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Steroid-Responsive Progressive Subacute Cerebellar Ataxia: An Unrecognized Subtype of Immune-Mediated Ataxia.

BACKGROUND: Subacute progressive cerebellar ataxia poses a diagnostic challenge due to its wide-ranging etiologies and symptom overlap with acute and chronic cerebellar disorders. Prompt identification and treatment are essential to improve clinical outcomes. CASE PRESENTATION: A 62-year-old woman presented with worsening vertigo, gait instability, and evolving neurological signs over five months, consistent with a syndrome of subacute progressive cerebellar ataxia. Despite normal findings on serial MRI and PET imaging, as well as negative serological and genetic testing, her recent history o…

Involuntary intoxication caused by vaping the synthetic cannabinoid ADB-BUTINACA: A case report.

Synthetic cannabinoids are gaining popularity globally and detection is not commonly available. We report a 27-year-old man who was admitted to the emergency room because of sudden headache, nausea, vertigo, red eyes and palpitations. He confirmed that he had been vaping an electronic cigarette (e-cigarette) earlier that day just before the onset of his symptoms. Despite all negative results in the point-of-care test for recreational drugs, the liquid chromatography-quadrupole time-of-flight mass spectrometry (LC-QTOF-MS) analysis showed that the liquid of the e-cigarette contained ADB-BUTINAC…

Atlas Subluxation Complex, National Upper Cervical Chiropractic Association Intervention, and Dizziness Improvement: A Narrative Review of Historical Perspectives, Literature Synthesis, and a Path for Future Care.

Dizziness is a non-specific and common condition in which the afflicted individual experiences abnormal sensations such as lightheadedness, imbalance, or a false sense of spinning (vertigo). The experience of "dizziness" can result from a wide spectrum of abnormal physiological states, including exhaustion, hypotension, and hypoglycemia, but could also indicate a serious underlying health issue. Since it has many potential generating causes, accurate identification of the underlying etiology of dizziness can present a challenge to clinicians, often resulting in ineffective treatments. We prese…

Complex diagnosis and management of metastatic esophagogastric junction adenocarcinoma with colonic and meningeal involvement.

This report presents a case of a 59-year-old male diagnosed with metastatic esophagogastric junction adenocarcinoma, who presented with mild dysphagia and vertigo. Brain magnetic resonance imaging initially showed no abnormalities. Upper gastrointestinal endoscopy revealed a vegetative lesion in the distal esophagus, and concurrent colonoscopy identified a laterally-spreading tumor in the transverse colon. Immunohistochemistry confirmed a poorly differentiated adenocarcinoma, suggesting an upper gastrointestinal origin. Further investigation of the worsening neurological symptoms led to the id…

Isolated abducens nerve involvement as a revealing sign of temporal bone fracture: A case report.

Isolated abducens nerve palsy is an uncommon yet clinically significant manifestation of temporal bone fracture, often following blunt head trauma. We report the case of a 52-year-old woman who sustained a right-sided head injury after a domestic fall under the influence of alcohol. She presented with diplopia, vertigo, and right-sided conductive hearing loss. Clinical examination revealed impaired abduction of the right eye, anisocoria with mydriasis, right retroauricular ecchymosis, and facial hypoesthesia in the maxillary (V2) and mandibular (V3) territories. Otoscopy showed hemotympanum, a…

Replication of Missense OTOG Gene Variants in a Brazilian Patient with Menière's Disease.

Ménière's Disease (MD) is a chronic inner ear disorder defined by recurring episodes of vertigo, fluctuating sensorineural hearing loss, tinnitus, and/or fullness in the ear. Its prevalence varies by region and ethnicity, with scarce epidemiological data in the Brazilian population. Although most MD cases are sporadic, familial MD (FMD) is observed in 5% to 20% of European cases. Through exome sequencing, we have found a rare missense variant in the OTOG gene in a Brazilian individual with MD with probable European ancestry (chr11:17599671C>T), which was previously reported in a Spanish cohort…

Current Status and Trends in Research Relating to the Diagnosis and Treatment of Meniere's Disease: A Bibliometric Analysis.

