Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P50583 (asymmetrical)
 12,197 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Listerial brainstem encephalitis is a rare disease. Only 62 cases have been reported previously; all were in adults, only 8% of whom were immunosuppressed. The disease has a characteristic biphasic course: a nonspecific prodrome of headache, nausea or vomiting, and fever lasting for several days is followed by progressive asymmetrical cranial-nerve palsies, cerebellar signs, hemiparesis or hypesthesia, and impairment of consciousness. Neck stiffness was initially present in only 55% of the cases described thus far. Studies of cerebrospinal fluid often revealed only mild abnormalities. Cultures of cerebrospinal fluid and blood were positive in 41% and 61% of cases, respectively. Respiratory failure occurred in 41% of cases. Initial computed tomography of the brain often gave normal results; magnetic resonance imaging better demonstrated brainstem abnormalities. Overall mortality was 51%. All untreated patients died. When treatment with ampicillin or penicillin was initiated early, the rate of survival was > 70%; however, neurological sequelae developed in 61% of survivors.
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PMID:Brainstem encephalitis (rhombencephalitis) due to Listeria monocytogenes: case report and review. 850 61

This report concerns a 51-year-old right-handed man with Japanese encephalitis, showing left hemiplegia and left hemispatial neglect. On admission, he had a slight fever, mild consciousness disturbance, left hemiplegia, and left hemispatial neglect but no neck stiffness, headache nor nausea. He was treated on the basis of cerebral infarction, but his fever and consciousness disturbance worsened. We found pleocytosis (145/mm3) in the cerebrospinal fluid (CSF) and right thalamic edema on a brain CT scan obtained 4 days later. He was finally diagnosed as having Japanese encephalitis on the basis of an increase in anti-viral antibodies observed in paired CSF and serum samples. In the exacerbation phase, 123I-IMP single photon emission CT (SPECT) demonstrated a marked decrease in cerebral perfusion in the right hemisphere, while a brain MRI revealed irregular lesions localized the right thalamus (mainly posterior and medial parts), showing low intensity on T1-weighted and high intensity on T2-weighted images. In the recovery phase, asymmetrical perfusion was no longer observed on SPECT and the symptoms including the left hemispatial neglect had improved. These findings suggest that the left hemispatial neglect in this patient might been caused by the right thalamic lesion resulting in damage to the activating system of the right hemisphere. This case thus shows that acute onset of hemispatial neglect could be caused by cerebral encephalitis.
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PMID:[Japanese encephalitis presenting with left hemiplegia and thalamic neglect--a case report]. 1125 92

Central Nervous System (CNS) infections like meningitis and cerebral abscess caused by Staphylococcus aureus are usually seen in patients with neurosurgical interventions or immune compromised patients or patients with cardiac vegetation's. They are extremely rare in healthy patients. We report a case of a 44 year old Indian gentleman who was perfectly healthy with no known co morbidities, which presented with fever, neck stiffness and altered mental status. He had fulminant staph bacteraemia (as evidenced by persistently positive blood cultures) with meningitis and cerebral abscess. Extensive search was made to find the source of infection, but it was inconclusive. Isolated CNS Methicillin Sensitive Staphylococcus aureus (MSSA) infection in an apparently healthy patient is very rare. This gentleman presented with altered mental status, asymmetrical exophthalmos and multiple cranial nerve palsies. This case highlights the challenge of making early diagnoses of a brain abscess; since it has symptomology mimicking cavernous sinus thrombosis .This is due to the involvement of the cerebellopontine angle and extensive brain oedema and oedema of the retro bulbar tissues.
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PMID:COMMUNITY ACQUIRED METHICILLIN SENSITIVE STAPHYLOCCUS AUREUS CEREBRAL ABSCESS IN A PREVIOUSLY HEALTH GENTLEMAN MIMICKING SIGNS OF CAVERNOUS SINUS THROMBOSIS-A UNIQUE PRESENTATION. 2618 90