جستجوی مقالات مرتبط با کلیدواژه "neurological" در نشریات گروه "پزشکی"

Seizures are a common presenting manifestation in children with amino acid metabolism disorders such as maple syrup urine disease (MSUD), nonketotic hyperglycinemia, sulfite oxidase deficiency, serine deficiency, and GABA-related disorders. In monoamine biosynthesis disorders, seizures are rare, but paroxysmal dystonia is often misdiagnosed as seizures. Metabolic changes, including amino acid turnover, have been noted during epileptogenesis and chronic epilepsy. Autophagy, a catabolic pathway crucial for maintaining tissue and organism homeostasis, is influenced by amino acids and plays a role in brain physiology and pathology, including epileptic disorders. Amino acid synthesis defects can cause neurological symptoms such as early-onset seizures, mental disability, and skin disorders. Besides neurological symptoms, amino acid metabolism disorders can impact other organ systems, resulting in various clinical manifestations. Early recognition and proper management of these disorders are vital for preventing long-term complications and enhancing patient outcomes. Ongoing research into the complex relationship between amino acid metabolism and neurological function may offer new insights into the pathogenesis of seizures and other neurological disorders.

Several formulations of vaccines against novel coronavirus have been launched. Thereby, increasing the plausibility of having one or more successful vaccines. India put in place the world’s largest Covid-19 vaccination drive in January 2021. However, the side effects of these vaccines are slowly unfolding. Each new vaccine has potential adverse events of special interest (AESI) that warrant a focused evaluation. We report a very rare neurological complication Guillain-Barré syndrome, immediately following the first dose of COVID vaccination in a young female. An apparently healthy 35 years old female presented with acute onset lower backache, weakness of bilateral lower limbs 11 days after receiving the first dose of Covishield vaccine, which rapidly ascended to upper limbs over 5 days with symmetric motor weakness, power 1/5 in bilateral lower limbs, 3/5 in bilateral upper limbs, with absent deep tendon reflexes. Mild sensory involvement was seen. Evolving dysphagia and hoarseness of voice. Bladder/bowel function, respiratory pattern, and hemodynamics were unaffected. A provisional diagnosis of Guillain-Barre Syndrome was made on basis of clinical presentation, neurological examination, and nerve conduction studies suggesting axonal polyneuropathy. Gradual improvement of the muscle power over the next 2 weeks following Human Intravenous immunoglobulin was seen. The risk-benefit analysis for an individual should be considered prior to Covid-19 vaccination, including the implementation of a pre-vaccination screening checklist to ensure vaccine safety for every vaccine recipient. The vaccine continues to be far more beneficial than detrimental for the public at large. Nonetheless, increased awareness amongst healthcare professionals and the public regarding the potential adverse effects of the vaccine is warranted.

Acute necrotizing encephalopathy (ANE) is an infrequent disease in childhood with Specific clinical complications. To date, the highest incidence of this disease has been reported in East Asian children. The clinical features of the disease include convulsions, frequent vomiting, and coma. Most of these patients die within days or cause severe neurological complications. The disease is characterized by symmetric and necrotic multifunctional lesions in the thalami and brainstem. We reported a 5-year-old girl infant from Besat Hospital, Sanandaj, Kurdistan, located in west of Iran.

To investigate the relationship between outcomes and demographic-clinical variables in in-hospital cardiac arrest (IHCA).

The Medline database was searched along with Google Scholar, Scopus, Web of Science, and Persian language database without time limitation until January 6th, 2020. The inclusion criteria included papers published in journals or presented in English and Persian congress that reported the IHCA outcomes based on the Utstein criterion. All the descriptive, cross-sectional, and cohort studies on CPR were covered based on inclusion and exclusion criteria. Primary checks covered titles and abstracts followed by a full-text check of the remaining papers from the first screening stage. Data analysis was done using comprehensive metaanalysis (CMA) software version 2.0. The finding’s heterogeneity was checked using Q and Cochran tests with heterogeneity >50% and the random-effects model was used to estimate survival and favorable neurological outcome (FNO) in the analysis. To detect the publication bias of studies, the subgroup test, meta-regression test,sensitivity analysis test, funnel plot, and Eagger’s regression test were used.

Survival to discharge was 19.1% (95% CI=16.8-21.7) and FNO in the survived to discharge cases was 68.1% (95% CI=55.8-78.3). Survival to discharge and FNO were notably higher in men, CPR duration <15min, and shockable dysrhythmias.

IHCA outcomes are poor in developing countries. The outcomes of IHCA in terms of gender were inconsistent with the result reported by other meta-analyses.

