Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0344232 (blurred vision)
 2,072 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Tuberculosis usually involves the brain through haematogenous spread. The mass lesion caused by tuberculosis in the brain is called tuberculoma, which is a conglomerate of tubercles. Tuberculomas may also be found in the spinal cord. Because of their slow growth they often become calcified. The study was conducted at the King Fahad Hospital, Hofuf, Al Hassia, Saudi Arabia between 1992 and 1998. It was a prospective study of all patients which had intracrainal mass lesions which showed typical ring-enhancement on brain CT scan with contrast. Twenty patients satisfied inclusion into the study. Of the 20 patients studied, 19 (95%) were males and 1 (5%) was a female. The ages ranged between 22 and 50 years. Eighteen (90%) of the patients were immigrant labourers from Asia and 2 (10%) were Saudi nationals, a male aged 50 years and a female aged 22 years. Fifteen (83.5%) were from India, 2 (11.1%) from Bangladesh, and 1 (5.6%) from Sri Lanka. The presenting feature in 60% of cases was focal seizure with secondary generalisation. 20% had primary generalized seizures, and 30% presented with headache, 25% with weakness of the limbs, 15% with fever and 10% each with vomitting and blurred vision, respectively. In 65% of cases, there was noneurological deficit but 35% had pyramidal weakness in the limbs. In 55% of cases the Tuberculomas were located in the left cerebral hemisphere. 30% in the right cerebral hemisphere and in 15%, the lesions were in both hemisphere. When a male Asian immigrant labourer aged between 20 and 40 years presents with seizures with or without headache, he should have a brain CT scan with contrast to exclude intracranial Tuberculoma. A short course of anti-tuberculous therapy may be tried where there is doubt, irrespective of normal erythrocyte sedimentation rate (ESR). We suggest that when the presenting symptom is primary generalized tonic clonic seizure, the intracranial Tuberculoma is located in the frontal lobe: a high erythrocyte sedimentation rate (ESR) may indicate multiple Tuberculomas.
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PMID:Intracranial tuberculomas: the Hofuf, Saudi Arabia experience. 1720 23

Just after Caesarean section for twin pregnancy and feto-pelvic dysproportion, a woman presented severe headaches and arterial hypertension, then blurred vision, then generalised seizures. There were no oedematous syndrome, proteinuria was negative, ASAT were 1.5 N and platelet count was 120,000/mm(3). Cerebral CT-scan was normal. Posterior reversible encephalopathy syndrome (PRES) was diagnosed on MRI. A second MRI performed at day 9 showed complete regression of cerebral lesions, while patient was taking anti-hypertensive and antiepileptic drugs. PRES has to be evoked in post-partum central neurological symptoms, even in absence of classical sign of pre-eclampsia, like proteinuria. PRES and eclampsia share probably common physiopathological pathways. There management and prognosis seems identical.
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PMID:[Isolated severe neurologic disorders in post-partum: posterior reversible encephalopathy syndrome]. 1757 73

Asthma and chronic obstructive pulmonary disease (COPD) are common disorders that are associated with increasing morbidity and mortality in older people. Bronchodilators are used widely in patients with these conditions, but even when used in inhaled form can have systemic as well as local effects. Older people experience more adverse drug effects because of pharmacodynamic and pharmacokinetic changes and particularly drug-drug and drug-disease interactions. Cardiovascular disease is common in older people and beta-adrenoceptor agonists (beta-agonists) have inotropic and chronotropic effects that can increase arrhythmias and cardiomyopathy. They can also worsen or induce myocardial ischaemia and cause electrolyte disturbances that contribute to arrhythmias. Tremor is a well known distressing adverse effect of beta-agonist administration. Long-term beta-agonist use can be associated with tolerance, poor disease control, sudden life-threatening exacerbations and asthma-related deaths. Functional beta2-adrenoceptors are present in osteoblasts, and chronic use of beta-agonists has been implicated in osteoporosis. Inhaled anticholinergics are usually well tolerated but may cause dry mouth, which can be troublesome in older people. Pupillary dilatation, blurred vision and acute glaucoma can occur from escape of droplets from loosely fitting nebulizer masks. Although ECG changes have not been seen in randomized controlled trials of long-acting inhaled anticholinergics, supraventricular tachycardias have been observed in a 5-year randomized controlled trial of ipratropium bromide. Paradoxical bronchoconstriction can occur with inhaled anticholinergics as well as with beta-agonists, but tolerance has not been reported with anticholinergics. Anticholinergic drugs also cause central effects, most notably impairment of cognitive function, and these effects have been noted with inhaled agents. Use of theophylline is limited by its adverse effects, which range from commonly occurring gastrointestinal symptoms to palpitations, arrhythmias and reports of myocardial infarction. Seizures have been reported, but are rare. Theophylline is metabolized primarily by the liver, and commonly interacts with other medications. Its concentration in plasma should be monitored closely, especially in older people. Although many clinical trials have been conducted on bronchodilators in obstructive airways disease, the results of these clinical trials need to be interpreted with caution as older people are often under-represented and subjects with co-morbidities actively excluded from these trials.
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PMID:Potential adverse effects of bronchodilators in the treatment of airways obstruction in older people: recommendations for prescribing. 1844 5

