Monoparesis is most commonly caused by dysfunction of the lower motor neurons (LMNs) which innervates the affected limb. This includes lesion affecting the anterior nuclei, ventral nerve roots, lumbosacral plexus, or peripheral nerve. Nevertheless, it can also be due to upper motor neuron lesion, typically seen in lesions of the spinal cord. In general, many conditions that cause hemiplegia, paraplegia or quadriplegia may begin as monoplegia. We illustrate an elderly patient with hypertension, diabetes mellitus, dyslipidemia and atrial fibrillation, who presented with acute monoparesis and radiological evidence suggestive of recent infarct and small vessel disease.
Isolated XIITH Cranial Nerve Palsy is an uncommon presentation. When it presents in isolation, it can be diagnostically challenging. We report a 43 year old male presenting with Unilateral Hypoglossal Nerve palsy marking the beginning of ongoing metastasis. This case report focusses on the importance of a meticulous approach towards diagnosis and finding the underlying cause.
The post neurosurgical ventriculitis caused by Acinetobacter baumannii (A. baumannii) is an important problem disorder in neurosurgical patients that can lead to serious medical complications, or even to death. This is because A. baumannii frequently can develop multi-drug resistance to several classes of antibiotic, rendering conventional treatment method ineffective. In this case study, we report a case where our patient who is infected with post neurosurgical ventriculitis from A. baumannii (pan-drug resistant strain) is successfully treated with 12 grams per day of intravenous sulbactam concurrent with usual dose of intravenous tigecycline and intraventricular colistin. This successful treatment can be another novel adjunctive therapy for the treatment of CNS infection caused by A. baumannii (pan-drug resistant) using intravenous non-colistin base plus intraventricular colistin base regimen in post neurosurgical condition.
Background and Aim: Guillain-Barré syndrome (GBS) is considered as an inflammatory postmanifestation of infectious, which acute ascending motor weakness, hyporeflexia or areflexia and sometimes sensory loss are hallmarks of this clinical syndrome. It is an acute polyradiculoneuropathy often provoked by an infectious agent. It is an acute polyradiculoneuropathy often provoked by an infectious agent, but its development following acute hepatitis A has rarely been reported.
Case Presentation: The authors report a 35 years old female of Guillain-Barre syndrome following acute hepatitis A in a young female, that developed symmetrically ascending motor weakness two weeks after the onset of initial symptoms of hepatitis infection. Our case presented with high-grade fever, vomiting and jaundice. The diagnosis of GBS was made according to clinical manifestations and albuminocytologic dissociation in cerebrospinal fluid. The patient was transferred in the ICU, NGT fixed, and plasmapheresis started. Patient’s neurological condition improved after 8 times plasmapheresis every 48 h after seven day in ICU. Treatment outcome was satisfactory and her facial palsy had almost completely improved.
Conclusion: Although GBS due to hepatitis A is very rar, this complication should be kept in mind and the best way to prevent Hepatitis A through vaccination and personal hygiene especially in close contact with an infected household member, beside good environmental sanitation.
A 68 yr old male presented with hearing loss due to an obstructing mass in his ear canal. A CT scan confirmed a non-erosive mass, which was biopsied. A diagnosis of Diffuse Large B-Cell Lymphoma was made. Following 6 courses of intra-thecal methotrexate the patient is asymptomatic and in remission. Diffuse Large B-Cell Lymphoma (DLBCL) of the EAC (external auditory canal) is extremely unusual with only 8 cases of documented DLBCL in the literature.
