| 1. |
- Berntsson, Shala Ghaderi, et al.
(författare)
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Does intrathecal baclofen have a place in the treatment of painful spasms in friedreich ataxia
- 2013
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Ingår i: Case Reports in Neurology. - : S. Karger AG. - 1662-680X. ; 5:3, s. 201-203
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Tidskriftsartikel (refereegranskat)abstract
- We present the case of a 50-year-old female patient with Friedreich ataxia (FA) who was treated successfully with an intrathecal baclofen (ITB)-delivering pump for painful spasms. To our knowledge, this is the second reported case of FA where ITB relieved painful and disabling spasms. We suggest that ITB should be considered in the treatment of disabling spasms in patients with FA.
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| 2. |
- Berntsson, Shala Ghaderi, et al.
(författare)
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Progressive Multifocal Leukoencephalopathy and Systemic Lupus Erythematosus : Focus on Etiology
- 2016
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Ingår i: Case Reports in Neurology. - : S. Karger AG. - 1662-680X. ; 8:1, s. 59-65
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Tidskriftsartikel (refereegranskat)abstract
- Progressive multifocal leukoencephalopathy (PML) caused by reactivation of the JC virus (JCV), a human polyomavirus, occurs in autoimmune disorders, most frequently in systemic lupus erythematosus (SLE). We describe a HIV-negative 34-year-old female with SLE who had been treated with immunosuppressant therapy (IST; steroids and azathioprine) since 2004. In 2011, she developed decreased sensation and weakness of the right hand, followed by vertigo and gait instability. The diagnosis of PML was made on the basis of brain MRI findings (posterior fossa lesions) and JCV isolation from the cerebrospinal fluid (700 copies/ml). IST was immediately discontinued. Cidofovir, mirtazapine, mefloquine and cycles of cytarabine were sequentially added, but there was progressive deterioration with a fatal outcome 1 year after disease onset. This report discusses current therapeutic choices for PML and the importance of early infection screening when SLE patients present with neurological symptoms. In the light of recent reports of PML in SLE patients treated with rituximab or belimumab, we highlight that other IST may just as well be implicated. We conclude that severe lymphopenia was most likely responsible for JCV reactivation in this patient and discuss how effective management of lymphopenia in SLE and PML therapy remains an unmet need.
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| 3. |
- Feresiadou, Amalia, et al.
(författare)
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Recurrence of Susac Syndrome following 23 Years of Remission
- 2014
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Ingår i: Case Reports in Neurology. - : S. Karger AG. - 1662-680X. ; 6:2, s. 171-175
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Tidskriftsartikel (refereegranskat)abstract
- Susac syndrome is an autoimmune microangiopathy affecting the brain, retina and inner ear (cochlea and semicircular canals), leading to encephalopathy, branch retinal artery occlusions (BRAOs) and asymmetric neurosensory hearing loss, respectively. The natural history and long-term prognosis are variable as the disease has been shown to be monophasic and self-limiting, polycyclic or chronic continuous. We describe a 35-year-old woman who presented with a sudden hearing loss in the left ear in the 37th week of her second pregnancy. She subsequently developed BRAO in the right eye 2.5 months after having given birth. MRI findings included round lesions in the corpus callosum which are pathognomonic for Susac syndrome. Previous patient records documented encephalopathy, sudden deafness of the right ear and visual field defects in the left eye at the age of 12, followed by permanent hearing and visual defects. We expand on the variability in the course of Susac syndrome as recurrence may occur after as long as 23 years. Cases of monophasic self-limiting Susac syndrome may in fact turn polycyclic with an interval of more than 2 decades between the bouts of the disease. In these cases, suspecting the development of exacerbation early is important in order to start the treatment promptly.
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| 4. |
- González, A, et al.
(författare)
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Cardiac Structure and Function in Epilepsy Patients with Drug-Resistant Convulsive Seizures
- 2022
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Ingår i: Case reports in neurology. - : S. Karger AG. - 1662-680X. ; 14:1, s. 88-97
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- High frequency of convulsive seizures and long-lasting epilepsy are associated with an increased risk of sudden unexpected death in epilepsy (SUDEP). Structural changes in the myocardium have been described in SUDEP victims. It is speculated that these changes are secondary to frequent convulsive seizures and may predispose to SUDEP. The aim of this cross-sectional study was to investigate the impact of chronic drug-resistant epilepsy on cardiac function and structure in patients with a high frequency of convulsive seizures. We consecutively included 21 patients (17 women, 4 men) aged 18–40 years, with at least 10 years with epilepsy and a minimum of six convulsive seizures in the last year and without a history of status epilepticus or nonepileptic events. A complete clinical examination, resting 12-lead electrocardiogram, 72-h Holter monitoring, and echocardiography were recorded in all patients. Ten patients were assessed by 3-Tesla cardiac magnetic resonance imaging. Echocardiography and MRI data were compared with those from age- and sex-matched healthy control individuals. No significant changes in cardiac structure or function were found among patients with chronic drug-resistant epilepsy and high frequency of convulsive seizures. However, we cannot exclude that there are subgroups of patients who are more prone to epilepsy-associated cardiac alterations.
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| 5. |
- Lindvall, Peter, et al.
(författare)
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Intracranial Hypertension due to Cerebral Venous Sinus Thrombosis following Head Trauma : A Report of Two Cases.
- 2013
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Ingår i: Case Reports in Neurology. - : S. Karger AG. - 1662-680X. ; 5:3, s. 168-174
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Tidskriftsartikel (refereegranskat)abstract
- Cerebral venous sinus thrombosis (CVST) may occur following head trauma and contribute to intracranial hypertension that mandates immediate action. Anticoagulant therapy is the first line of treatment in CVST but may not be applicable in patients with head trauma. Here, we report on the treatment of 2 patients with CVST. In 1 patient, there was an attempt to perform thrombectomy and thrombolysis, and eventually a decompressive craniectomy was performed. In this patient, there was an excellent outcome. In the other patient, an immediate decompressive craniectomy was performed that did not improve the outcome.
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| 6. |
- Sveinsson, O, et al.
(författare)
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Intra-Arterial Mechanical Thrombectomy: An Effective Treatment for Ischemic Stroke Caused by Endocarditis
- 2016
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Ingår i: Case reports in neurology. - : S. Karger AG. - 1662-680X. ; 8:3, s. 229-233
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Patients with stroke secondary to infectious endocarditis have a high in-hospital morbidity and mortality, with only one-third becoming functionally independent. Infective endocarditis is usually considered a relative contraindication to thrombolytic therapy. We describe 3 consecutive cases of acute middle cerebral artery occlusion due to infective endocarditis, who were all successfully treated with intra-arterial mechanical thrombectomy using the Solitaire device. From this limited experience, mechanical thrombectomy could be used as an effective acute treatment for ischemic stroke in patients with infective endocarditis. Mechanical thrombectomy is most likely a more effective and safer treatment than intravenous thrombolysis in this patient group.
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