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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-one patients with brucellosis wereinvestigated. Four patients with the classical manifestations of acute brucellosis presented no problems in diagnosis. The other 17 patients suffered from chronic disease and had no history of any acute episode of brucellosis. The most common symptoms in this group were tiredness, fatigue, depression, arthralgia and muscular pains. Abdominal pain and pain in the temperomandibular joints were marked in some patients. Most of these patients had been receiving psychiatric treatment. Clinical examination was largely negative, but lymphadenopathy was found in 9 cases. Brucella meningo-encephalitis was diagnosed in 7 patients who complained of severe headache. Problems in the diagnosis of chronic brucellosis with an insidious onset are discussed.
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PMID:Clinical aspects of chronic brucellosis. 81 22

Tick-borne encephalitis is transmitted by the tick ixodes ricinus. After the second world war an increase in the number of cases of encephalitis was observed and the neurotropic virus was isolated for the first time in 1948. Reservoir animals are mouse-like wild animals and also agricultural domestic animals. The infection is transmitted to humans through tick bites. It becomes apparent subjectively in headaches, vomiting, tiredness, giddiness and insomnia, and objectively in meningeal symptoms, extrapyramidal tremor, cerebellar ataxia, vestibular nystagmus and paresis. The treatment consists of strict rest in bed for 10 days at least and symptomatic support of the general health. Good results are obtained with antiedematous therapy with hydrocortisone or pyritinol.
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PMID:[Clinical picture of Central European tick-borne encephalitis (author's transl)]. 82 10

The clinical eye signs of 31 myasthenic patients are presented and those signs important for an early diagnosis are then discussed: lid symptoms caused by fatigue (Simpson-test), characteristic lid twitches as well as alternating asymmetrical eye muscle pareses. The importance of an investigation with the tangent scale in the course of which tensilon is injected is pointed out. False diagnosis and differential diagnostic signs are then considered (disseminated sclerosis, aneeurysm, encephalitis, pseudopulbarparalysis). - Our electronystagmographical investigations of saccadic eye movements showed hypometric, alternating saccades with occasional nystagmuslike jerks. After Tensilon injection hypermetric saccades (overshoots) were observed which depended on a disproportion of the supranuclear oculomotor centers and the eye muscles. The "muscleparetic" nystagmus is a pathologically increased endposition nystagmus. The hypometric nystagmuslike jerks during a saccadic eye movement are caused by insufficient phasic innervation.
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PMID:[Diagnosis of myasthenic eye signs. Clinical signs and electronystagmographical findings of saccadic eye movements (author's transl)]. 120 48

Nuclear medicine has a place in the study of brain trauma, brain tumours, stroke, dementia epilepsy and depression. The development of new tracers labelled with widely available radionuclides, such as technetium-99m (99Tc) and iodine-123, has played a key role here. Practical methodology can now be implemented in the routine setting. Additional applications are reviewed in the context of brain death, encephalitis, post-viral fatigue syndrome, Parkinson's disease and schizophrenia.
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PMID:The role of nuclear medicine in neurology and psychiatry. 146 80

We describe the unusual clinical course in a case of exanthema subitum with affection of the liver and central nervous system in a 10-months-old girl. HHV-6 infection was confirmed serologically (positive HHV-6 IgM from 10th to 29th day, increasing IgG-titres). At the beginning of the illness convulsions with preference to the right side were noticed, which were consistent with an encephalitis (on top to a suspected pre/perinatal lesion) and resulting in spastic triplegia. Nuclear magnetic resonance imaging and cranial computertomographic results showed severe, predominantly left-sided cerebral lesions. In addition there was clinical and biochemical evidence of an associated hepatitis. Human herpesvirus-6 has been identified as the cause of exanthema subitum. In addition, the virus is known to cause other clinical entities (lymphadenopathy, febril seizures, hepatitis, postinfectious chronic fatigue a.o.) and has been identified in brain tissues. Our observations show that the course of exanthema subitum can be complicated by affection of the liver and central nervous system. At present it is impossible to estimate the clinical outcome in our patient.
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PMID:[Exanthema subitum, encephalopathy and hepatitis caused by human herpesvirus type 6 (HHV-6) in a 10-month-old infant]. 165 45

Post-mortem neurohistopathologies that document polio virus-induced lesions in reticular formation and hypothalamic, thalamic, peptidergic, and monoaminergic neurons in the brain are reviewed from 158 individuals who contracted polio before 1950. This polioencephalitis was found to occur in every case of poliomyelitis, even those without evidence of damage to spinal motor neurons. These findings, in combination with data from the 1990 National Post-Polio Survey and new magnetic resonance imaging studies documenting post-encephalitis-like lesions in the brains of polio survivors, are used to present two hypotheses: 1) polioencephalitic damage to aging reticular activating system and monoaminergic neurons is responsible for post-polio fatigue, and 2) polioencephalitic damage to enkephalin-producing neurons is responsible for hypersensitivity to pain in polio survivors. In addition, the antimetabolic action of glucocorticoids on polio-damaged, metabolically vulnerable neurons may be responsible for the fatigue and muscle weakness reported by polio survivors during emotional stress.
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PMID:Polioencephalitis, stress, and the etiology of post-polio sequelae. 175 94