BACKGROUND: Meniere's disease (MD) is a challenging vestibular disorder causing vertigo and hearing loss, significantly impacting patients' quality of life. METHODS: A bibliometric analysis of MD-related literature (up to September 2023) from Web of Science and PubMed was conducted, using R and VOSviewer to assess publication trends, key authors, institutions, and research topics. RESULTS: The literature review through September 2023 identified 1337 publications showing steady growth (5.33% annually). These works involved 3130 authors across 198 journals, with 26% appearing in 3 leading jour…

Канадская ассоциация редиологов, центральная нервная система, руководство по диагностике изображений.

В состав Группы экспертов Канадской ассоциации редиологов (КАР) по центральной нервной системе входят врачи, специализирующиеся в таких областях, как радиология, экстренная медицина, нейрохирургия и неврология, консультант пациента и методолог-эпидемиолог/руководитель. После подготовки перечня из 24 клинических/диагностических сценариев был проведен оперативный обзор в целях определения систематически разрабатываемых руководящих принципов направления к специалистам, в которых содержатся рекомендации по одному или нескольким из этих клинических/диагностических сценариев. Рекомендации из 55 руко

Совпадение в аннотации оригинала
The Canadian Association of Radiologists (CAR) Central Nervous System Expert Panel is made up of physicians from the disciplines of radiolog … shunt malfunction, normal pressure hydrocephalus), vestibular and cochlear symptoms (hearing loss, vertigo), mental status change (acute, dementia/memory loss), visual loss, epilepsy and seizure, CNS infection, intracranial space-occupying lesions, suspected cerebral venous sinus thrombosis, vasculitis, movement disorders/Parkinsonism, metabolic and toxi …

Gas Embolism Complicating Endoscopic Retrograde Cholangiopancreaticography: Case Report of a Complex Condition.

This case report explores the complex clinical trajectory of a 72-year-old female with a history of hypertension, iron-deficiency anaemia, and vertigo, who underwent an endoscopic retrograde cholangiopancreaticography (ERCP) procedure for common bile duct (CBD) stone removal. After an uneventful laparoscopic cholecystectomy, she continued to experience abdominal pain and icterus. Investigations including magnetic resonance cholangiopancreatography (MRCP), revealed a dilated CBD with multiple stones, prompting ERCP. During the procedure, a fall in saturation and arrhythmia were noted, leading t…

Intracranial Inflammatory Myofibroblastic Tumor: A Rare Case Report.

INTRODUCTION: Inflammatory pseudotumor encompasses a broad range of non-neoplastic and neoplastic entities, including inflammatory myofibroblastic tumors (IMTs). Because it is a rare mesenchymal tumor of unknown etiology and pathogenesis, and its clinical symptoms and radiologic features are not distinctive, intracranial IMT could be misdiagnosed as other extra-axial tumors. Here, we present a case of intracranial IMT suspected to be a brain abscess. CASE PRESENTATION: In this case, a 73-year-old woman presented headaches, nausea, and vertigo. Brain computed tomography (CT) and magnetic reson…

Excessive smartphone use increases self-reported auditory and vestibular symptoms.

BACKGROUND: With widespread smartphone use, there is growing concern about their potential impact on human health. OBJECTIVE: The effects of smartphone use on self-reported hearing ability, tinnitus, balance, falls, and anxiety level were investigated in this study. METHODS: This study included 682 participants who were divided into 2 groups: a high smartphone use (HSU) group and a low smartphone use (LSU) group. Both groups were evaluated for hearing ability using the Amsterdam inventory for auditory disability and handicap; balance status using the vertigo, dizziness, imbalance symptom sca…

The Characteristics and Prognosis of Acute Hearing Loss in Military Personnel.

Introduction: The military population is one of the high-risk groups for acute hearing loss. This retrospective study aims to examine acute … the left ear, and all individuals in this group presented with tinnitus at the time of trauma, but vertigo was less common in the AAT group than in the ISSNHL group. Hearing improvement after treatment was significant in both groups. An intergroup comparison of post-treatment hearing recovery revealed that prognosis was primarily determined by the initia …

Co-occurrence of tethered cord syndrome and cervical spine instability in hypermobile Ehlers-Danlos syndrome.

The Ehlers-Danlos Syndromes (EDS) represent a group of hereditary connective tissue disorders, with the hypermobile subtype (hEDS) being the … nd bowel or bladder dysfunction. Cervical instability due to ligament laxity can lead to headaches, vertigo, tinnitus, vision changes, syncope, radiculopathy, pain, and dysphagia. TCS and cervical instability not only share clinical features but can also co-occur in hEDS patients, posing challenges in diagnostics and clinical management. We present a revi …

Encephalitis by Epstein Barr Virus in a Transplant Immunosuppressed Patient.

