SIADH is a common and important electrolyte disorder encountered in GBS. It has significant association with severity of GBS and is an indicator of poor prognosis. It can be symptomatic even though the majority of patients are asymptomatic.
Scrub typhus is a rickettsial disease caused by Orientia tsutsugamushi, one of the most common infectious diseases in the Asia-Pacific region. It has been reported from northern, eastern, and southern India, and its presence has been documented in at least 11 Indian states. However, scrub typhus meningoencephalitis has not been well documented in Kerala. We report two cases of scrub typhus meningoencephalitis from northern Kerala. The diagnosis was made based on the clinical pictures, presence of eschar, and a positive Weil–Felix test with a titer of > 1:320. The first patient succumbed to illness due to respiratory failure and the second patient improved well.
ChAdOx1 nCoV‐19 is an effective and well‐tolerated coronavirus disease 2019 (COVID‐19) vaccine. Rare cases of serious adverse events have been reported with this vaccine. We report three patients who developed Guillain‐Barré syndrome following ChAdOx1 nCoV‐19 vaccination, who did not have active or prior COVID‐19 infection. The neurological illness in all patients had an onset of 11‐13 days after the first dose of vaccine. All were characterized by sensorimotor weakness of the upper and lower limbs, with facial diplegia in one and dysautonomia in the other. Nerve conduction studies were consistent with demyelination in two and axonopathy in one. Cerebrospinal fluid analysis showed albuminocytological dissociation in two patients. All patients had moderate‐to‐severe disability. They were treated with intravenous immunoglobulin, with stabilization of the disease. Proper monitoring and prompt reporting of such cases is required to ensure safety of the vaccine.
Inflammatory
pseudotumor most commonly occurs in the orbit
and produces orbital pseudotumor, but extension
into brain parenchyma is uncommon. We report a
case of inflammatory pseudotumor involving
sphenoid sinus, cavernous sinus, superior
orbital fissure, orbital muscle, and intracranial
extension into left temporal lobe producing
right hemiparesis and wernicke's aphasia.
The patient improved clinically and
radiologically with steroid administration. This
paper provides an insight into the spectrum of
involvement of inflammatory pseudotumor and the
importance of early diagnosis of the benign
condition.
Cerebral venous thrombosis (CVT) is a well-recognized entity, but its clinical presentation is varied and often mimics many neurological disorders, making it a diagnostic challenge. Cerebral venous thrombosis has a wide spectrum of signs and symptoms, which may evolve suddenly or over weeks. It mimics many neurological conditions such as meningitis, encephalopathy, idiopathic intracranial hypertension, and stroke. Cerebral venous thrombosis presenting as multiple lower cranial nerve palsies, are rarely reported. We describe a pregnant lady who presented with sensorineural deafness of the right ear and paralysis of the 9th, 10th, and 12th cranial nerves on the right side. She was diagnosed to have thrombosis of the right transverse sinus and sigmoid sinus with extension to the jugular vein and confluence of sinuses. She improved with anticoagulant treatment.
Background:Therapeutic plasma exchange (PE) or plasmapheresis is the treatment of choice in many neurological disorders. Even though it is safe in experienced hands, there is a major concern about its safety among physicians.Objectives:To analyze our experience with 230 patients who underwent PE for various neurological disorders.Materials and Methods:Retrospective review of PE procedures done during a period of 48 months, from July 2007 to June 2011 in a tertiary care teaching hospital in South India. Indications, clinical results and technical factors are discussed.Results:The main indication for PE was GBS (203 patients; 88.3%). Age of patients ranged from 14-65 (mean = 42.3 years). The most common complications were paraesthesias and/or cramps (36.1%) and hypotension (32.2%). Four pregnant patients who underwent PE had good recovery with one intrauterine death. There was no mortality.Conclusion:The analysis of 240 cases of PE done in our department shows that the procedure is safe, with only minimal procedure related complications and no mortality.
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