We report two cases of cytomegalovirus (CMV) encephalitis in immunologically normal adults. Patient 1, a 53-year-old man: onset was acute with headache and pyrexia, followed by moderate disturbance of consciousness with meningeal signs. Repeated lumbar puncture revealed 58 CSF cells per microliters and 96 mg protein per dl. On the 11th day after onset, we started treatment with adenine arabinoside (ara-A). He recovered completely. With IgG-ELISA methods, antibody to CMV turned into positive on the third week, and into negative again on the fifth week, and these conversions were concomitant with the symptomatic aggravation and amelioration, respectively. Patient 2, a 78-year-old woman: onset was acute with general fatigue and pyrexia, followed by meningeal signs and mild disturbance of consciousness. Consciousness level was worsened and two courses of acyclovir (Acv) treatment were started on the 59th and on the 93rd day after onset, but consciousness level went down to coma and she died. Repeated lumbar puncture revealed 787 CSF cells per microliters and 229 mg protein per dl. CMV antibody titer (CF) in CSF was 1:32 and antibody index was 58 or more, suggesting antibody production in central nervous system. CMV encephalitis in immunologically normal adults is very rare, only 10 cases having been reported so far. Most patients recover spontaneously, but some may be fatal. In our view ara-A treatment should be taken in consideration in case of acute encephalitis unresponsive to Acv.
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PMID:[Cytomegalovirus encephalitis in immunologically normal adults]. 216 21

All major types of human interferons (IFNs) have been purified and clinically administered as antitumor agents. We summarize here experience to date with toxicity of IFNs in cancer patients. The acute syndrome consists of fever, chills, myalgias, arthralgias, and headache, with some variation according to type of IFN, route of administration, schedule, and dose. Fatigue, perhaps reflecting CNS toxicity, is the most prevalent nonacute symptom. At high doses, IFNs are neurotoxic; the abnormalities seen by EEG resemble those in diffuse encephalitis. Hematologic toxicity consists mainly of leukopenia, but anemia and thrombocytopenia occur in some patients. Nausea, vomiting, and diarrhea are the main gastrointestinal symptoms. Elevation of serum transaminases seems to reflect liver toxicity. Renal function is well preserved, except for rare instances of acute renal failure. Cardiac toxicity remains questionable, although heart failure and arrhythmias have been associated with the administration of IFNs. Most, if not all, of these effects are reversible or can be ameliorated. With IFN alpha, the type most widely used in clinical studies, doses of 1 million to 9 million units (MU) are generally well tolerated, but doses greater than or equal to 18 MU yield moderate to severe toxicity. Doses greater than or equal to 36 MU can induce severe toxicity and significantly alter the performance status of the patient.
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PMID:Clinical toxicity of interferons in cancer patients: a review. 241 69

During 1959-1987, 126 patients in Aland Islands and main Finland had serologically verified infections with the virus of tick-borne encephalitis (Kumlinge disease). The most useful test for specific virological diagnosis was haemagglutination inhibition-IgM (HI-IgM). Most cases were from Aland Islands and nearby south-western main Finland. Two of the infections were imported. There were three laboratory infections and two transfusion infections. The disease occurred mainly from July to September. Detailed hospital records of 108 of the patients could be obtained. Ninety-five per cent of the patients had headaches, 82% had lymphocytosis of the cerebrospinal fluid, and 81% had high fever. Forty-four per cent had a confirmed biphasic course of disease. Seventeen per cent were severely ill. There were no deaths. The sequels were psychic irritability and fatigue for up to 1 year. There were eight cases of paresis, two of which became permanent.
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PMID:Tick-borne viral encephalitis in Finland. The clinical features of Kumlinge disease during 1959-1987. 270 99

Two patients had clinical findings of encephalopathy that progressed in 4 to 5 months. One patient had headache, fatigue, lethargy, hemiparesis, and a seizure. The second patient had only forgetfulness, confusion, and lethargy without focal signs. Herpes simplex virus was grown from brain biopsy in the first patient and from CSF in the second patient. These cases suggest that herpes simplex virus caused the encephalitis and that it should be considered in the differential diagnosis of chronic encephalopathy.
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PMID:Chronic encephalitis possibly due to herpes simplex virus: two cases. 403 28


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