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

Lyme disease typically begins with a unique skin lesion, erythema chronicum migrans (ECM) (stage 1). Patients with this lesion may also have headache, meningeal irritation, mild encephalopathy, multiple annular secondary lesions, malar or urticarial rash, generalized lymphadenopathy and splenomegaly, migratory musculoskeletal pain, hepatitis, sore throat, non-productive cough, conjunctivitis, periorbital edema, or testicular swelling. After a few weeks to months (stage 2), about 15% of patients develop frank neurologic abnormalities, including meningitis, encephalitis, cranial neuritis (including bilateral facial palsy), motor or sensory radiculoneuritis, mononeuritis multiplex, or myelitis. At this time, about 8% of patients develop cardiac involvement--AV block, acute myopericarditis, cardiomegaly, or pancarditis. Throughout this stage, many patients continue to experience migratory musculoskeletal pain in joints, tendons, bursae, muscle, or bone. Months to years after disease onset (stage 3), about 60% of patients develop frank arthritis, which may be intermittent or chronic. Recently evidence suggests that Lyme disease may also be associated with chronic neurologic or skin involvement. Thus, Lyme disease occurs in stages with different clinical manifestations at each stage, but the course of the illness in each patient is highly variable.
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PMID:Clinical manifestations of Lyme disease. 355 39

Fourteen patients infected with human immunodeficiency virus (HIV) had a lymphocytic pleocytosis unexplained by secondary pathogens or neoplasms. Three men had prior diagnoses of Kaposi's sarcoma; none had acquired immune deficiency syndrome-defining opportunistic infections. Two patterns of illness were observed. Seven men had an acute, self-limited illness that was often accompanied by meningeal findings. The other seven had chronic headaches without signs of meningeal irritation and had less marked abnormalities of cerebrospinal fluid (CSF) cell count and protein. Encephalopathy was a finding in only one of 14 patients. In four of five CSF specimens studied, HIV was recovered. HIV has been associated with acute meningitis at the time of seroconversion and can apparently also cause sporadic episodes of acute or chronic meningitis in patients with prior infection and relatively preserved immune function. Both the clinical presentation with predominant headache rather than encephalopathy and the presence of CSF inflammation differentiate this syndrome from other HIV-related neurologic complications.
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PMID:Human immunodeficiency virus-associated meningitis. Clinical course and correlations. 367 88

The pathology and pathogenesis of tuberculous encephalopathy are reviewed. They confirm the findings in a smaller series previously published. The main features were: diffuse brain edema and myelin pallor in the majority of specimens; microvascular distension or necrosis with perivascular macrophage reaction and greater demyelination; focal glial nodules in the white matter; less frequently, hemorrhagic lesions in the presence of mild-to-moderate tuberculous meningitis (TM), but in the virtual absence of the commoner brain-damaging mechanisms. Focal demyelinating lesions in the nerve roots are now added to the above pathology in the brain in some of the cases of spinal tuberculous meningitis. In addition, a picture similar to that in human postinfectious allergic or experimental allergic encephalomyelitis (EAE) has emerged. The spinal cords from one case of the former condition and from four animals with EAE are described to illustrate this similarity. The pathogenesis of tuberculous encephalopathy and myeloradiculopathy is believed, as before, to be due to delayed hypersensitivity, i.e., cell-mediated immunity (CMI) to tuberculoprotein. Experimental confirmation of this demyelination as a nonspecific consequence of CMI to various forms of tubercle bacillus proteins has recently been published. In a proportion of our cases, where two episodes of TM had occurred, the possibility of a hypersensitivity reaction to the brain's own myelin protein is also considered.
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PMID:The pathology and pathogenesis of tuberculous encephalopathy and myeloradiculopathy: a comparison with allergic encephalomyelitis. 373 Nov 58

A 21 month old girl who presented with what seemed to be hypertensive encephalopathy is described. Although her encephalopathy resolved with antihypertensive treatment, subsequent investigations revealed haemophilus meningitis.
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PMID:Meningitis presenting as hypertension. 382 98

