS) involvement is extremely rare and treatment strategy has not been established. We report a case of intravenous cyclophosphamide (IVCY)-resistant GPA with associated cranial neuropathies that was successfully treated with rituximab (RTX). Case presentation: A 37-year-old man with intractable sinusitis had several months of headache, hoarseness, and dysphagia; a month of right-sided deafness and nasal bleeding; and a week of dysarthria, steppage gait, and numbness in the right L5 distribution...
2018: Inflammation and Regeneration
https://read.qxmd.com/read/30459136/a-case-of-entecavir-associated-bullous-fixed-drug-eruption-and-a-review-of-literature
#14
Selami Aykut Temiz, İlkay Özer, Arzu Ataseven, Sıddıka Fındık
Fixed drug eruption (FDE) is a type of drug reaction characterized by localized erythema, hyperpigmentation, and bullous at the same site(s), generally observed following every intake of a causative drug. Delayed-type cellular hypersensitivity (Type IVC) is considered to play a role in FDE etiology. Several antibiotics, barbiturates, oral contraceptives, nonsteroidal anti-inflammatory drugs, laxative-containing phenolphthalein, metronidazole, and quinine are known to be the primary drugs responsible for FDE...
November 19, 2018: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://read.qxmd.com/read/30456045/retrosigmoid-craniotomy-for-resection-of-an-epidermoid-cyst-of-the-posterior-fossa
#15
M Yashar S Kalani, William T Couldwell
This video illustrates the case of a 51-year-old woman who presented with sudden-onset headache, vertigo, and nausea. Imaging revealed an epidermoid cyst of the posterior fossa with mass effect upon the brainstem and displacement of the basilar artery. This lesion was approached using a left-sided keyhole retrosigmoid craniotomy with monitoring of the cranial nerves. This video illustrates the technique of internal debulking of the cyst contents with minimal manipulation of the cyst capsule, which is often densely adherent to the brainstem, cranial nerves, and vessels in the posterior fossa...
December 2018: Journal of Neurological Surgery. Part B, Skull Base
https://read.qxmd.com/read/30390733/a-case-of-generalized-superinfected-dermatitis-and-inguinal-mycobacterium-lymphadenitis-tb-or-not-tb
#16
Maria Rotaru, Sanda Marchian, Gyula Laszlo Fekete, Gabriela Mariana Mariana Iancu
Dear Editor, Eczema is an inflammatory dermatitis mediated by cellular immunity, with an etiology in which environmental, immunological, and genetic factors are involved. Skin inflammation through proinflammatory cytokines creates a favorable environment for microbial antigens and optimal conditions for infection (1). In case of underlying immunosuppression, inflammatory features of dermatitis and superimposed infections are more severe. The presence of minor trauma of the skin in the form of fissures can favor both easier inoculation of some bacterial germs, leading to a dermatitis superinfection, and/or the transcutaneous inoculation of atypical mycobacteria, with a possibility of developing localized types of tuberculous lymphadenitis (TLA)...
October 2018: Acta Dermatovenerologica Croatica: ADC
https://read.qxmd.com/read/30344840/contraceptive-implant-related-acute-ulnar-neuropathy-prompt-diagnosis-early-referral-and-management-are-key
#17
Ayman Saeed, Nitisha Narayan, Ankur Pandya
Objective: Subdermal contraceptive implants are a well-established method of contraception. Aside from common side effects such as irregular menstrual periods, headaches, and weight gain, rarer complications related to their insertion and removal have been reported. These include traumatic peripheral neuropathy after procedures to remove nonpalpable implants. Only 2 cases of ulnar neuropathy after insertion of a contraceptive implant have been described in the literature, one which resolved spontaneously and another in which postoperative recovery was not described...
2018: Eplasty
https://read.qxmd.com/read/30332974/complications-of-immunoglobulin-therapy-and-implications-for-treatment-of-inflammatory-neuropathy-a-review
#18
Ahmed Abbas, Yusuf A Rajabally
Intravenous immunoglobulin (IVIg) forms a cornerstone of effective treatment for acute and chronic inflammatory neuropathies, with a class I evidence base in Guillain-Barré syndrome (GBS), chronic inflammatory demyelinating polyneuropathy (CIDP) and multifocal motor neuropathy (MMN). It is generally considered to be a safe therapy however there are several recognised complications which are reviewed in this article. Most adverse events are immediate and mild such as headache, fever and nausea although more serious immediate reactions such as anaphylaxis may rarely occur...
October 17, 2018: Current Drug Safety
https://read.qxmd.com/read/30302419/trigeminal-hypertrophic-interstitial-neuropathy-presenting-as-unilateral-proptosis-ptosis-tearing-and-facial-neuralgia
#19
Elizabeth R Duvall, Jennifer Pan, Kim Tien T Dinh, Majd Al Shaarani, Golden Pan, Marlyn P Langford, William A Byrd
Purpose: To show the utility of MRI and histology in diagnosing rare cases of trigeminal hypertrophic interstitial neuropathy (HIN). Observations: A 57-year-old African-American woman presented with a 4-year history of right eye proptosis with tearing, headaches, and worsening right-sided trigeminal neuralgia symptoms and jaw pain. HIV and diabetes tests were negative and thyroid function was normal. MRI identified abnormal thickening of all trigeminal nerve divisions and proptosis secondary to right trigeminal nerve V1 division enlargement...
December 2018: American Journal of Ophthalmology Case Reports
https://read.qxmd.com/read/30290905/thalidomide-before-and-after-autologous-stem-cell-transplantation-in-recently-diagnosed-multiple-myeloma-hovon-50-long-term-results-from-the-phase-3-randomised-controlled-trial
#20
RANDOMIZED CONTROLLED TRIAL
Niels Wcj van de Donk, Bronno van der Holt, Monique C Minnema, Edo Vellenga, Sandra Croockewit, Marie José Kersten, Peter A von dem Borne, Paula Ypma, Ron Schaafsma, Okke de Weerdt, Saskia K Klein, Michel Delforge, Mark-David Levin, Gerard M Bos, Kon-Siong G Jie, Harm Sinnige, Jules Llm Coenen, Esther G de Waal, Sonja Zweegman, Pieter Sonneveld, Henk M Lokhorst
BACKGROUND: In patients with recently diagnosed multiple myeloma, the HOVON-50 phase 3 trial showed improved event-free survival for thalidomide-containing induction and maintenance regimens (in conjunction with high-dose melphalan and autologous stem cell transplantation [auto-SCT]) after a median of 52 months of follow-up, by comparison with regimens containing classical cytotoxic drugs. In this follow-up analysis, we aimed to determine the long-term effects of thalidomide in induction and maintenance therapy in multiple myeloma...
October 2018: Lancet Haematology
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