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

In perioperative settings where a patient under general anesthesia, presentation of serotonin syndrome might be far from the "classical" description of this potentially fatal condition. A patient who manifested signs of serotonin toxicity during an intravenous anesthetic, remifentanil, is presented. At the time of surgery, the patient was being treated with tramadol for pain management. The patient displayed myofasciculations on both gastrocnemius muscles confirmed electromyographically. All other conventional signs of serotonin syndrome were absent except hypotension and nystagmus. A presumptive diagnosis of serotonin syndrome was made intraoperatively. The symptoms resolved once remifentanil infusion was discontinued in the operating room without incident. Mild-to-moderate perioperative serotonin syndrome may manifest with myofasciculations in gastrocnemius muscles in the settings of no neuromuscular blockade. In spinal surgeries involving intraoperative EMG monitoring, the neuromonitoring team should be aware of this presentation and include serotonin syndrome in the differential diagnosis of unexplained EMG activity.
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PMID:Perioperative Serotonin Syndrome Manifesting as Gastrocnemius Myofasciculations: A Case Report. 3300 15

Vertebral Artery Dissection (VAD) is a rare condition that can be caused by a wide amplitude of neck movement, which injures the vessel wall and can cause ischemia in the cerebellum. We present a 37-year-old man with herniated lumbar disc and allergic rhinosinusitis, which caused sneezing spells. After one of these bouts with a ricochet of the head, he presented C3 misalignment with local pain. Twenty-one days later, affected by a new crisis, he presented left temporal headache, nystagmus, and vertigo. After 3 days, Magnetic Resonance Imaging (MRI) identified 2 regions of cerebellar ischemia and filling failure of the right vertebral artery. After 2 days, Computed Angiotomography (CT Angiography) was performed and showed right VAD with a local thrombus, without aneurysmal signs. Transcranial Doppler did not indicate an increase in blood flow from this artery. The suggested treatment involved administration of anticoagulant Apixabana 5mg, 12/12h, for 3 months, until the condition was reevaluated with new Angio CT and MRI. It was recommended that the patient was released from work for 1 month and forbidden from doing intense physical exercises for 3 months; however, due to setbacks, these deadlines were extended until a new appointment, 4 months after the first visit. The new tests showed no changes, indicating that the condition was stable. This case aims to indicate the possible investigations of the diagnosis and therapeutic options of the rare association between VAD with cerebellar infarction in a well-documented case.
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PMID:Cerebellar infarction after sneezing. 3317 25


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