Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0028738 (nystagmus)
 7,431 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We present our experience in the diagnosis, surgical management and long-term follow-up of congenital and acquired osseous-ligamentous abnormalities or pathologies of the craniovertebral junction. The purpose of this study was: (i) to determine the incidence and degree of cervicomedullary compression in pediatric and young adult patients with congenital and acquired abnormalities, and (ii) to correlate cervicomedullary compression with other imaging and clinical factors to determine to what extend cervicomedullary compression is successfully treated with a posterior decompressive procedure, transoral decompression, and medical management. Between January 1995 and December 2004, 26 cases were managed in our department. These patients had: rheumatoid arthritis (RA) (3); traumatic injury (2); congenital basilar impression (5, in 2 cases a posteriorly oriented or retroflexed odontoid); infection (10); craniovertebral junction Pott's disease (9); os odonteideum (3); condylus tertius (1); and tumor (2). Six of the patients (23.1%) had syringomyelia. Only three (11.3%) were in the pediatric age group. Symptoms and signs included headache (72%), ataxia (38%), lower cranial nerve dysfunction (54%), quadriparesis (44%), hyperreflexia (76%), Hoffman positivity (72%), achilles clonus (72%) nystagmus (33%) and dysphagia (22%). The mean follow-up time was 44 months (range 3-85). Twelve (46.2%) had undergone posterior fossa decompression; seven (26.6%) had ventral decompression. Seven of the patients (26.6%) had medical management. The major morbidity included pharyngeal wound sepsis leading to dehiscence (3.8%), valopharyngeal insufficiency (3.8%), cerebrospinal fluid leakage (3.8%), postoperative macroglossia (3.8%) and inadequate anterior decompression (3.8%). Transient neurological deterioration occurred in two patients (7.6%). Our management paradigm will result in some neurologic improvements and limit the progression of symptoms. Patients with these pathologies are likely to show a good neurologic outcome when treatment, whether with or without surgery, is administered early in the course of the disease.
 ...
PMID:Management of cervicomedullary compression in patients with congenital and acquired osseous-ligamentous pathologies. 1733 28

1. Fatal Type I pneumococcal meningitis may be produced in rabbits by intracisternal injection of pneumococci. 2. When organisms are of high virulence, the rabbit does not tend to localize them in the meninges, but an early septicemic process results. Death is septicemic rather than meningeal. 3. In such instances very little cellular reaction occurs in the meninges. 4. Active or passive immunization previous to intracisternal infection inhibits partially the septicemia and permits the development of reactional processes in the meninges. 5. The immunization likewise retards the meningeal disease, but multiplicity of factors prevents us from stating precisely to what this retardation is due. It is not correlated with the presence of agglutinins in the spinal fluid at the time of infection. 6. The rapidity of production of meningitis is influenced by the phase of growth of the culture used, and likewise by the growth activity of that culture. 7. To some extent in the partially immune rabbit the meningeal spaces constitute a relatively non-immune reservoir, constantly feeding the blood stream and breaking down systemic resistance. 8. Intrathecal serum treatment causes rapid agglutination and phagocytosis of pneumococci, and has very rarely, possibly, resulted in cure. Essentially no phagocytosis occurs in the absence of immune serum. 9. Phagocyted pneumococci stained supravitally take up the neutral red stain and are therefore probably injured. 10. The treatment employed subsequent to infection only slightly prolongs life in the majority of cases. It does retard septicemia. 11. The treatment improves the cellular reactional processes in the meninges. 12. A study of the pathology of rabbit pneumococcal meningitis shows that the location of pneumococci precludes complete contact with serum introduced intrathecally, and that these locations provide isolated foci, from which organisms may reinfect the meningeal spaces as rapidly as they are removed by lavage or antibody injections. 13. In recovered rabbits postmeningeal symptoms, weakness, ataxia, nystagmus, and paralyses arise. 14. In our opinion there is some objective evidence of benefit of serum therapy. The rabbit is too susceptible, however, and conditions too artificial to admit of definite conclusions. 15. Rough Type I pneumococci introduced in large quantity cisternally may kill and may be recovered 24 hours after infection, from spinal fluids. In a series of eleven passages, no reversion to smooth type occurred. In all animals injected with rough forms, transient bacteremia resulted.
 ...
PMID:LOCAL SPECIFIC THERAPY OF EXPERIMENTAL PNEUMOCOCCAL MENINGITIS : I. EXPERIMENTAL PNEUMOCOCCAL MENINGITIS IN RABBITS. 1986 45

