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Bithalamic Infarct Revisited: Clinical, Imaging, Neuropsychological Profile and Prognosis
Thierry Adoukonou,
Mendinatou Agbétou,
Raphaël Kaboré,
Frédéric Faugeras,
Francisco Macian-Montoro,
Jean-Michel Vallat,
Laurent Magy
Issue:
Volume 4, Issue 3, September 2020
Pages:
44-50
Received:
8 June 2020
Accepted:
19 June 2020
Published:
4 July 2020
Abstract: The bilateral thalamic infarcts are a particular entity by their clinical presentations, neuropsychological, etiologic and prognostic. We report here the presentations of 19 consecutive cases collected at University Teaching Hospital of Limoges. All patients underwent clinical evaluation, neuropsychological (only some of them), a diagnostic imaging and a full workup. A follow-up was performed for certain patients These 19 patients including 11 women, mean age 65.6 years (+/- 14.0 years), 13 were hypertensive. Clinically 84.2% had oculomotor disorders and 73.7% of vigilance disorders. Seven patients had motor problems that have persisted for two days in one. In territorial terms, 17 had bilateral paramedian infarction including 10 with a stem associated injury; 1 patient had a heart attack in the paramedian and tubero-thalamic territory and the last patient had tubero-thalamic and thalamo-geniculated infarction. On the etiological among the stroke patients bithalamique paramedian, 9 patients had a disease of the small arteries and March 1 cardioembolic infarction. Neuropsychological disorders in patients examined were marked by disorder of episodic memory, working, executive dysfunction, speech disorders. After a mean follow up of 35 months and among all patients with bilateral thalamic stroke 5 patients had died. Our series confirms some data in the literature on the evolution of these heart attacks and suggests that they are mainly topography paramedian, due to small artery disease and have a particular neuropsychological outcome.
Abstract: The bilateral thalamic infarcts are a particular entity by their clinical presentations, neuropsychological, etiologic and prognostic. We report here the presentations of 19 consecutive cases collected at University Teaching Hospital of Limoges. All patients underwent clinical evaluation, neuropsychological (only some of them), a diagnostic imaging...
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Bacteria and Antibiotic Susceptibility Patterns of Cerebrospinal Fluid Isolated in Children with Bacterial Meningitis at Sanglah Hospital, Bali from 2016 to 2018
Gina Henny Kristianti,
I Gusti Ngurah Made Suwarba,
Dewi Sutriani Mahalini,
I Wayan Gustawan,
I Made Gede Dwi Lingga Utama
Issue:
Volume 4, Issue 3, September 2020
Pages:
51-56
Received:
22 June 2020
Accepted:
14 July 2020
Published:
28 July 2020
Abstract: Periodic review from laboratory about the pathogens causing the bacterial meningitis and its antimicrobial sensitivity test result is important to determine the most common etiology of meningitis, since they can be varied according to time, geography, and patient’s age. This study is a retrospective descriptive study. Affordable population in this study was children with positive cerebrospinal fluid culture results who were treated in Pediatric ward at Sanglah hospital, Denpasar from January 1st, 2016 until December 31st, 2018. The study used secondary data from the microbiology register in Clinical Microbiology Laboratory and medical record of Sanglah Hospital. This study employed total sampling method to collect samples. There were 52 samples that obtained in this study. Most of them were gram negative bacteria (53.8%). The most common gram negative bacteria found were Pseudomonas sp, with Pseudomonas stutzeri. The most common gram positive bacteria found were Staphylococcus sp, with Staphylococcus hemolitikus. Vancomycin, Linezolid and Tigecyclin have high sensitivity against gram positive bacteria. Carbapenem, aminoglycoside and fourth generation of cephalosporine still had high sensitivity against gram negative bacteria. About 26.9% of bacterias were multidrug resistant organisms (MDRO) and most of them (78.6%) were gram positive. Ceftriaxone as our empirical therapy has low sensitivity (30%) to gram positive bacteria and moderate sensitivity to gram negative bacteria (53.57%). Resistance to cephalosporin might be quite high in this particular clinical setting due to high number of MDRO. It should be taken into account before giving treatment for bacterial meningitis.
Abstract: Periodic review from laboratory about the pathogens causing the bacterial meningitis and its antimicrobial sensitivity test result is important to determine the most common etiology of meningitis, since they can be varied according to time, geography, and patient’s age. This study is a retrospective descriptive study. Affordable population in this ...
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Tuberous Sclerosis Complex (TSC) in 8-Year-Old Girl: A Case Report
I Gusti Ngurah Made Suwarba
Issue:
Volume 4, Issue 3, September 2020
Pages:
57-60
Received:
3 August 2020
Accepted:
17 August 2020
Published:
27 August 2020
Abstract: Tuberous Sclerosis Complex (TSC) are clinically associated with the development of non-malignant tumors throughout the body. The clinical presentation of TSC is highly variable among individual in which make the diagnosis is challenging too. Based on the 2012 International TSC Consensus Group guidelines, diagnosis is made either by genetic diagnosis or clinical diagnosis. Managing Tuberous Sclerosis Complex (TSC) is as challenging as diagnosis. Multiple organs are affected, it requires multidisciplinary approach to deal with. An 8-year-old girl consulted from Dermato-venerology department with chronic facial angiofibroma with suspicion of TSC. The symptoms at the time of examination were face lump and decreased ability to concentrate at class subjectively reported by parents. Investigation were carried and revealed that patient had a history of seizure during infancy, had finished anti epilepsy medication and has been remaining symptoms free up to this case were investigated. Diagnosis were made by matching investigation result to clinical diagnosis of the 2012 International TSC Consensus Group guidelines. Several supporting examinations had been done, with result: subependymal nodule from head CT Scan; Rhabdomyoma from echocardiograph; multiple mass on kidney from USG; and EEG abnormality. Management were emphasized on treating the rose symptoms and prioritization of the most potential result that might possess significant burden. TSC possess potential challenge starts from case presentation to management. Thorough investigation and multidisciplinary approached are required to successfully manage the case and eventually reduce the burden of the disease.