Encephalitis due to Epstein-Barr Virus (EBV) is a rare condition that primarily affects children and immunosuppressed patients. Diagnosing EBV encephalitis can be challenging due to its nonspecific clinical presentation and the lack of confirmatory tests. We present the case of a 66-year-old woman with a history of kidney transplantation who was admitted due to progressive subacute mental deterioration, preceded by vertigo and without fever. Physical examination revealed no cranial nerve abnormalities, focal neurological deficits, or meningeal signs. Cerebrospinal fluid (CSF) analysis showed a…

Historical descriptions of nystagmus and abnormal involuntary eye movements in various ancient cultures.

Original texts and expert translations from various ancient cultures covering a time span from the 2nd millennium BC to the ninth century AD … s of abnormal involuntary eye movements with different beating directions, possibly associated with vertigo, seizures or ear symptoms and their impact on patients' quality of life (e.g. oscillopsia, blurred vision) are preserved in many fragmentary ancient documents including papyrus scrolls and stone tablets from Egypt, Mesopotamia, India, China, Greece, …

Recurrent Pericardial Effusion Due to Panhypopituitarism: A Rare Case Report.

INTRODUCTION: A female patient, 48 years of age, with a complaint of recurrent episodes of diffuse chest pain, vertigo, and shortness of breath in the last five years, presented needing immediate medical attention. CASE PRESENTATION: The patient was evaluated and suspected of severe hypotension, cold hands, and feet with distended neck veins and muffled heart sounds. ECG revealed low voltage complexes and large pericardial effusion with a collapse in the diastole of the right auricle and ventricle. The provisional diagnosis was kept as pericardial effusion with hemodynamic compromise. Detaile…

Pediatric internal auditory canal cavernous hemangioma with rapid progression of sensorineural hearing loss: illustrative case.

BACKGROUND: Cavernous hemangioma of the internal auditory canal is extremely rare and is characterized by symptoms such as vertigo, sensorineural hearing loss, and facial nerve dysfunction. OBSERVATIONS: A health examination on an 11-year-old female in the fifth grade revealed hearing loss in the left ear. She also had dizziness that had persisted for approximately 1 year. Pure-tone audiometry revealed sensorineural hearing loss in her left ear. Rightward horizontal and rotatory nystagmus was detected. Facial paralysis was not present. Magnetic resonance imaging showed a lesion that was suspe…

Opalski syndrome, a rare variant of wallenberg syndrome, the first case reported from Pakistan: A case report.

BACKGROUND: Wallenberg syndrome, also known as a lateral medullary syndrome, is a rare neurological condition caused by an infarction in the brainstem's lateral medulla. There are subtypes of Wallenberg syndrome with distinctive and atypical symptoms, such as Opalski syndrome. CASE PRESENTATION: A 41-year-old hypertensive male arrived at the emergency department with abrupt onset of right-sided bodily weakness, vertigo, facial numbness, dysphagia, hoarseness of voice, and double vision. The neurological examination indicated right hemiparesis, right facial numbness, crossed sensory deficit, r…

Rare Deletions or Large Duplications Contribute to Genetic Variation in Patients with Severe Tinnitus and Meniere Disease.

Meniere disease (MD) is a debilitating disorder of the inner ear defined by sensorineural hearing loss (SNHL) associated with episodes of vertigo and tinnitus. Severe tinnitus, which occurs in around 1% of patients, is a multiallelic disorder associated with a burden of rare missense single nucleotide variants in synaptic genes. Rare structural variants (SVs) may also contribute to MD and severe tinnitus. In this study, we analyzed exome sequencing data from 310 MD Spanish patients and selected 75 patients with severe tinnitus based on a Tinnitus Handicap Inventory (THI) score > 68. Three rare…

Complications of sinus floor elevation procedure and management strategies: A systematic review.

AIM: This systematic review aimed to investigates the types and incidences of complications following sinus floor elevations (SFE) along wit … nusitis cases compared with a transcrestal SFE (TSFE). The presence of benign paroxysmal positional vertigo following TSFE was significant in certain selected studies. CONCLUSION: Given the inherent limitations, this systematic review showed distinct features of complications in SFE using varying techniques. Treatment planning for these procedures should …