Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0242429 (sore throat)
 2,760 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 46-year-old healthy man suffered from sore throat, fever and right otalgia. On the next day, he developed hoarseness and difficulty in swallowing. On the 6th day, he suffered from vertigo, nausea and vomiting associated with unsteady gait. He was admitted to the otorhinolaryngology department in our hospital and pointed out to have vesicles at his right ear. On the 13th day, he was referred to our service. On admission, no vesicles were noted at the right ear or pharynx. Neurological examination revealed mild nuchal rigidity and marked hoarseness, associated with poor elevation of soft palate and loss of pharyngeal reflex on the right side. He also had horizontal-clockwise rotatory nystagmus in primary gaze and ataxic gait. There was no hearing loss nor facial palsy. No other abnormal neurological findings were noted. The cerebrospinal fluid showed pleocytosis associated with increased protein. The viral antibody titre for herpes zoster was significantly elevated on 18th day in serum as well as in cerebrospinal fluid. Vertigo, nausea, vomiting, ataxia and difficulty in swallowing were all disappeared by the 25th day, whereas hoarseness was improved but still noted 6 months later. Among cranial nerves, trigeminal and facial nerves are the most commonly affected in patients with herpes zoster, but there have been a few reported cases of the 9th and 10th cranial nerve involvement in the literature. In these previously reported cases, all were written before the era of serological diagnosis, and herpes zoster was diagnosed by the vesicles at the ear or pharynx.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of unilateral VIIIth, IXth and Xth cranial nerve involvement with herpes zoster]. 216 88

A 49-year-old woman, who presented gait disturbance, orofacial dyskinesia, choreoathetosis and slightly cloudy consciousness, was admitted to our hospital on February 7, 1986. She had a slight fever and sore throat for the previous ten days. She had been treated for hypothyroidism as well as migraine with abnormal electroencephalogram since age 47, and was given a daily dosage of 70 mg phenytoin, 80 mg phenobal, and 125 mg dried thyroid. On admission, she was somnolent, and her speech was slurred. There were choreoathetosis of all extremities, orofacial dyskinesia, horizontal nystagmus, and dysdiadochokinesis with impaired heel-knee and finger-nose test. She could not only walk but also stand by herself. The plasma level of phenytoin was above 40 micrograms/ml (normal: 10 to 20 micrograms/ml). The plasma level of phenobal was normal. T3 was 0.76 ng/dl (normal: 0.96-1.92). T4 was 3.3 micrograms/dl (normal: 5.1-12.8). Biochemical screening, liver and kidney function tests were normal. Cerebrospinal fluid, ECG, chest X-rays and brain CT were normal. Electroencephalogram showed 5 to 6 Hz moderate voltage theta waves with artifacts of electromygram due to orofacial dyskinesia. After phenytoin was discontinued, the dyskinetic movement and gait disturbance disappeared, and her consciousness became alert in parall with reduction of plasma level of phenytoin. We suggested that acute phenytoin intoxication due to low dosages of phenytoin might be precipitated by upper respiratory infection and that involuntary movements in this case might be related to hypothyroidism.
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PMID:[A case of involuntary movements probably produced by low doses of phenytoin intoxication]. 240 Nov 19

Two patients with sudden progressive profound hearing loss resulting from Ramsay Hunt syndrome are reported. Case 1: A 63-year-old woman was admitted to Jichi Medical School Hospital with sudden, progressing deafness of the left ear, vertigo, sore throat, and hoarseness. An otoscopic examination revealed the external ear and the tympanic membrane to be normal. Pure-tone audiometry revealed profound deafness in the left ear. A horizontal nystagmus in the non-affected direction was observed by gaze nystagmus test. An endoscopic examination revealed herpetic vesicles and shallow ulcers on the left side of the pharynx and the larynx. There was complete paralysis of the left recurrent nerve. Hearing acuity of the left ear did not recover at all with steroid hormone therapy. Case 2: A 75-year-old man was referred to the ENT Clinic by a dermatologist for hearing evaluation in Ramsay Hunt syndrome. The man had noticed severe otalgia and sudden progressive deafness of the right ear approximately 2 weeks prior to admission. Physical examination revealed herpetic vesicles and ulcers in the right external ear and lateral neck. Complete paralysis of the right facial nerve was noted. Profound hearing loss in the affected ear was observed by pure-tone audiometry. A gaze nystagmus test revealed a horizontal nystagmus in the non-affected direction. No recovery of the cochlear function was noted following administration of antiviral drug. The pertinent literature is briefly reviewed.
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PMID:Acute profound deafness in Ramsay Hunt syndrome. Two case reports. 285 31

Neurological manifestations of mononucleosis are extremely rare, occurring in about 1% of all cases. However, when they occur, appropriate treatment must be undertaken to ensure appropriate symptomatic management and reduce morbidity. We present the case of a 25-year-old graduate student with weeklong complaints of fever, sore throat, fatigue, nausea, and "dizziness." She later developed increased sleep requirements, ataxia, vertigo, and nystagmus with a positive EBV IgM titer confirming acute infectious mononucleosis. The patient was clinically diagnosed with EBV-associated cerebellitis and encephalitis, displaying neurological and psychiatric impairment commonly seen in postconcussion syndrome. MRI showed no acute changes. She was started on valacyclovir and a prednisone taper, recovering by the end of twelve weeks. Though corticosteroids and acyclovir are not recommended therapy in patients presenting with EBV-associated ataxia, clinicians may want to keep a low threshold to start these medications in case more serious neurological sequelae develop.
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PMID:Ataxia and Encephalitis in a Young Adult with EBV Mononucleosis: A Case Report. 2378 57