Tetanus is an infectious disease of the nervous system caused by Clostridium tetani, and is characterized by tonic muscle contractions, painful spasms, and autonomic dysfunction. Severe autonomic dysfunction associated with tetanus can be life-threatening. We present a 62-year-old female who experienced lockjaw after an ankle fracture. The patient was diagnosed with tetanus and received tetanus immunoglobulin and a vaccination. The patient subsequently experienced labile hypertension. This case highlights the challenge and importance of managing cardiovascular instability.
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Successful management of severe generalized tetanus in a 23‐year man with phenobarbital adjuvant: A case report Arezoo Ahmadi, Elahe Karimpour‐Razkenari, Ramin Ansari, Mahforouzalsadat Marashi, Hamidreza Sharifnia, Atabak Najafi, Mojtaba Mojtahedzadeh Clinical Case Reports.2023;[Epub] CrossRef
Background and Objective : Carpal tunnel syndrome(CTS) is the most common mononeuropathy encountered in clinical practice. No single procedure or group of procedures has demonstrated adequate sensitivity. F-wave study in CTS is very rarely reported. To determine the diagnostic usefulness of new parameters of F-wave and comparative study of F-wave parameters of median and ulnar nerves in patients with CTS. Methods : F-wave responses of median and ulnar nerves were analyzed from 27 patients with clinically diagnosed CTS and 22 age and gender-matched normal control. Conventional F-wave parameters were studied. Also, the usefulness of new parameters such as mean and maximal ulnar-median F-wave latency differences, ulnar-median F-wave persistence and chronodispersion differences, median/ulnar F-wave amplitude ratio, and F-wave conduction velocity(FCV) using mean and maximal latency were assessed. Results : Compared with controls, median F-wave minimal, maximal and mean latencies, mean F-wave amplitude/M-wave amplitude, minimal, mean and maximal ulnar-median F-wave latency differences, and FCVs using minimal, maximal and mean latency difference, and FCVs using minimal, maximal and mean latency showed high sensitivity and specificity. Mean ulnar-median F-wave latency difference and FCVs using maximal and mean latency were new parameters. Conclusion : New F-wave parameter including mean ulnar-median F-wave latency difference and FCVs using maximal and mean latency may be a useful to assess the CTS. Also, median F-wave minimal, maximal and mean latencies, and FCV using minimal latency may be included in routine diagnostic tests in CTS
Myoclonus may originate from the cerebral cortex, subcortical structures, brainstem, spinal cord or peripheral nerve.But unilateral upper limb myoclonus related to cortical infarct is an unusual clinical picture. We report a 67-year-oldman presented with myoclonus, associated with primary motor cortex infarction.
We report a case of thoracolumbar radiculopathy presented with first symptom of leptomeningeal metastasis. A 65-year old man with non-Hodgkins lymphoma with complete remission was referred for further investigation of dull painand numbness of right lower quadrant of abdomen. Electromyogram revealed right thoracolumbar radiculopathy. Aftertwo weeks, he complained severe continuous bilateral frontal dull headache. An examination of the cerebrospinal fluidrevealed malignant lymphoid cells. We would like to emphasize that radiculopathy sometimes presents with first symptomof leptomeningeal metastasis.
The Guillain-Barre syndrome (GBS) is an acute polyradiculoneuropathy marked by flaccid areflexic paralysis.Although the pathogenesis of GBS remains incompletely defined, considered as an autoimmune disease most frequentlytriggered by an previous infection. Antecedent infections with Campylobacter jejuni, cytomegalovirus, Ebstein-Barrvirus, Mycoplasma pneumoniae, Haemophilus influenzae, human immunodeficiency virus, enterovirus, rotavirus arecommon. But, it is rare that GBS following typhoid fever. We present a case of typical GBS after antecedentSalmonella typhi infection.
Patients of chronic alcoholism may show many kinds of complications such as myopathy, nutritional problems,peripheral neuropathy, withdrawal seizure and encephalopathies. We report an unusual case of alcoholic myopathy diagnosed with typical laboratory and pathological findings initially manifested as acute reversible encephalopathy showing transient abnormalities on brain MRI.
We present a case with stepwise weakness and sensory involvement of both hands for more than 2 months. His nerve conduction study findings revealed prolonged terminal latencies, decreased motor and sensory conduction velocities and conduction blocks of both ulnar nerves, more severely on left side. And there were other abnormalities manifested with mononeuropathy multiplex. Increased cerebrospinal fluid protein was found. We diagnosed him as Lewis-Sumner syndrome and tried high dose oral steroid therapy for 2 months. He showed improvement of motor functioning with persistent conduction block.
The Guillain-Barre Sydrome (GBS) is post-infectious autoimmune disease and it could be caused by auto-antibodies producedafter infections. Mycoplasma pneumoniae is one of rare cause of GBS and known to be associated with antibodyto galactocerebroside (GalC) which is a major neutral glycolipid constituent of myelin. We report a case of GBS with immunoglobulinM GalC antibody after M. pneumoniae infection.
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