Intracranial lipomas are one of the rarest brain lesions. It is thought to form due to abnormal persistence and differentiation of the meninx. Here we report a unique case of a five-year-old male child with no known chronic medical illnesses and with no history of previous surgeries or allergic problems. He was brought to the pediatric emergency department after having episodes of focal seizures, which lasted only two minutes. On arrival to the emergency department, the child had no neurological deficits or any form of distress. A detailed neurological examination was conducted, and it was normal. Brain CT was requested according to the departmental policy, which showed a well-defined oval shape homogenous fat density in the midline along the falx cerebri at the vertex level, likely representing interhemispheric lipoma. Intracranial lipomas are rare and usually asymptomatic lesions that are formed of adipose tissue. The tumor is usually diagnosed as an incidental finding on CT or MRI scans as patients are usually asymptomatic. However, if symptomatic, the most common presentation of this tumor is seizures. The management is usually conservative, and surgical intervention is not usually recommended.
Salbutamol-induced QT interval prolongation is a relatively rare adverse effect of beta2-agonists. We report a case of a two-year-old female patient with no known past medical history, brought by her parents to the ED 30 minutes after ingesting a total dose of 97 mg of salbutamol solution. ECG was done for the patient when she arrived and showed sinus tachycardia with prolonged QTc (509 ms) and normal QRS complex. The patient was admitted to the Pediatric Intensive Care Unit (PICU) with persistent tachycardia and tachypnea in the initial reassessment. ECG was repeated with normal QT interval after IV Mg sulfate. The patient was observed in PICU for 12 hours with serial ECG and venous blood gas (VBG). IV potassium chloride (KCL) infusion started, and serial VBG showed normal potassium and lactate. The patient was doing well in the next six hours, with normal serial ECG, labs, and vital signs.
In conclusion, salbutamol-induced QT prolongation has infrequently been reported in the literature. Although inhaled salbutamol is commonly used in clinical practice, physicians have limited experience with the severe features of its toxicity. Salbutamol is known to cause minimal side effects, which may be under-recognized and progress to serious manifestations such as hypokalemia, QT prolongation, and sudden cardiac death.
Bell’s palsy is an acute peripheral facial paralysis commonly associated
with viral infections. COVID-19 may be a potential cause of peripheral
facial paralysis and other neurological manifestations. We report a case
of Bell’s palsy due to COVID-19 infection in a previously healthy 35
-year- old male.
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