Abstract: Tuberous Sclerosis Complex (TSC) are clinically associated with the development of non-malignant tumors throughout the body. The clinical presentation of TSC is highly variable among individual in which make the diagnosis is challenging too. Based on the 2012 International TSC Consensus Group guidelines, diagnosis is made either by genetic diagnosi...
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Orthostatic Jaw Tremor, a Diagnostic Challenge for Neurologists
Rafaela Magalhães Britto Pacheco de Moraes,
Fernando José de Souza,
João Fellipe Santos Tatsch,
Livia Souza Santos,
José Furtado Alves Junior,
Maria Sheila Guimarães Rocha
Issue:
Volume 4, Issue 3, September 2020
Pages:
61-65
Received:
27 June 2020
Accepted:
22 July 2020
Published:
31 August 2020
Abstract: Jaw tremor is usually associated with tremor or other abnormal involuntary movements affecting additional body parts, but isolated jaw tremor is a rare clinical presentation. A 40-year-old man presented with history of paroxysmal jaw tremor for 3 years with no other neurological symptoms, psychiatric conditions, or a family history of neurological disorders. The tremor occurred only in the resting jaw position, with 10 episodes per day on an average, and lasted from 10 minutes to hours. It disappeared with any voluntary activation of the masseter muscle and did not change (in amplitude or frequency) with distraction maneuvers. The remainder of neurologic examination was unremarkable. The patient underwent extensive testing, including contrast-enhanced brain magnetic resonance imaging, blood tests and neuropsychiatric evaluation by two different neuropsychiatrists which failed to reveal the underlying cause. The needle electromyography examination revealed involuntary, intermittent, and synchronized muscular contractions in both masseter muscles, at a frequency of 13 to 14 Hz. No changes were discovered in the other muscles. He was treated with propranolol, primidone, valproic acid, diazepam, and amitriptyline, but the response was not significant. Injection of 25 units of botulinum toxin type A in the masseter muscle on both sides of the fac was effective five days after the injection. No adverse effects or masseter weakness were observed.
Abstract: Jaw tremor is usually associated with tremor or other abnormal involuntary movements affecting additional body parts, but isolated jaw tremor is a rare clinical presentation. A 40-year-old man presented with history of paroxysmal jaw tremor for 3 years with no other neurological symptoms, psychiatric conditions, or a family history of neurological ...
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Post-Stroke Epileptic Crises: Profile of Patients at Brazzaville Chu
Sounga Bandzouzi Prince Eliot Galieni,
Mpandzou Ghislain Armel,
Ebelebe Evence Vital,
Sounga Dufeil,
Mialoudama Karl,
Motoula Latou Dina Happhia,
Diatewa Josue,
Matali Edgard,
Obondzo Aloba Karen,
Koubemba Godefroy Charles,
Ossou-Nguiet Paul Macaire
Issue:
Volume 4, Issue 3, September 2020
Pages:
66-70
Received:
26 August 2020
Accepted:
10 September 2020
Published:
23 September 2020
Abstract: Epilepsy and cerebrovascular accident (stroke) are two common conditions in neurology, the frequency of which increases with age. One of the most common comorbidities after a stroke is epilepsy; nearly 10% of stroke patients will have a seizure immediately or later. The aim of study was to describe the epidemiological, clinical, electrical and evolutionary aspects of post-stroke crises at the Brazzaville University Hospital. This was a cross-sectional study carried out from March 1 to September 30, 2018 in the neurology department of the University Hospital of Brazzaville. It focused on patients over 18 years of age hospitalized for a seizure following a stroke documented by imaging. The epidemiological, electroclinical and therapeutic variables were evaluated. 322 patients hospitalized for stroke, 62 (15.5%) presented with seizures following the vascular event. Men were more affected (57%). The median time to onset of seizures was 2478 days (6.8 years) after stroke. These attacks were early in 69.4% of cases, and most often focal (37.1%). The epileptic seizures were related to the arterial infarctions in 79% of the cases and the abnormalities found on the EEG tracing were consistent with the location of the vascular lesion in 63.6% of the cases. The death rate was 14.5%. The predictive factors of this mortality were: the late onset of epileptic seizures (p=0.048), the presence of hyperglycemia (p=0.006) and the absence of a return to a normal state of consciousness (p<0.001). Post-stroke epileptic seizures are frequent in our region. Secondary prevention of stroke would help reduce the occurrence of strokes and therefore epileptic seizures
Abstract: Epilepsy and cerebrovascular accident (stroke) are two common conditions in neurology, the frequency of which increases with age. One of the most common comorbidities after a stroke is epilepsy; nearly 10% of stroke patients will have a seizure immediately or later. The aim of study was to describe the epidemiological, clinical, electrical and evol...
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