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Query: UMLS:C0085584 (encephalopathy)
 18,178 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The emphasis upon the remarkably large number of cases of Guillain-Barre syndrome which resulted from the 1976 National Swine Influenza immunization program in the U.S.A. has obscured the fact that other neurological complications, involving the central nervous system also occurred. The anatomical distribution of lesions is almost identical with that seen following other types of vaccination: involvement of the brain, cerebellum, optic nerve, cranial nerves and spinal cord occurred with approximately the same frequency. 5 instances of the very rare subacute or chronic, progressive, post-vaccinal encephalopathy are described, a situation which is identical to the subacute and chronic forms of polyradiculoneuropathy. In a number of cases, in particular the myelopathies, a subclinical involvement of peripheral nerves was demonstrated by means of electrodiagnostic studies, illustrating the often overlooked fact that central nervous system involvement will mask peripheral nerve lesions. The etiological significance of the swine influenza vaccination was overlooked and completely erroneous diagnoses were established in a surprisingly large number of the 26 new cases reported here.
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PMID:Neurological complications of swine influenza vaccination. 612 62

Thiamine deficiency is known to lead to certain neurological sequelae including Wernicke- Korsakoff encephalopathy. Signs attributable to this condition include ataxia, ophthalmoplegia, nystagmus, and mental confusion. Recognised predisposing conditions include alcoholism gastric carcinoma, pyloric obstruction, hyperemesis gravidarum, and prolonged intravenous feeding. We have recently encountered two cases of Wernicke's encephalopathy after vertical banded gastroplasty for morbid obesity . Other neurological sequelae are recognised after vertical banded gastroplasty, including Guillain-Barre syndrome, psychosis, and pseudoathetosis, but the causes are multifactorial.
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PMID:Wernicke's encephalopathy after vertical banded gastroplasty for morbid obesity. 863 78

This report provides updated information concerning the potential adverse events associated with vaccination for hepatitis B, poliomyelitis, measles, mumps, diphtheria, tetanus, and pertussis. This information incorporates findings from a series of recent literature reviews, conducted by an expert committee at the Institute of Medicine (IOM), of all evidence regarding the possible adverse consequences of vaccines administered to children. This report contains modifications to the previously published recommendations of the Advisory committee on Immunization Practices (ACIP) and is based on an ACIP review of the IOM findings and new research on vaccine safety. In addition, this report incorporates information contained in the "Recommendations of the Advisory Committee on Immunization Practices: Use of Vaccines and Immune Globulins in Persons with Altered Immunocompetence" (MMWR 1993;42[No. 44-4]) and the "General Recommendations on Immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP)" (MMWR 1994;43[No. RR-1]). Major changes to the previous recommendations are highlighted within the text, and specific information concerning the following vaccines and the possible adverse events associated with their administration are included: hepatitis B vaccine and anaphylaxis, measles vaccine and a) thrombocytopenia and b) possible risk for death resulting from anaphylaxis or disseminated disease in immunocompromised persons; diphtheria and tetanus toxoids and pertussis vaccine (DTP) and chronic encephalopathy; and tetanus-toxoid-containing vaccines and a) Guillain-Barre syndrome, b) brachial neuritis, and c) possible risk for death resulting from anaphylaxis. These modifications will be incorporated into more comprehensive ACIP recommendations for each vaccine when such statements are revised. Also included in this report are interim recommendations concerning the use of measles and mumps vaccines in a) persons who are infected with human immunodeficiency virus and b) persons who are allergic to eggs; ACIP is still evaluating these recommendations.
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PMID:Update: vaccine side effects, adverse reactions, contraindications, and precautions. Recommendations of the Advisory Committee on Immunization Practices (ACIP) 880 42

Influenza viruses rarely cause acute encephalopathy. Post-influenzal encephalitis, which occurs a few weeks after recovery from influenza is thought to be an autoimmune process associated with demyelination and vasculopathy. It has been suggested that Economo lethargic encephalitis followed by postencephalitic Parkinsonism was associated with the influenza A epidemic of 1918 (Spanish flu). The incidence of Reye's syndrome has markedly decreased due to the avoidance of salicylates in the treatment of influenza or varicella. One inactivated flu vaccine is thought to have caused Guillain Barre syndrome due to molecular mimicry between viral protein and myelin, which triggered autoimmune responses. The persistence of influenza virus genes in neural cells as one of the causes of chronic degenerative diseases of the central nervous system by inducing apoptosis of the host cells is yet to be proven.
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PMID:Influenza virus and neurological diseases. 931 61

We report the case of a 73-year-old man who developed an acute encephalopathy during IVIg therapy for AIDP. The signs and symptoms of the encephalopathy completely resolved after discontinuation of the treatment. We also reviewed the literature over the major neurological complications of IVIg therapy, including aseptic meningitis, cerebral infarction, and acute encephalopathy. About 30 cases of aseptic meningitis are reported. They are probably related to an immunoallergic reaction, caused by the entry of the exogenous IgG into the CSF compartment. CSF examinations usually show a neutrophilic or a mixed pleocytosis. Three cases of cerebral infarction and 2 patients with acute encephalopathy, following IVIg therapy, were also reported in the literature. Cerebral vasospasm, cerebral vasculitis, and/or serum hyperviscosity may be implicated in the pathogenesis of these neurological complications. There is a clinical similarity between these IVIg-related encephalopathy and the "reversible posterior leukoencephalopathy syndrome", described by Hinchey et al., 1996.
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PMID:Neurological complications of intravenous immunoglobulin (IVIg) therapy: an illustrative case of acute encephalopathy following IVIg therapy and a review of the literature. 992 23

