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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The purpose of this study was to delineate distant neurological and neuropsychological effects of severe neuroborreliosis. A group of 33 patients (12 men and 21 women) were selected for the study. Every patient had suffered from severe meningitis, meningoencephalitis or meningopolyradiculoneuritis due to neuroborreliosis in the chronic form of the illness. Standardised medical interview, physical examination and a series of neuropsychological tests (WAIS-R, BDI, BENTON-BENDER, DUM) were performed. In the clinical history, 36.4% of the patients complained of headache, 27.3% of subjective memory distortions; 33.3% of the patients suffered from sleeplessness. The neurological examination showed that 36.4% of the patients experienced such cerebellum integrity disturbances as abnormalities in gait and coordination or even mild ataxia. 21.2% of the patients experienced dysfunction in the proprioceptive pathways, 9% asymmetry in deep tendon reflexes (DTR's), 27.3% disturbances in the sensory responses. The examination showed, however, no muscular strength abnormalities. Half of the patients had slight depression. Psychological tests indicated that 21.2% of the patients had problems in thinking process and experienced memory impairment. 36.4% of the patients had significant organic damage in the central nervous system. The results of this study suggest the existence of long-lasting consequences of acute neuroborreliosis, which can significantly influence the quality of life of patients.
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PMID:Neurological and psychological symptoms after the severe acute neuroborreliosis. 1142 30

A previously healthy 50-year-old man developed aseptic meningoencephalitis with clinical manifestations including fever, headache, seizure, Wernicke aphasia, right hemiplegia, and blindness in the left eye. One and one-half months after remission of meningoencephalitis, marked ataxia and psychiatric symptoms became apparent. Magnetic resonance imaging revealed multiple new lesions involving the basal ganglia, thalamus, white matter, and cerebellum. Despite these developments, cerebrospinal fluid findings continued to improve except for excessive content of myelin basic protein. Within 2 weeks, steroid therapy dramatically resolved the ataxic symptoms and disseminated lesions.
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PMID:Acute disseminated encephalomyelitis following aseptic meningoencephalitis. 1153 55

A 38-year-old man with past history of head injury at the age of 16 years was admitted to our hospital in April, 2000 because of bacterial meningitis. At the end of March 2000, he experienced massive cerebrospinal fluid (CSF) rhinorrhea when he rested in bed, and subsequently he developed high-grade fever, headache, and nuchal stiffness in 2 weeks. His symptoms and signs improved with the antibiotic therapy alone. He had no recurrence of meningitis since then. A defect of his right skull base was clarified by 3D-CT, and multiplanar reconstruction (MPR)-CT. MRI brain scan showed the dislocation of the right frontal lobe into the ipsilateral anterior ethmoidal sinus. The diagnosis of CSF rhinorrhea and bacterial meningoencephalitis were made according to his clinical manifestations and neuroradiological studies including 3D-CT, MPR-CT and MRI brain scans. These imaging modalities, which described his head anatomy precisely, helped us to clarify the cause of his illness. When CSF rhinorrhea is present, it is important to take detailed past history of head trauma, even if the event occurred more than 20 years previously.
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PMID:[A case with bacterial meningitis caused by cerebrospinal fluid rhinorrhea 22 years after head trauma]. 1180 57

A 18-year-old woman was admitted to our hospital because of high fever and headache. Nuchal stiffness was present, and a CSF examination showed lymphocyte-domonant pleocytosis and a decreased level of glucose. Although antibiotics, aciclovir and an antimycotic drug were administered, disturbance of consciousness, involuntary movements, and pyramidal tract signs appeared. Soon after the medications were changed to antituberculous medicines, the meningoencephalitis started to subside, and was finally cured. Judging from the clinical findings, the CSF findings, the effectiveness of antituberculous medicines, an elevated ADA level in CSF, and positive conversion in tuberculin tests, the final diagnosis was made as tuberculous meningoencephalitis. At the severest stage of the disease, a brain MRI showed symmetric, linear lesions without the effect of Gd-enhancement in the bilateral thalamus, which thereafter disappeared along with the healing of the illness. From all these things, we conclude that thalamic and other parenchymal lesions should be kept in mind in case of acute tuberculous meningoencephalitis.
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PMID:[Acute onset of tuberculous meningoencephalitis presenting with symmetric linear lesions in the bilateral thalamus: a case report]. 1188 39

Human herpesvirus 6 (HHV-6) has recently been recognized as an important pathogen in immunocompromised hosts, such as patients who have undergone allogeneic bone marrow transplantation (allo-BMT). Here we report a case of HHV-6 meningoencephalitis in a patient who underwent allo-BMT from an HLA-identical sibling. The patient suffered from headache, high fever, tremor, and disorientation on day 35 after allo-BMT. Findings at magnetic resonance imaging, electroencephalography, and routine cerebrospinal fluid (CSF) examination suggested the presence of viral meningoencephalitis. We diagnosed HHV-6 meningoencephalitis by means of polymerase chain reaction (PCR) analysis of a CSF specimen. Successful treatment was achieved with ganciclovir. Because HHV-6 encephalitis has a potentially fatal and fulminant course, it is necessary that HHV-6 encephalitis be recognized as one of the central nervous system complications that can follow allo-BMT. PCR analysis for HHV-6 in the CSF specimen is necessary for appropriate diagnosis and treatment.
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PMID:Human herpesvirus 6 meningoencephalitis successfully treated with ganciclovir in a patient who underwent allogeneic bone marrow transplantation from an HLA-identical sibling. 1204 76

