Cerebral toxoplasmosis is often caused by the reactivation of pre-existing infections. The increasing number of HIV/AIDS increased cases of cerebral toxoplasmosis. Cerebral toxoplasmosis can show clinical symptoms of neurological and psychiatric. Psychiatric symptoms such as psychosis are often associated with cerebral toxoplasmosis infection. Hemichorea and hemiballism are movement disorders often found in cerebral toxoplasmosis, although movement disorders are less common than other neurological symptoms. We report that a 53-year-old man with complaints of whole-body weakness three days before admitted to the hospital. Patient's appetite decreased. While being treated, he saw an oriental figure walking back and forth as if watching him. Patient also heard voices and complained involuntary movements in the right hand and leg. Neurological examination revealed right hemichorea with characteristics; arrhythmic, irregular, high amplitude, and improved at rest. Psychiatric examination revealed visual and auditory hallucinations. Laboratory examination showed anemia and leukopenia. Chest X-ray revealed a left pleural effusion. Magnetic Resonance Imaging (MRI) of the head with contrast showed multiple lesions with perifocal edema, suspected cerebral toxoplasmosis. Patient received anti-toxoplasmosis and antipsychotic. Patient improved on the sixth day of treatment. Cerebral toxoplasmosis can cause serious complications in patients with HIV/AIDS. Psychotic symptoms such as hallucinations and delusions are often associated with cerebral toxoplasmosis infection. Hemichorea is the most common type of movement disorder in toxoplasmosis cerebral patients related to HIV/AIDS. The main treatment is anti-toxoplasmosis medication. Combination with antipsychotics is effective in treating the symptoms of psychosis and hemichorea, while also inhibiting the replication of Toxoplasma gondii. Keywords: Cerebral Toxoplasmosis, HIV/AIDS, Neuropsychiatric
Obstructive Sleep Apnea (OSA) is a sleep disorder caused by breathing problems that occur during sleep due to airway obstruction. Obstructive Sleep Apnea is quite common, but is often overlooked and misdiagnosed and untreated. Many studies have proven the relationship between OSA and pathological diseases such as cardiovascular disease and stroke. Intermittent Hypoxia (IH) that occurs in OSA patients can cause endothelial dysfunction and play a role in the atherogenesis of peripheral and central blood vessels of the brain. Hypoxic conditions cause the release of microparticles, inflammatory mediators and increase the expression of the enzyme Cyclooxygenase (COX) in the vascular endothelium. This causes an increase in inflammation-related prostanoid production which in turn causes endothelial damage and increases the risk of atherosclerotic plaque formation. This review article will discuss the role of inflammatory mediators, especially COX enzymes in OSA-related cerebrovascular incidents. Keywords: cerebrovascular incidents, cyclooxygenase, intermittent hypoxia, obstructive sleep apnea
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