Human coronavirus (CoV) infection is accompanied by upper and lower respiratory symptoms. It can infect the central nervous system and cause neurological symptoms (including stroke) (1). Although recent studies have reported the coronavirus's neurological consequences, the neurological manifestations of coronavirus are also ignored (2). In this paper, we will discuss the neurological effects of this virus by introducing a stroke after infection by CoV to help diagnose this disease earlier to prevent its side-effects.

SARS-CoV-2 is a member of the betacoronavirus genus that primarily targets the human respiratory system and causes pneumonia-like symptoms. This article aims to review neuromuscular problems in patients with COVID-19 based on the available evidence and possible consequences.

This narrative review study gathered the related and newest studies published (without time limitation) about the neurological impairment of the coronavirus. 

The studies showed that the patients with COVID-19 show a variety of respiratory symptoms and neuromuscular and neurological symptoms. The neurological symptoms associated with the underlying disease include headache, dizziness, disturbance of consciousness, ataxia, manifestations of epilepsy, stroke, peripheral nerve injury (like hypoadomia, hyposemia, neuralgia). The findings of this review study also reveal that there are a variety of neuromuscular symptoms in the affected patients. Besides, some specific changes in these symptoms have occurred since the emergence of this epidemic.

Neurologists should pay more attention to the possible signs of direct and indirect involvement of the nervous system and its lasting effects, which might have been ignored in the acute phase of the disease.

Primary immunodeficiencies (PID) are a heterogeneous group of disorders with a variable clinical spectrum of manifestations. The central nervous system may be involved in PIDs with symptoms which may present initially or develop at later stages. Neurological manifestations of primary immunodeficiencies are common with diverse pathologic mechanisms. Neurological deficits may be mild or they may greatly influence the course of the disease with major impacts on the quality of life of the patients. Physical examination may give the clinician valuable clues to the cause of PIDs that underlie the neurological signs. Certain neurological abnormalities may later signify a PID.
Therefore physicians should be aware of the neurological features accompanying immunodeficiencies. Neuromascular abnormality presenting with ataxia(ataxia-telangiectasia) , flaccid paralysis after live poliovirus immunization (combined or antibody deficiencies) ,pernicious anaemia (CVID), cognitive impairment, nystagmus and cerebellar, spinal and peripheral neuropathies(Chediac-Higashi syndrome), seizures, ataxia and occulomotor and reflex abnormalities(Griscelli syndrome) are examples of neurologic features seen in different immunodeficiency syndromes. Early recognition and treatment is important to prevent or reduce future irreversible neurological sequelae. The aim of this study is to review the neurological manifestations of different primary immunodeficiency syndromes.

To correlate the Magnetic Resonance Imaging findings and clinical presentation in patients of eclampsia. This one year prospective study was conducted in the HDU of Department of Obstetrics and Gynecology, PT.B.D.Sharma, PGIMS, Rohtak .A total of 50 women with eclampsia (both antepartum and postpartum) were divided into two groups: a) study group patients with abnormal MRI b) control group: b) control group: patients with normal MRI.Comparison was done using chi-square test and unpaired student ‘t’ test. MRI revealed abnormal findings in 24% of women, commonest diagnosis being CVT without infarct (10%) followed by infarct (8%), PRES (4%) and HLE (2%).Totally 66% (n = 33) of the women presented with postpartum eclampsia while 34% (n = 17) had antepartum eclampsia.96%(n = 48) were unbooked cases. Unconsciousness, altered sensorium, headache, blurring of vision, seizures, GCS < 3 correlated well with MRI findings (p = 0.000, p = 0.027, p = 0.001, p = 0.007, p = 0.005, p = 0.000 respectively) whereas fundoscopic changes did not (p = 0.520). The mean uric acid and serum creatinine levels was higher (0.41 ± 0.11 mmol/ L vs 0.26 ± 0.10 mmol/ L and 80 ± 18 µmol/ L vs 71 ± 9 µmol/ L) in the study group and this was statistically significant (p = 0.003, p = 0.04 respectively).There was no statistically significant difference between blood pressure values of cases with or without MR imaging evidence of brain lesions. There was no maternal mortality among 50 cases. The sensitivity, specificity, positive predictive value and negative predictive value of neurological findings for abnormal MRI in patients with eclampsia was found to be 91.7%, 73.7%, 52.4%, 96.6% respectively. Unconsciousness, altered sensorium, headache, blurring of vision,seizures, GCS < 3, elevated uric acid and serum creatinine levels in the follow-up of pregnant patients with preeclampsia/eclampsia should be a warning for possible brain lesions whereas booking status, mean BP, fundoscopy, platelet, hemoglobin, liver enzymes were not significantly associated with positive MRI findings in patients of eclampsia.