Reversible posterior leukoencephalopathy syndrome (RPLS) is an acute form of cerebrovascular injury that has been described recently in the setting of uncontrolled hypertension, puerperal eclampsia, or treatment with certain immunosuppressive drugs, including cyclosporine. It is reversible if treated promptly. Two patients with systemic lupus erythematosus (SLE), renal failure, and uncontrolled hypertension developed acute cerebrovascular symptoms; one had seizures and the other had headache and blurred vision. Both patients showed abnormal predominantly posterior lobe findings on neuroimaging films. The patients' symptoms and imaging abnormalities resolved completely with prompt correction of their hypertension and concomitant treatment with corticosteroids. RPLS should be recognized in SLE patients with uncontrolled hypertension and renal failure who present with headaches, seizures, cortical blindness, and other visual abnormalities. Prompt treatment with control of hypertension and withdrawal of precipitating drugs may be most important and can prevent permanent neurologic damage.
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PMID:Reversible posterior leukoencephalopathy syndrome in systemic lupus erythematosus. 1907 72

A 50-year-old male presented with a recurrent epidermoid cyst with malignant transformation into squamous cell carcinoma. The patient was first hospitalized for intermittent seizures in 2000. Computed tomography (CT) showed a hypodense lesion with enhanced capsule but no peripheral edema in the right temporal lobe. Craniotomy was performed and the lesion was completely removed. The histological diagnosis was epidermoid cyst. Six years later, the patient experienced blurred vision and hemiparesis in the left extremities. CT showed a hyperdense mass with peripheral edema in the right temporal lobe. Repeat CT 2 months later revealed a larger mass. The recurrent lesion was removed, and the histological diagnosis was squamous cell carcinoma. Intracranial epidermoid cyst is a benign tumor which often appears hypodense on CT, so change to hyperdensity in the recurrent tumor may indicate malignant transformation.
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PMID:Recurrent epidermoid cyst with malignant transformation into squamous cell carcinoma. 1977 95

Sarcoidosis is a chronic disease of unknown aetiology. Neurosarcoidosis is registered in 5% of patients with sarcoidosis. Clinical manifestations of sarcoidosis are numerous and diverse. Manifestation of Neurosarcoidosis includes partial- and grand-mal seizures, low-grade fever, headache, increased intracranial pressure, visual disturbances, diabetes insipidus, amenorrhea- galacterorrhea syndrome and pituitary failure, hypogonadotropic hypogonadism, hyperprolactinemia, unilateral and bilateral facial palsy, infiltration of meninges (aseptic meningitis) and nerve roots, leptominingitis, pachymeningitis with cranial neuropathies, pseudotumor, mild cognitive disorder, psychosis, delirium, dementia, disorientation, amnesia, progressive visual deterioration and proptosis, axonal polyneuropathies, mononeuropathies, chronic polyradiculoneuritis, peripheral neuropathy, cranial nerve abnormalities, radiculopathies, peripheral neuropathy, mononeuritis multiplex, progressive numbness and deep sensation disturbance in bilateral lower extremities, hemiplegia, hyperreflexia with pathological reflexes and hypesthesia, upward gaze palsy, spinal cord compression, dysarthria, dysphagia, weakness, episodes of blurred vision, diplopia, intracerebral hemorrhage, neuro-ophthalmic manifestations, intranuclear ophthalmoplegia, dysorientation, vasculitis presenting with strokes, intracranial hypothalamic lesion, paresthesis, hemiparesis, myelopathy in the cervico-thoracic region, lumbar pain, sensory level and inability of lateral gaze (Tab. 2, Ref. 60).
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PMID:Clinical manifestations of neurosarcoidosis. 1982 43

