• Title/Summary/Keyword: Encephalopathy

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Toxic Encephalopathy

  • Kim, Yangho;Kim, Jae Woo
    • Safety and Health at Work
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    • v.3 no.4
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    • pp.243-256
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    • 2012
  • This article schematically reviews the clinical features, diagnostic approaches to, and toxicological implications of toxic encephalopathy. The review will focus on the most significant occupational causes of toxic encephalopathy. Chronic toxic encephalopathy, cerebellar syndrome, parkinsonism, and vascular encephalopathy are commonly encountered clinical syndromes of toxic encephalopathy. Few neurotoxins cause patients to present with pathognomonic neurological syndromes. The symptoms and signs of toxic encephalopathy may be mimicked by many psychiatric, metabolic, inflammatory, neoplastic, and degenerative diseases of the nervous system. Thus, the importance of good history-taking that considers exposure and a comprehensive neurological examination cannot be overemphasized in the diagnosis of toxic encephalopathy. Neuropsychological testing and neuroimaging typically play ancillary roles. The recognition of toxic encephalopathy is important because the correct diagnosis of occupational disease can prevent others (e.g., workers at the same worksite) from further harm by reducing their exposure to the toxin, and also often provides some indication of prognosis. Physicians must therefore be aware of the typical signs and symptoms of toxic encephalopathy, and close collaborations between neurologists and occupational physicians are needed to determine whether neurological disorders are related to occupational neurotoxin exposure.

Atypical Metronidazole-Induced Encephalopathy in Anaerobic Brain Abscess

  • Jang, Han Jin;Sim, Sook Young;Lee, Jong Yun;Bang, Ji Hwan
    • Journal of Korean Neurosurgical Society
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    • v.52 no.3
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    • pp.273-276
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    • 2012
  • Metronidazole-induced encephalopathy is a very rare complication of the long standing use of metronidazole. The encephalopathy is bilateral and symmetric in nature. We report on the magnetic resonance imaging (MRI) and clinical course of metronidazole-induced encephalopathy in a 60-year-old female with a persistent anaerobic brain abscess after draining of the abscess. After 3 months of metronidazole administration, the patient complained of dysarthria, tingling sense of all extremities, and left hemiparesis. MRI revealed symmetric hyperintensity lesions in medulla, pons, dentate nuclei of cerebellum, and splenium of corpus callosum, all of which represent typical findings of metronidazole-induced encephalopathy. In addition, asymmetric lesions in midbrain, thalamus, putamen and cerebral subcortical white matter were noted. The patient recovered after discontinuation of metronidazole and the remaining abscess was successfully treated with meropenem and levofloxacine.

Hypertensive Encephalopathy in a 10-year-old Boy with Ureteral Stone (10세 남아에서 생긴 요관 결석에 의한 고혈압성 뇌병증)

  • Kim Yong-Joo;Kang Hoon-Chul;Koo Ja-Wook
    • Childhood Kidney Diseases
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    • v.8 no.1
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    • pp.51-56
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    • 2004
  • Hypertensive encephalopathy is an acute neurologic syndrome that occurs in association with abrupt and marked elevation of blood pressure and is characterized by headache, vomiting, seizure, visual disturbances and altered mental status. Hypertensive encephalopathy is most commonly associated with renal disease in children, including acute glomerulonephritis, reno-vascular hypertension, and end-stage renal disease. Hypertensive encephalopathy associated with nephrolithiasis has not been reported. We have experienced a 10-year-old boy with hypertensive encephalopathy associated with ureteral stone.

