1/17. Preservation of the brainstem auditory evoked potential in non-convulsive status epilepticus.Brainstem auditory evoked potentials (BAEPs) were recorded from a patient simultaneously experiencing non-convulsive generalized status epilepticus (NGSE). Waves I, III and V were normal but all subsequent waves were absent. This finding indicates that structures within the brainstem adjacent to the generators for the BAEP are likely not affected by NGSE and also illustrates the resilient nature of the BAEP. This is the first report of the recording of an evoked potential during a naturally occurring generalized seizure.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/17. Episodic coma in a new leukodystrophy.Among the leukodystrophies of a hypomyelinating nature, childhood ataxia with diffuse central nervous system hypomyelination exhibits the unique feature of rapid decrease in mental status after relatively minor head injuries or otherwise noncomplicated febrile illnesses. This article reports the case of a child with progressive spastic quadriparesis in whom unconsciousness developed repeatedly as a result of minor head trauma and required prolonged critical-care nursing. Although cognition is believed to be relatively preserved in this disorder, this child developed progressive cognitive decline. A detailed review of the literature is presented along with discussion of the potential mechanisms of neurologic deterioration.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/17. Unintentional toxicity due to endosulfan: a case report of two patients and characteristics of endosulfan toxicity.Unrestricted use of endosulfan, a cyclic chlorinated hydrocarbon insecticide, results in many intentional and unintentional toxicities in turkey. Due to its chemical stability in the environment, toxicity may be seen even if exposure happens 6-mo after the endosulfan has been sprayed. We discuss a case of 2 patients with unintentional exposure to endosulfan after eating contaminated foods, one of which presented with neurological manifestations and required mechanical ventilation, the other having only mild symptoms. Because of the toxicity to humans and threats for nature, use of endosulfan should be restricted or banned.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/17. Clinical aspects of mitochondrial disorders.Mitochondrial disorders have long been regarded as neuromuscular diseases only. In fact, owing to the ubiquitous nature of the oxidative phosphorylation, a broad spectrum of clinical features should be expected in mitochondrial disorders. Here, we present eight puzzling observations which give support to the view that a disorder of oxidative phosphorylation can give rise to any symptom in any organ or tissue with any apparent mode of inheritance. Consequently, we suggest giving consideration to the diagnosis of a mitochondrial disorder when dealing with an unexplained association of symptoms, with an early onset and a rapidly progressive course involving seemingly unrelated organs. Determination of lactate/pyruvate and ketone body molar ratios in plasma can help to select patients at risk for this condition.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/17. A report of acute ethanol poisoning in a child: mouthwash versus cologne, perfume and after-shave.The ingestion of ethanol-containing products, such as cologne, perfume and after-shave, in children under six years of age is common, but serious poisoning is rarely reported. Thus, it has been recently suggested that children ingesting up to 3.5 ounces of these products may be safely observed at home as long as they remain asymptomatic. While it may be assumed that products with a significantly lower alcohol content represent a much smaller poisoning hazard, mouthwashes are a relatively frequent cause of serious poisoning in children. In the following case report, 75 milliliters of mouthwash caused hypoglycemia, coma and manifestations of tonic seizure activity. Because of the palatable nature of mouthwash, wine and liquor, it appears that children are more apt to drink large quantities, consuming dangerous amounts of ethanol. The apparent safety of cologne, perfume, and after-shave may be due to a lack of palatability as well as the irritant nature of high concentrations of ethanol. This case suggests that consumer items such as mouthwash should be packaged in child-resistant containers.- - - - - - - - - - ranking = 2keywords = nature (Clic here for more details about this article) |
6/17. coma with triphasic wave pattern in EEG as a complication of temporal arteritis.coma is rare in temporal arteritis (TA). We describe a patient with TA who suddenly developed coma with a triphasic EEG pattern that resolved after initiation of steroid treatment. Although the arterial lesions in TA are segmental in nature, TA may present with signs of diffuse neurologic deficit; early treatment can result in complete resolution.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/17. Triphasic waves in coma from brainstem infarction.There have been reports on patients in stupor or coma from a variety of disorders that affect the brain diffusely, notably hepatic failure, whose EEGs showed triphasic waves. We describe a patient in coma with neurologic signs localizing to the brainstem who had triphasic waves on EEG. This case further confirms the nonspecific nature of triphasic waves.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/17. The concept of self in the context of crisis: a study of families of the severely brain-injured.patients in coma and a persistent vegetative state (PVS) lack cognitive ability, but may survive for prolonged periods. They present their family members with complex and difficult questions with respect to their treatment and care ranging from the type of technical support they should receive to the nature of adjustments in daily life to accommodate new circumstances and needs. Such decisions are often made in the face of considerable socio-economic and moral constraints with little if any medical guidance and no firm cultural guidelines. Based on a continuing study of families of patients in coma and PVS living in the greater new york area and using the case-study method, this paper argues that such patients and their families find themselves in socially ambiguous and isolated positions which can best be described through the anthropological concept of liminality. Further, it is hypothesized that decisions concerning these patients will in part reflect the way in which family members define the concept of self.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/17. coma as a presenting sign of Epstein-Barr encephalitis.Among the many different manifestations of Epstein-Barr virus (EBV) infection, neurologic disturbances are less frequently observed, and they are diverse in nature. A young woman was admitted with acute hyperthermia, mydriasis, nystagmus, respiratory insufficiency, muscular hypertonia, evolving to decerebrate posturing, and bilateral facial epileptic contractions. The appearance of atypical blood lymphocytes, hepatitis, migrating skin rash, positive heterophile antibody tests, and specific serologic tests for EBV led to a diagnosis of EBV encephalitis. Under treatment with intravenously administered acyclovir, the patient recuperated almost completely. This case illustrates a less frequent manifestation of EBV infection.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/17. diffuse axonal injury by assault.A case of diffuse axonal injury (DAI) by assault is reported. The majority of DAI cases documented have been due to traffic accidents and some due to falls from height. DAI is caused by angular or rotational acceleration of the victim's head. The condition is common and is the second most important head injury after subdural hematoma with regard to death. Its clinical picture is characterized by immediate and prolonged coma or demented state. Because of the subtle nature of histological changes in DAI, awareness and intentional search for the lesion is essential. The triad of DAI is as follows: focal lesions (hemorrhages and/or lacerations) in the corpus callosum and brain stem, and microscopic demonstration of axonal damage--retraction balls. The concept of DAI will elucidate and enhance the understanding of many head trauma cases.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
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