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Query: UMLS:C0018991 (hemiplegia)
 3,997 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Actinomyces species are rare but treatable causes of central nervous system infection. A case of actinomycotic cerebral abscess is reported. The primary source of infection was probably the lung based on radiological findings although culture of the bronchial brushings was negative. The patient had surgical excision and repeated drainage with two prolonged causes of antibiotic therapy. At follow-up examination 36 months later, the patient was well except for a residual left hemiplegia. Diagnosis of cerebral actinomycosis can be made by anaerobic culture of the appropriate specimens or on histologic grounds. Optimal management combines adequate surgical drainage and prolonged antibiotic therapy.
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PMID:Actinomycosis of the brain. 180 77

A 34-year-old homosexual male developed cryptococcal meningitis as the initial manifestation of Acquired Immune Deficiency Syndrome (AIDS). With antifungal therapy he improved. Six weeks later he developed focal motor seizures and progressive hemiplegia. Computer assisted tomography revealed multiple, ring-enhancing, low density lesions. The patient expired and at necropsy he was found to have multiple toxoplasma brain abscesses as well as chronic cryptococcal meningitis. This case demonstrates that in a patient with AIDS with pre-existing central nervous system infection who develops new neurological symptoms the possibility of a second and potentially treatable infection must be considered and its diagnosis pursued vigorously.
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PMID:Cryptococcal meningitis and cerebral toxoplasmosis in a patient with acquired immune deficiency syndrome. 395 46

Despite frequent colonization with Mycoplasma hominis, the invasive disease is rare in neonates. This study describes a neonatal case with meningitis in which M. hominis was isolated from a cerebrospinal fluid sample by culture and detected by PCR. The M. hominis infection was confirmed by elevated metabolic inhibition titers against the isolated M. hominis strain and anti-M. hominis antibodies in serum samples. Minocycline and moxifloxacin were effective against M. hominis, which caused meningitis in the patient. However, the patient exhibited left hemiplegia because of massive brain infarction. Based on data of the previously reported 28 cases in addition to our case, the high morbidity and mortality of the M. hominis central nervous system infection were confirmed; it was assumed to result from delayed diagnosis and ineffective initial therapy. Early diagnosis and prompt initiation of appropriate antimicrobial treatment are necessary for a favorable prognosis. Fourth-generation fluoroquinolones, especially moxifloxacin, deserve wider use in such cases.
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PMID:Mycoplasma hominis meningitis in a neonate: case report and review. 1879 May 39

Idiopathic hemiconvulsion hemiplegia and epilepsy syndrome (IHHE) and febrile infection-related epilepsy syndrome (FIRES) are rare epileptic syndromes characterized by the occurrence of status epilepticus in a previously healthy child during or closely after a febrile episode. In both syndromes, there is no evidence of central nervous system infection (encephalitis) and the etiology remains unclear. Treatment is disappointing, particularly in FIRES, except for a response to ketogenic diet (KD) in half of patients. In IHHS, children develop hemispheric brain atrophy with contralateral hemiplegia, epilepsy, and a variable degree of cognitive deficit. Patients with FIRES develop refractory epilepsy with severe cognitive deficit affecting the temporal and frontal lobe functions. The role of inflammation is hypothesized with a vicious circle involving inflammation and seizure activity facilitated by brain maturation putting them under the concept of "acute encephalopathy with inflammation-mediated status epilepticus."
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PMID:FIRES and IHHE: Delineation of the syndromes. 2400 Oct 74

Progressive multifocal leukoencephalopathy (PML) is a central nervous system infection caused by John Cunningham (JC) virus reactivation in an immunocompromised patient. PML has various neurologic symptoms and has very poor prognosis. A 36-year-old man developed transverse myelitis and had a psychiatric disorder at the age of 26. He was diagnosed with systemic lupus erythematosus (SLE) and neuropsychiatric SLE (NPSLE), on the basis of leukopenia and presence of anti-DNA and anti-nuclear antibodies. Treatment with glucocorticoid (GC) was started, and remission was introduced. Six months before PML onset, his condition was complicated with hemophagocytic lymphohistiocytosis (HLH) due to exacerbation of SLE. Remission re-induction therapy by GC, cyclosporine-A, intravenous cyclophosphamide, and rituximab (RTX) was initiated and HLH improved. However, interleukin-6 levels of the cerebrospinal fluid (CSF) continued to rise. We thought that the disease activity of NPSLE worsened; thus, we introduced mycophenolate mofetil (MMF) 4 months before the PML onset. He developed progressive dysarthria and right hemiplegia. He was diagnosed with PML via magnetic resonance imaging and JC virus polymerase chain reaction in CSF. Considering that immunosuppressants, including RTX and MMF, are precipitating factors of PML, we discussed the RTX removal using plasma exchange (PEx), but we did not introduce PEx, because it was expected that the concentration of RTX was already lowered when he was diagnosed with PML. Treatment for PML with mefloquine and mirtazapine saved his life, but severe residual disabilities remained. This is the first report of a patient who developed PML during combination therapy with RTX and MMF.
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PMID:A case of developing progressive multifocal leukoencephalopathy while using rituximab and mycophenolate mofetil in refractory systemic lupus erythematosus. 2998 69