During the summer of 2000, 35 patients with West Nile Virus Fever were admitted to our hospital. Of these, the 26 (21 adults, mean age 56 (19-86) and 5 children (aged 9-15)) presented have neurological involvement, 33% with meningitis, 52% with meningoencephalitis, 10% with encephalitis and 5% with acute polyneuropathy. Presenting clinical features were fever in 95% of cases, headache in 90%, nausea/vomiting in 52%, confusion in 48%, somnolence in 38%, neck stiffness in 33%, a skin rash in 19%, diarrhea in 14%, cervical pain in 14%, seizure in 9%, photophobia in 9% and limb weakness in 4%. Leucopenia was not found. Two patients diagnosed with meningoencephalitis died. Three patients had signs of an acute polyneuropathy, this being the only complaint of one patient. The EEG was abnormal in all cases of meningitis or meningoencephalitis, except in three cases. Outbreaks of West Nile Virus Fever are emerging as a worldwide disease with high rates of neurological involvement and death. It should be considered in cases presenting with aseptic meningoencephalitis, meningitis and acute polyneuropathy, especially during the summer months and in areas along bird migration pathways.
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PMID:Neurological features of West Nile virus infection during the 2000 outbreak in a regional hospital in Israel. 1212 78

Laboratory findings for cerebrospinal fluid (CSF) specimens were correlated with clinical presentations and histories in 55 cases of encephalitis or meningitis due to herpes simplex virus (HSV), as determined by polymerase chain reaction (PCR)-based detection of HSV DNA. Sixteen patients (29%) had HSV encephalitis (HSVE), 3 had mild or "atypical" meningoencephalitis, 34 (64%) had HSV meningitis (HSVM), and 1 had disseminated neonatal HSV infection. CSF findings included elevated leukocyte counts and/or elevated CSF protein levels in all HIV DNA-positive specimens. CSF leukocyte and protein abnormalities were more pronounced in cases of HSVM than they are in cases of HSVE. Patients with HSVE who had only mild CSF abnormalities also had minimal numbers of erythrocytes in the CSF. Patients with HSVM were younger than were patients with HSVE and were predominantly female. Eleven patients with HSVM reported having prior episodes, and 5 reported a history of recurrent headaches. These findings suggest that milder forms of HSV infection of the central nervous system may be identified by PCR for HSV. Prescreening of CSF specimens for the presence of leukocytes or elevated protein level may improve test utilization.
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PMID:Differences in laboratory findings for cerebrospinal fluid specimens obtained from patients with meningitis or encephalitis due to herpes simplex virus (HSV) documented by detection of HSV DNA. 1214 25

The clinical manifestations and outcome of patients with severe eosinophilic meningoencephalitis has never been reported. We reported 11 comatose patients with eosinophilic meningoencephalitis. Most of them presented with subacute to chronic headache and fever, followed by acute coma. Cerebrospinal fluid abnormalities were similar to alert patients with eosinophilic meningitis. None of them had received antihelmintic drug and seven patients were treated with corticosteroids. Ten patients died and one patient is still in a coma. Corticosteroids seem to be ineffective in severe eosinophilic meningitis.
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PMID:Clinical manifestations and outcome of patients with severe eosinophilic meningoencephalitis presumably caused by Angiostrongylus cantonensis. 1223 18

The aim of this study was to characterize the epidemiology and clinical features of tick-borne encephalitis in north-eastern Poland. Clinical and epidemiological data were analysed of patients hospitalized with the diagnosis in the Department of the Infectious Diseases and Neuroinfections of the Medical University in Bialystok in 1997-2001. Tick-borne encephalitis was diagnosed in 152 patients: 51 (34%) presented with meningitis, 89 (59%) with meningoencephalitis and 12 (8%) with meningoencephalomyelitis. Headache (84%) and fever (81%) were the most common symptoms. Meningeal signs were present in 137 patients (90%). Most common neurological abnormalities were: Oppenheim and Babinski signs (74 patients, 49%), ataxia (37, 24%), impaired consciousness (37, 24%) and pareses (16, 10%). Of patients examined, 146 (96%) had raised pleiocytosis, frequently accompanied by high cerebrospinal fluid protein concentration (90%), raised erythrocyte sedimentation rate (65%), peripheral blood leucocytosis (26%) and increased aminotransferase activity (16%). There was only 1 forest worker among the patients. Tick-borne encephalitis remains common in north-eastern Poland but, possibly because of effective vaccination, it has virtually disappeared among forest employees. The diagnosis appears difficult in some cases, as meningeal signs may not be present and laboratory findings may not be suggestive of a viral infection.
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PMID:Tick-borne encephalitis in north-eastern Poland in 1997-2001: a retrospective study. 1258 23

Sinus thrombosis is an acute life-threatening disease. While cavernous sinus thrombosis secondary to facial infections is described in the literature, it is uncommon. The key clinical characteristics are a facial infection, headache, chemosis and edema of the eyelid. The main differential diagnostic consideration is meningoencephalitis. Early diagnosis by angiography, magnetic resonance imaging and examination of CSF is important as treatment should be initiated as soon as possible in order to decrease morbidity and mortality. The mainstays of therapy are heparinization and appropriate intravenous antibiotic therapy.
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PMID:[Septic thrombosis of the cavernous sinus due to folliculitis]. 1266 8


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