1/15. Effects of TENS and methylphenidate in tuberculous meningo-encephalitis.PRIMARY OBJECTIVE: Beneficial effects of transcutaneous electrical nerve stimulation (TENS) on cognition and behaviour were observed in a child with probable herpes simplex Encephalitis. Based on these positive findings, it was examined in the present case study whether a child who had been diagnosed to suffer from tuberculous meningitis would benefit from TENS. Furthermore, as aggression and overactive behaviour were also prominent clinical symptoms, the effects of methylphenidate were investigated. methods AND PROCEDURES: neuropsychological tests were used to assess attention/concentration and visuospatial and visuoconstructive memory. Behaviour, including the level of activity during 24 hours, was assessed by one observation scale and actigraphy. EXPERIMENTAL INTERVENTIONS: TENS and methylphenidate. MAIN OUTCOMES AND RESULTS: TENS particularly improved overall affective behaviour. methylphenidate appeared to have the opposite effect on cognition and hardly any effect on patient's behaviour. CONCLUSIONS: TENS might improve the patient's behavioural functioning. Pros and cons for treatment effects are discussed.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
2/15. Late clinical manifestation of cerebral tuberculomas in two children with tuberculous meningoencephalitis.We report on two children with cerebral tuberculomas leading to late dramatic clinical exacerbation after appropriate antituberculous chemotherapy and high-dose corticosteroids. A 6-year-old girl with tuberculous meningoencephalitis initially fully recovered. However, after 9 months of continuous therapy she presented with acute increased intracranial pressure caused by tuberculomas requiring rapid drainage of CSF. A 16-year-old boy with miliary pulmonary tuberculosis and severe meningoencephalitis had reached a stable condition for more than 10 months although still suffering from a left-dominant spasticity and motor dysphasia. Fifteen months after initiation of therapy he presented with an acute central paralysis of the left facial nerve, progressive hemiplegia, severe ataxia and increasing lethargy caused by a cerebral tuberculoma with a perifocal oedema. Prolonged treatment with antituberculous chemotherapy and high-dose corticosteroids led to complete recovery in the younger patient and marked improvement in the older patient who remains severely handicapped. CONCLUSION: patients with initially successful treatment of central nervous system tuberculosis should undergo an alert follow-up for the development of late cerebral tuberculomas. Treatment should consist of prolonged courses of antituberculous chemotherapy and high-dose corticosteroids.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
3/15. Tuberculous meningitis with initial manifestation of isolated oculomotor nerve palsy.Tuberculous meningitis (TB meningitis) is a subacute meningitis known for its various form of initial manifestations, which often make early diagnosis difficult. The present case report demonstrates a patient with TB meningitis, who had initial manifestation of isolated right oculomotor nerve palsy. High vigilance is needed in diagnosing TB meningitis. A 75 year-old female was hospitalized due to acute onset of right side ptosis. Thorough neurological examination at admission revealed isolated right oculomotor nerve palsy. brain magnetic resonance imaging and cerebral angiography showed no specific finding. Lumbar puncture was performed two days later due to low grade fever. cerebrospinal fluid (CSF) study and the polymerase chain reaction on CSF confirmed the diagnosis of TB meningitis. Because TB meningitis is a chronic disease, cranial nerve palsies are common manifestations. This report suggests that TB meningitis should be a disease of differential diagnosis for isolated oculomotor nerve palsy.- - - - - - - - - - ranking = 8keywords = nerve (Clic here for more details about this article) |
4/15. Neurosarcoidosis--demonstration of meningeal disease by gadolinium enhanced magnetic resonance imaging.Arriving at a firm diagnosis of neurosarcoidosis continues to pose serious problems, particularly when evidence of granulomatous disease outside the nervous system is lacking. The commonest mode of presentation of neurosarcoidosis is with cranial nerve palsies. Two cases of presumed neurosarcoidosis with cranial nerve palsies showed clear evidence of focal meningeal disease on gadolinium-DTPA enhanced MRI brain scans. Although not specific for sarcoidosis, this technique may be very useful in aiding the diagnosis in suspected cases.- - - - - - - - - - ranking = 2keywords = nerve (Clic here for more details about this article) |
5/15. Tuberculous meningiomyeloradiculitis--a report of two cases.Two cases of tuberculous meningitis complicated by spread to the spinal cord and nerve roots are described. Recognition of impending paraplegia by a rising cerebrospinal fluid protein content and manometric block should prompt steroid therapy as this may prevent irreversible neurological deficit.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
6/15. Suprasellar tuberculoma developing during treatment of tuberculous meningitis requiring urgent surgical decompression.An adult patient on treatment for tuberculous meningitis developed visual failure due to a tuberculoma compressing both optic nerves and chiasm. Although continued anti-tuberculous chemotherapy is the treatment of choice for intracranial tuberculoma, the rapid deterioration in vision necessitated urgent surgical decompression, which resulted in complete recovery of vision.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
7/15. Tuberculous otitis media with complications.Tuberculous otitis media, although uncommon today, is still a differential diagnosis of suppurative otitis media. Our patient's otitis progressed from a draining ear with hearing loss to include facial nerve paralysis and meningitis. Several surgical procedures including radical mastoidectomy were insufficient to halt progression of the disease. After culture of acid-fast bacilli from the aural drainage and the cerebrospinal fluid, antituberculous chemotherapy was started and the patient responded well to treatment.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
8/15. hemifacial spasm in tuberculous meningitis.hemifacial spasm developed in a 47-year-old man with tuberculous meningitis. The spasms ceased completely following vigorous antituberculous treatment. A selective compression of the facial nerve root along its exit at the brainstem by a localised inflammatory process is the most tenable explanation for the development of the hemifacial spasm.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
9/15. optic nerve tuberculoma. A case report.An intrinsic tuberculoma of the left optic nerve was found at necropsy in a 1 1/2-year-old child with tuberculous meningitis and disseminated miliary tuberculosis.- - - - - - - - - - ranking = 5keywords = nerve (Clic here for more details about this article) |
10/15. Tuberculous hypertrophic pachymeningitis involving the posterior fossa and high cervical region--case report.A 44-year-old female presented with a rare tuberculous hypertrophic pachymeningitis involving the posterior fossa and high cervical region manifesting as progressive multiple cranial nerve pareses and myelopathy developing over 6 months. magnetic resonance imaging demonstrated the thickened dura mater and associated syrinx. Despite decompressive craniectomy and antituberculous treatment, she died of disseminated intravascular coagulation. Hypertrophic pachymeningitis is probably best treated by the most extensive excision of affected dura mater possible, unless medical treatment can be instituted for an identifiable underlying causative disease.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
| | Next -> |