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

This is a single-case study employing positron emission tomography (PET) scanning and neuropsychological assessment on a 47-year-old male with a 15-year history of repeated respiratory and dermal exposure to high levels of organic solvents with at least 750 peak exposures (i.e., solvent "intoxication"). At age 43, he presented with neuropsychological symptoms of a solvent encephalopathy and multiple abnormalities in his peripheral neurological examination but had normal MRI and EEG findings. Four years after cessation of exposure to degreasing and solvent chemicals, the patient produced a grossly abnormal PET scan in which frontal, hippocampal, and parietal hypometabolism were particularly noteworthy. During this same 4-year period of nonexposure, modest improvements in neuropsychological testing were noted, along with substantial improvements in partial seizurelike symptoms. Frontal lobe deficits elicited in testing and from collateral interview, however, did not change. Findings suggest that repeated peak exposures to organic solvents m y result in a neurobehaviorally complex solvent syndrome caused by central nervous system damage that is readily apparent on PET scan, even though it is not evident in either imaging technologies. In addition, the case is the first reported in which functional neuroimaging was employed to study a patient with chronic solvent encephalopathy many years after cessation of solvent exposure.
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PMID:PET scan findings in a patient with a remote history of exposure to organic solvents. 1631 60

We report the case of a 32-year-old man presenting symptoms of parkinsonism. Neurological examination revealed parkinsonism symptoms such as akinesia and postural instability, dementia and frontal lobe signs. He was diagnosed as having human immunodeficiency virus (HIV) encephalopathy. Brain MRI, 99mTc ECD-SPECT and 1H-MR spectroscopy demonstrated symmetrical cerebral white matter lesions, predominantly in the bilateral frontal lobes. Frontal lobe dysfunction could be responsible for his parkinsonism associated with HIV encephalopathy. His neurological symptoms improved transiently after the initiation of HAART but fluctuated when antiretroviral drugs were changed because of their side effects. Although HAART effectively decreased plasma HIV-RNA load and increased peripheral blood CD4 cell count, his parkinsonism and dementia eventually exacerbated. Our results suggest that a combination of antiretroviral drugs affects the therapeutic efficacy against HIV encephalopathy, and that CNS symptoms could be aggravated during HAART, even when plasma HIV-RNA load and CD4 cell count are maintained under favorable conditions.
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PMID:[A patient with HIV encephalopathy presenting with parkinsonism during HAART therapy]. 1685 18

A 1-year-old girl with influenza-associated encephalopathy initially exhibited prolonged febrile convulsions and subsequent drowsiness. She became unconsciousness and experienced a cluster of seizures 4 days later. Diffusion-weighted magnetic resonance imaging (DWI) showed high signal intensity in the bilateral frontal white matter. This signal change migrated to the bifrontal cortical areas and the caudate nuclei within 10 days, when T2 elongation appeared over the gray and white matter of frontal lobes. Choreoathetosis and oculogyric crisis were transiently noted at this period. Frontal lobe signs, including the forded mouth opening response, after diminution of these movement disorders. The DWI signal change subsequently resolved and frontal cortical atrophy appeared thereafter. Levels of inflammatory cytokines in the cerebrospinal fluid were normal during the acute phase of clinical course. The biphasic clinical course with initial prolonged seizure, involvement of the frontal lobes, and the progression of signal change on DWI from white to gray matter, meets the characteristics of "status epilepticus-type acute encephalopathy" suggested by Shiomi et al. Although pentobarbital infusion, steroid pulse therapy and mild hypothermia did not show any apparent effects on the clinical course of this patient, further trial of these therapies may be warranted for the treatment of this type of encephalopathy.
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PMID:[Influenza-associated encephalopathy with onset of prolonged convulsion: a case report]. 1709 68