Anti-Ma2 encephalitis is a paraneoplastic disorder characterised by brainstem and/or limbic involvement. Eye movement abnormalities can occur in this condition, often with confusion or somnolence. We describe a patient with progressive oscillopsia (with upbeat nystagmus) and unsteadiness, followed by acute pancreatitis. She did not respond to immunomodulatory treatment and subsequently died of complications related to pancreatitis and sepsis. There was no tumour identified at autopsy, but the anti-Ma2 antibodies in her serum and the discovery of a brainstem-predominant inflammatory infiltrate at autopsy strongly suggest a paraneoplastic disorder. Our case illustrates that upbeat nystagmus can be a predominant feature in anti-Ma2 encephalitis; clinicians should consider testing for anti-Ma2 antibodies in patients with upbeat nystagmus of unknown cause.
...
PMID:Upbeat nystagmus in anti-Ma2 encephalitis. 2404 43

An 11-year-old, male castrated, Boston Terrier was presented to the North Carolina State University College of Veterinary Medicine Small Animal Emergency Service with a 2-day history of progressive ataxia, left-sided head tilt, and anorexia. The dog had previously been diagnosed with chronic lymphoid leukemia and suspected immune-mediated destruction of his bone marrow precursor cells, possibly due to therapy with immunosuppressive dosages of prednisone and azathioprine. During the physical examination, abnormal findings included an increased body temperature and horizontal nystagmus. Diagnostic investigations included a computed tomography (CT) scan, which confirmed bilateral otitis media, and a blood culture, which was positive for Listeria monocytogenes serotype 4b (epidemic clone 1). Upon treatment with ampicillin/sulbactam, enrofloxacin, and minocycline, the dog became normothermic and the neurologic signs improved. L monocytogenes serotype 4b (epidemic clone 1) has been associated with outbreaks of human listeriosis originating from food contamination. Although rare case reports of Listeria spp. infection in dogs exist, an actual infection with the epidemic clone 1 strain has never before been reported in a dog. It should be included in the differential diagnoses in immunocompromised dogs with clinical signs of septicemia.
 ...
PMID:Listeria monocytogenes septicemia in an immunocompromised dog. 2721 30

Laparoscopic pylorus-preserving pancreaticoduodenectomy (PPPD)/pancreaticoduodenectomy (PD) is cautiously regarded as a safe and effective approach in well-selected patients with periampullary cancer. However, postoperative pancreatic fistula (POPF), delayed gastric emptying (DGE), postoperative bleeding, and sepsis and detrimental complications that can follow PPPD/PD. These complications can result in poor oral intake for a significant period of nothing per oral (NPO) or deterioration of long-term function. A 65-year-old man underwent laparoscopic PPPD for ampulla of vater (AoV) cancer. After surgery, He experienced POPF, DGE, Postoperative bleeding and these complications result in poor oral intake for one month. Approximately 50 days after surgery, an abrupt confused state was noted. He had horizontal nystagmus and ataxia. Abnormal Brain magnetic resonance imaging tomography findings detected in the bilateral medial thalami, dorsal midbrain, and medulla. The association of confusion, ataxia, and horizontal nystagmus along with poor oral intake and the MRI findings suggested acute Wernicke's encephalopathy. After thiamine therapy, He recovered completely. Wernicke's encephalopathy is very rare, but it can progress coma and even death. Therefore, Wernicke's encephalopathy needs to be considered in patients with complicated PPPD/PD associated with malnutrition.
 ...
PMID:A case of Wernicke's encephalopathy following complicated laparoscopic pylorus-preserving pancreaticoduodenectomy. 3150 22