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A Case of Wernicke's Encephalopathy Presenting as Acute Bilateral Wrist Drop (급성 양측 손목처짐으로 발현한 베르니케뇌병증 1예)

  • Kim, Do-Hyung;Oh, Sun-Young
    • Annals of Clinical Neurophysiology
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    • v.16 no.1
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    • pp.27-31
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    • 2014
  • Thiamine deficiency can cause peripheral polyneuropathy and Wernicke's encephalopathy. Wernicke's encephalopathy is characterized by ataxia, ophthalmoplegia, nystagmus, and confusion, and typically presents acute and rapidly progressive course, whereas peripheral neuropathy associated with thiamine deficiency manifests chronic and slowly progressive one. However, acute and rapidly progressive axonal polyneuropathy combined with Wernicke's encephalopathy is quite rare and unusual. Here, we describe a patient with Wernicke's encephalopathy who presented with acute bilateral axonal neuropathy.

A Case of Wernicke's Encephalopathy Associated with Hyperemesis Gravidarum (임신입덧으로 발생한 베르니케 뇌병증 1예)

  • Lee, Seung-Hyun;Lee, Se-Jin;Lee, Yun-Kyung;Ha, Jung-Sang;Lee, Jun
    • Yeungnam University Journal of Medicine
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    • v.21 no.1
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    • pp.91-95
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    • 2004
  • Wernicke's encephalopathy is an acute-onset illness characterized by mental confusion, ataxia and ophthalmoplegia due to a thiamine deficiency. Immediate administration of thiamine prevents progression of the disease and reverses brain lesions. We have experienced a case of Wernicke's encephalopathy associated with hyperemesis gravidarum. As Wernicke's encephalopathy is mostly associated with chronic alcoholism, the possibility of Wernicke's encephalopathy may be ignored in young women. We emphasize the need for thiamine supplementation in the patient requiring intravenous alimentation such as hyperemesis gravidarum.

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A case report of Hypoxic ischemic encephalopathy (저산소성 허혈성 뇌손상 환아의 치험 1례)

  • You, Han-Jung;Koh, Duck-Jae;Cho, Hyung-Jun;Lee, Jin-Yong
    • The Journal of Pediatrics of Korean Medicine
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    • v.18 no.2
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    • pp.143-160
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    • 2004
  • Objective: There were few reports on the treatment of Hypoxic ischemic encephalopathy. We treated a hypoxic ischemic encephalopathic patient after accident with Oriental medical approach, and get a significant result. this treatment shows the possibility of healing Hypoxic ischemic encephalopathy, So we are reporting that case. Method : The acupuncture, herb medication. rehabilitation therapy was applied for treting patient's chife symptom(involuntary movement, dystonia, aphasia, dysuria, constipation) Results : 1. Generally patients with Hypoxic ischemic encephalopathy show language impairment and cognition disorder for several weeks to months. After coma stage, first they recover consciousness but have various degree of confusional mentality, visual agnosia, extrapyramidal stiffness and motor disturbance. 2. Consciousness loss in acute stage of Hypoxic ischemic encephalopathy can be considered as Mental Confusion due to Phlegm(Dammisimgyu) in veiw point of Oriental medicine. 3. After oriental medical treatment, patient's chief symptoms were improved. Conclusion: We treated a hypoxic ischemic encephalopathic patient with Oriental medical approach and patient's chief symptoms were improved. this treatment shows the possibility of healing Hypoxic ischemic encephalopathy.

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KCNQ2 Encephalopathy Showing a Distinct Ictal Amplitude-Integrated Electroencephalographic Pattern

  • Kwak, Naeun;Lee, Yun Jeong;Kim, Dongsub;Hwang, Su-Kyeong;Kwon, Soonhak;Lee, Eun Joo
    • Neonatal Medicine
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    • v.27 no.4
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    • pp.202-206
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    • 2020
  • KCNQ2 mutations induce a neonatal-onset epileptic encephalopathy of widely varying severity, ranging from benign familial neonatal epilepsy to severe refractory epileptic encephalopathy. Refractory seizures with KCNQ2 mutations have a positive response to sodium-channel blockers. Recently, a distinctive ictal pattern has been reported during amplitude-integrated electroencephalographic (aEEG) monitoring in infants with KCNQ2 encephalopathy. Herein, we describe a case of KCNQ2 encephalopathy with this distinctive ictal aEEG pattern, which was confirmed using conventional electroencephalography (EEG). A 3-day-old female infant presented with neonatal seizures accompanied by cyanosis and desaturation. Her seizure semiology was tonic and focal clonic. Her ictal aEEG demonstrated a sudden rise in amplitude followed by a suppressed background pattern. This pattern was also confirmed on conventional EEG. Her seizures were refractory despite the administration of multiple conventional antiepileptic drugs. Finally, c.794C>T; p. (Ala265Val) mutation was observed in the KCNQ2 gene on genetic testing, and she was diagnosed with KCNQ2 encephalopathy. Identifying this distinctive ictal pattern on aEEG monitoring facilitates the early detection of KCNQ2 encephalopathy and timely targeted treatment in patients with refractory seizures.