Toxic leukoencephalopathy has been more thoroughly investigated during the last decade because of the advance of magnetic resonance imaging (MRI) techniques. We analyzed fludarabine (Flu)-associated hematopoietic cell transplantation (HCT), resulting in severe leukoencephalopathy (n = 39/1596, 2.4%), and describe 3 clinical syndromes with unique clinical and radiographic characteristics. Posterior reversible encephalopathy syndrome (PRES) presents predominantly with seizures, persistent headache, and vision changes, along with variable mental status alterations. PRES is likely to be reversible, particularly after withholding cyclosporine (CsA). Acute toxic leukoencephalopathy (ATL) presents with cognitive dysfunction, decreased levels of consciousness, and vision changes. Other leukoencephalopathy (OLE) includes patients who behave similar to the ATL group, but with less prominent deep white matter changes on MRI. ATL and OLE are less likely to be reversible. The neurologic syndromes correlate with different MRI patterns. In PRES, subcortical and cortical involvement on MRI is associated with seizure, blurred vision, and dysarthria versus ATL and OLE, which involve deep white matter and cause mainly cognitive dysfunction. The different syndromes also carry different prognoses. All patients with Flu-associated encephalopathy had a median overall survival of only 169 days. Those with ATL had shorter overall survival (median 66 days) than patients with PRES (median 208 days). Potential risk factors for Flu-associated encephalopathy were older age, poor renal function, Flu dose, previously treated central nervous system (CNS) disease, or previous Flu-based transplant conditioning. Additional risk factors for PRES CNS toxicity are CsA use and acute hypertension. Flu pharmacokinetic studies may be useful to reduce life-threatening Flu-associated risks of neurotoxicity.
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PMID:Toxic leukoencephalopathy following fludarabine-associated hematopoietic cell transplantation. 2039 78

Background. Cervicocephalic arterial dissection (CCAD) is rare in the postpartum period. To our knowledge this is the first reported case of postpartum angiopathy (PPA) presenting with ischemic stroke due to intracranial arterial dissection. Case. A 41-year-old woman presented with blurred vision, headache, and generalized seizures 5 days after delivering twins. She was treated with magnesium for eclampsia. MRI identified multiple posterior circulation infarcts. Angiography identified a complex dissection extending from both intradural vertebral arteries, through the basilar artery, and into both posterior cerebral arteries. Multiple segments of arterial dilatation and narrowing consistent with PPA were present. Xenon enhanced CT (Xe-CT) showed reduced regional cerebral blood flow that is improved with elevation in blood pressure. Conclusion. Intracranial vertebrobasilar dissection causing stroke is a rare complication of pregnancy. Eclampsia and PPA may play a role in its pathogenesis. Blood pressure management may be tailored using quantitative blood flow studies, such as Xe-CT.
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PMID:Intracranial vertebrobasilar artery dissection associated with postpartum angiopathy. 2070 Apr 23

Neurologic complications of post-partum are serious and usually secondary to eclampsia or stroke. We here report a 26-year-old female who presented with severe headaches, blurred vision, and repeated generalized seizures secondary to posterior reversible encephalopathy that occurred after a caesarean section for fetal death in utero. Outcome was favourable. Although uncommon, this neurologic complication of the post-partum should be discussed in the presence of any sign of encephalopathy occurring in the context of acute hypertension.
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PMID:[Unusual leukoencephalopathy of post-partum]. 2088 89

Partial epilepsy comprises simple partial seizures, complex partial seizures, and secondarily generalized seizures, and covers more than 60% of patients with epilepsy. Antiepileptic drugs are generally considered to be the major therapeutic intervention for epilepsy but, despite a broad range of commonly used antiepileptic drugs, approximately 30% of adult patients and approximately 25% of children with epilepsy have inadequate seizure control. Eslicarbazepine acetate (ESL) is a novel voltage-gated sodium channel-blocking agent with presumed good safety and efficacy for adjunctive treatment of patients with drug-resistant partial epilepsy. ESL is a prodrug of eslicarbazepine (the active entity responsible for pharmacologic effects), and is rapidly and extensively hydrolyzed during first pass by liver esterases after oral administration. The half-life of eslicarbazepine at steady-state plasma concentrations is 20-24 hours, compatible with once-daily administration. ESL 800 mg and 1200 mg significantly reduces seizure frequency and shows a favorable safety profile in adult patients with drug-resistant partial-onset seizures, as demonstrated in previous Phase II and III trials. In children, ESL showed a clear dose-dependent decrease in seizure frequency with good tolerability. The most commonly reported adverse events associated with ESL are dizziness, somnolence, nausea, diplopia, headache, vomiting, blurred vision, vertigo, and fatigue. In conclusion, these characteristics suggest that ESL might be a valid and well tolerated treatment option for patients with drug-resistant partial-onset epilepsy. The convenience of once-daily dosing and a short, simple titration regimen would be of special interest for children, although conclusive published data are lacking to date. Hence, there is an urgent need to establish the therapeutic value of ESL in this special population in the near future.
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PMID:Update on treatment of partial onset epilepsy: role of eslicarbazepine. 2112 91


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