We report the case of a 43-year-old man who developed an acute encephalopathy after IVIg therapy for AIDP. Imaging studies showed predominantly posterior leukoencephalopathy. The signs and symptoms of the encephalopathy completely resolved by steroids. Two patients with acute encephalopathy, following IVIg therapy, were reported previously in the literature. However, our observation differed from them by the presence of a marked pleiocytosis of cephalospinal fluid before beginning of IgIV. Two hypothesis may be made: a post-infectious meningo-encephalo-AIDP or a complication of IgIV. This side effect, even rare, has not to be underestimated.
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PMID:[Acute encephalitis complicating acute polyradiculoneuritis]. 1198 91

Neurological involvement during influenza infection has been described during epidemics and is often consistent with serious sequelae or death. An increasing incidence of influenza-associated encephalitis/encephalopathy has been reported in Japan, mainly in children. A variety of other clinical CNS manifestations, such as Reye's syndrome, acute necrotising encephalopathy (ANE), and myelitis as well as autoimmune conditions, such as Guillain-Barre's syndrome, may occur during the course of influenza infection. Virological diagnosis is essential and based on virus isolation, antigen detection, RNA detection by PCR, and serological analyses. Neuroimaging with CT and MRI of the brain are of prognostic value. The pathogenic mechanisms behind the influenza CNS complications are unknown. The treatment is symptomatic, with control of vital functions in the intensive care unit, antiepileptic medication and treatment against brain oedema.
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PMID:Influenza virus and CNS manifestations. 1452 59

Celiac disease (CD) long has been associated with neurologic and psychiatric disorders including cerebellar ataxia, peripheral neuropathy, epilepsy, dementia, and depression. Earlier reports mainly have documented the involvement of the nervous system as a complication of prediagnosed CD. However, more recent studies have emphasized that a wider spectrum of neurologic syndromes may be the presenting extraintestinal manifestation of gluten sensitivity with or without intestinal pathology. These include migraine, encephalopathy, chorea, brain stem dysfunction, myelopathy, mononeuritis multiplex, Guillain-Barre-like syndrome, and neuropathy with positive antiganglioside antibodies. The association between most neurologic syndromes described and gluten sensitivity remains to be confirmed by larger epidemiologic studies. It further has been suggested that gluten sensitivity (as evidenced by high antigliadin antibodies) is a common cause of neurologic syndromes (notably cerebellar ataxia) of otherwise unknown cause. Additional studies showed high prevalence of gluten sensitivity in genetic neurodegenerative disorders such as hereditary spinocerebellar ataxia and Huntington's disease. It remains unclear whether gluten sensitivity contributes to the pathogenesis of these disorders or whether it represents an epiphenomenon. Studies of gluten-free diet in patients with gluten sensitivity and neurologic syndromes have shown variable results. Diet trials also have been inconclusive in autism and schizophrenia, 2 diseases in which sensitivity to dietary gluten has been implicated. Further studies clearly are needed to assess the efficacy of gluten-free diet and to address the underlying mechanisms of nervous system pathology in gluten sensitivity.
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PMID:Neurologic presentation of celiac disease. 1582 33

Patients with Leigh syndrome classically present in early childhood with developmental regression, ataxia, and hypotonia with subsequent respiratory and brainstem dysfunction. However, the clinical presentation can be highly variable. This report presents five cases of Leigh syndrome with atypical presentations. The first patient is a 17-month-old female who presented with progressive limb weakness diagnosed as Guillain-Barre syndrome. Postmortem examination demonstrated Leigh syndrome confined to the spinal cord. The case series then describes two sisters one of whom presented at 11 years of age with central respiratory failure and encephalopathy. Her 15-year-old sister presented with a progressive diplegia. The fourth patient presented with bronchiolitis and apnea at 3 months of age due to bilateral brainstem lesions. Her second cousin presented at 6 months of age with hypotonia, blindness, and tonic seizures. All patients had laboratory and radiologic findings consistent with Leigh syndrome. Evidence of spinal cord involvement was observed on magnetic resonance imaging in four of the five patients. Leigh syndrome can involve any level of the neuroaxis, resulting in a wide variety of presentations. Many atypical variants are observed, of which clinicians should be aware. Evidence of brainstem or spinal cord involvement should also be sought in patients with Leigh syndrome.
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PMID:Atypical presentations of leigh syndrome: a case series and review. 1586 34

The authors of the article describe two cases of hemorrhagic fever with renal syndrome (HFRS) with prevalence of signs of nervous system involvement. The first case was a 40-year-old woman with moderate HFRS, who developed Guillain-Barre syndrome of axonal-demyelinating polyneuropathy. An important observation was the absence of hemorrhagic or renal syndrome; combined therapy including plasmapheresis was successful. The second case demonstrated polymorphism of HFRS clinical manifestations with prevalence of neurological symptoms, which consisted in encephalopathy and no renal failure signs; hemorrhagic syndrome was moderate. In both cases the diagnosis was confirmed by elevated titer of antibodies to HFRS virus, belonging to the group of hantaviruses.
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PMID:[Nervous system involvement in hemorrhagic fever with renal syndrome]. 1650 29


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