In relation to cochlear implants, the authors review the various etiologies of deafness in infancy and childhood, either genetic or acquired in order to determine the criteria for advising implantation. They put forward the necessity of complete evaluation of all the auditory pathways involved to determine if a premature who has sustained hypoxicischemic encephalopathy and a full term baby have the same chance to benefit from cochlear implants after meningitis. Defined criteria are urgent needs for patients and parents.
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PMID:[Etiological evaluation of deafness in children]. 384 49

A study of 170 patients with juvenile rheumatoid arthritis and a review of the literature indicate that this disease can significantly affect the central nervous system. Signs of CNS dysfunction were observed in 13 children. During the acute toxic stages the EEG is abnormal in many cases. Other manifestations of toxic encephalopathy such as irritability, drowsiness, stupor, convulsions and marked meningismus may be evident in severe cases. Meningitis is often suspected but ruled out by the finding of normal CSF. Steroids can rapidly improve the condition of these children. If ;unexplained' seizures occur during the chronic stage, the diagnosis of cerebral vasculitis should be entertained.
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PMID:Cerebral complications in juvenile rheumatoid arthritis. 466 94

Determination of monoamine metabolites was accomplished in the spinal fluid of 22 psychotic children and in 22 sex- and almost-age-matched "normal" controls. Also, specimens from groups of mentally retarded children and children with progressive encephalopathy or meningitis were used for comparison. The psychotic children showed raised levels of homovanillic acid. Thirteen children diagnosed as autistic by Rutter's criteria showed isolated increase of this metabolite. In the group of 9 children with other psychoses, both the level of homovanillic acid and that of 5-hydroxy-indoleacetic acid was raised. The comparison with the group of "simply" mentally retarded children and results within the psychotic group revealed that the increased concentration of monoamines was not attributable to mental retardation per se.
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PMID:Childhood psychosis and monoamine metabolites in spinal fluid. 619 18

The association between admission coma score and eventual outcome was assessed using a coma scale developed for children with a variety of central nervous system injuries. As opposed to the Glasgow coma scale, this scale does not demand assessment of verbalization, and thus can be applied to the preverbal or previously intubated child. Cortical function is graded from 6 (purposeful, spontaneous movements) to 0 (flaccid), and brainstem function is graded from 3 (intact) to 0 (absent and apneic). Maximum total score is 9. In 91 children treated for intracranial hypertension, the association was moderately good. The scale was better in predicting the outcome of patients with hypoxic encephalopathy and head trauma than that of patients with Reye's syndrome, meningitis, or encephalitis. No child with a score of less than 3 survived in spite of intensive therapy. Most of these children were flaccid with depressed or absent brainstem reflexes. No child with flaccidity on admission survived.
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PMID:Coma scale for use in brain-injured children. 650 97

A 35-year-old woman had a diffuse encephalopathy with increased intracranial pressure and chronic lymphocytic meningitis. Hypoglycorrhachia and ventricular accumulation of tracer on radionuclide brain scanning suggested an infection. Cerebral cortical and leptomeningeal biopsies were done when she failed to improve with antituberculous therapy, but were not diagnostic. Granulomatous angiitis of the nervous system was diagnosed at postmortem examination and should be considered in the differential diagnosis of culture-negative chronic meningitis.
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PMID:Granulomatous angiitis presenting as chronic meningitis and ventriculitis. 668 32

More than 300 head injuries per year are evaluated by the neurotrauma team at the Maryland Institute of Emergency Medicine. Although most of the injuries follow motor vehicle accidents, a significant number also follow industrial accidents or acts of personal violence. Approximately 25% of patients with serious head injuries have associated episodes of sepsis--commonly because of other bodily injuries. We have identified a syndrome characterized by encephalopathy and/or accentuation of focal neurological dysfunction in head injury patients that presents during episodes of sepsis and that occurs in the absence of meningitis. Aggressive fever management alone does not reverse the encephalopathy. Neurodiagnostic studies reveal no focal changes. The intracranial pressure often remains normal or unchanged, and no improvement is evident after the empirical administration of standard doses f steroid or osmotic agents. The patient's neurological condition returns to base line once the sepsis has been eradicated. Ongoing investigations suggest an immunological basis for this abnormality.
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PMID:Alterations in neurological function in head-injured patients experiencing major episodes of sepsis. 709 94


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