Stroke is an important cause of disability in children. Pediatric stroke may be due to significant permanent cognitive and motor handicap in children. In this study, we evaluated long‑term outcomes of stroke in pediatric patients who have been discharged with definite diagnosis of stroke in Tehran Mofid children’s Hospital and Imam Hossein children’s Hospital located in Isfahan, Iran, from 2005 to 2012.

A total of 53 children with stroke were included in the study. Stroke outcomes as motor disability, seizures, and cognitive dysfunctions were assessed.

After a median follow‑up of 4 years, 15 (29%) patients experienced full recovery. Thirty‑eight (71%) patients had some degree of neurological handicap.

Approximately 70% of children with arterial ischemic stroke suffer from long‑term neurological disabilities including motor deficits, cognitive impairment, and late seizures. Stroke recurrence is the most important risk factor responsible for severe adverse neurological outcomes in pediatric stroke.

NP-C is a severe, progressive and irreversible neurovisceral disease, which is invariably fatal. NP-C is a rare disease, with an estimated minimal incidence of 1/120,000 live births . NP-C is caused by mutations in NPC1 (~95% of patients) or NPC2 genes .Defective NPC1 and NPC2 proteins result in a disruption of lipid metabolism . One of special features of this disorder is heterogeneous manifestations. Overall various clinical manifestation of NPC disease can be categorized in three main groups: Visceral or systemic, neurological and psychiatric. The most important clinical features of each group are as follow: Visceral (prolonged neonatal jaundice, unexplained splenomegaly with or without hepatomegaly), neurological (vertical supranuclear gaze palsy, gelastic cataplexy), Psychiatric (early cognitive decline or dementia).In addition of variable clinical features, NPC disease has a wide range of age manifestation, from neonatal period through adulthood. Neurologic features unlike visceral symptoms are not common under early infancy period. After that neurological symptoms become prominent and finally from juvenile period through adolescent/adult age psychiatric symptoms in addition of neurological signs will present.Therefore with considering the variability in clinical presentations and age manifestation of NPC disease, it seems a little hard to diagnose the disease.
The NP-C Guidelines Working Group revised the recommendations for the diagnosis and management of Niemann-Pick type C disease in 2012, to provide the most up-to-date information about NP-C. A new tool – the NP-C Suspicion Index – has also been developed for healthcare professionals to help identify patients for whom further investigation is required. This will hopefully help to achieve earlier and improved diagnosis of NP-C in patients suspected of having the disease . Suspicion index is one of important tools for early diagnosis of NPC disease that developed in 2012 by Wijburg et al. Early diagnosis is important, because it help us to start early treatment with Zavesca (the only available drug for NPC disease that acts as a substrate reduction therapy). This process finally helps to patients with reducing the progression of disease. From a physician’s point of view the Suspicion Index works both as a reminder of the complex and varied symptoms characteristic of NP-C, as well as support in making the right referral decision.Suspicion index likes a checklist and fill it tells us the NPC risk prediction score. The three main categories of disease symptoms have been ranked into five groups according it’s importance. Co-Occurrence of symptoms (within and across categories) and family history are also taken into account to define the Risk Prediction Score.

Neurologic and Adaptive Capacity Scoring (NACS) has been introduced as a screening test for diagnosis of central nervous system depression due to intrapartum drugs on the neonate. This test can show neurological and behavioral changes even in the presence of a normal Apgar score. NACS has 20 indicators, each indicator allocating to itself the score zero, one or two. The aim of this study was to compare the effects of different anesthetic techniques on the NACS values.

This study was performed as a randomized, single‑blind clinical trial on 75 infants born with elective cesarean in Shahid Beheshti Hospital, Isfahan. Simple Sampling method was carried out and the information was gathered by questionnaires. Anesthetic techniques included general, spinal or epidural anesthesia. NACS score was assessed at 15th min, 2 and 24 h after birth and then the anesthesia technique was recorded in the questionnaire. NACS score 35 or above was considered normal and 34 or less was abnormal.

In the present study, no significant correlation was found between the anesthesia techniques and NACS score. The mean NACS at 15 min after birthin the general, spinal and epidural groups were 33.5 ± 2.2, 33.0 ± 4.4 and 33.7 ± 1.6 respectively (P = 0.703).

All three anesthetic techniques have identical effects on neurological and compatibility capacity of neonates born with elective cesarean; so, this could necessarily be a base to recommend the three methods equally.