Significance of Triphasic Waves in Metabolic Encephalopathy (대사성 뇌병증에서 삼상파의 중요성)

  • Park, Kang Min;Shin, Kyong Jin;Ha, Sam Yeol;Park, JinSe;Kim, Si Eun;Kim, Hyung Chan;Kim, Sung Eun
    • Annals of Clinical Neurophysiology
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    • v.16 no.1
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    • pp.15-20
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    • 2014
  • Background: Triphasic waves are one of the electroencephalographic patterns that can be usually seen in metabolic encephalopathy. The aim of this study is to compare the clinical and electrophysiologic profiles between patients with and without triphasic waves in metabolic encephalopathy, and reassess the significance of triphasic waves in metabolic encephalopathy. Methods: We recruited 127 patients with metabolic encephalopathy, who were admitted to our hospital. We divided these admitted patients into two groups; those with and without triphasic waves. We analyzed the difference of duration of hospitalization, mortality rate during admission, Glasgow Coma Scale, severity of electroencephalographic alteration, and presence of acute symptomatic seizures between these two groups. Results: Of the 127 patients with metabolic encephalopathy, we excluded 67 patients who did not have EEG, and 60 patients finally met the inclusion criteria for this study. Patients with triphasic waves had more severe electroencephalographic alterations, lower Glasgow Coma Scale, and more acute symptomatic seizures than those without triphasic waves. After adjusting the clinical variables, Glasgow Coma Scale and acute symptomatic seizures were only significantly different between patients with and without triphasic waves. Conclusions: We demonstrated that patients with triphasic waves in metabolic encephalopathy had more significant impairment of the brain function.

Hyperperfusion in DWI Abnormality in a Patient with Acute Symptomatic Hypoglycemic Encephalopathy

  • Park, Ji Kang
    • Investigative Magnetic Resonance Imaging
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    • v.21 no.2
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    • pp.106-108
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    • 2017
  • The perfusion change in acute symptomatic hypoglycemic encephalopathy (ASHE) is not well known. We present the perfusion-weighted imaging of a patient with ASHE. The area of diffusion-weighted imaging abnormalities and adjacent normal-appearing white matter showed increased cerebral blood volume and flow, and shortening of time-to-peak.

A Case of Severe Hypoglycemic Encephalopathy with Extensive Brain Lesions in Non-diabetics and Alcoholism (당뇨병이 없는 알코올중독 환자에서 광범위한 뇌병변을 보인 저혈당성 뇌병증 1예)

  • Bin, Chang-Hun;Park, Min-Su;Lee, Se-Jin
    • Yeungnam University Journal of Medicine
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    • v.27 no.1
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    • pp.37-41
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    • 2010
  • Hypoglycemic encephalopathy is a rare problem among diabetic patients who are receiving treatment with insulin or other glucose-lowering drugs. The MRIs of patients with hypoglycemic encephalopathy commonly show scattered lesions in the cerebral cortex, hippocampus and basal ganglia, but lesions in the cerebellum or brain stem are extremely rare. A 44-year-old alcoholic woman without diabetes was admitted with a semicomatose mentality and seizure with severe hypoglycemic encephalopathy with extensive brain lesions seen on MRI at the middle cerebellar peduncle and midbrain, as well as in the other brain areas.

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