Is Borrelia burgdorferi responsible for the persistence of symptoms after the standard successful course of antibiotics in Lyme disease patients?This highly controversial issue,concerning the underlying mechanism of p...Is Borrelia burgdorferi responsible for the persistence of symptoms after the standard successful course of antibiotics in Lyme disease patients?This highly controversial issue,concerning the underlying mechanism of posttreatment Lyme disease syndrome(PTLDS),still seems to be a matter of intense conflict of opinion.PTLDS is the manifestation of nonspecific symptoms including fatigue,musculoskeletal pain,dysesthesias,and neurocognitive deterioration after the standard antimicrobial therapy administered to patients suffering from Lyme disease.In this article,we review the conflicting views and published highlights of recent human studies regarding PTLDS.展开更多
Scleromyxedema is a rare dermatologic disorder,characterized by erythematous or yellowish lichenoid waxy papules.Neurological manifestations are rare but well-recognized.A 51-year-old woman,diagnosed with scleromyxede...Scleromyxedema is a rare dermatologic disorder,characterized by erythematous or yellowish lichenoid waxy papules.Neurological manifestations are rare but well-recognized.A 51-year-old woman,diagnosed with scleromyxedema,was admitted to the hospital with status epilepticus,caused by brain lesions,as disclosed in a brain magnetic resonance imaging(MRI).The patient was treated with anticonvulsants and corticosteroids and gradually recovered fully.A complete remission of the lesions was shown in a follow-up brain MRI.In cases with scleromyxedema and the presence of neurological manifestations,we need to pay attention to central nervous system involvement,especially when combined with brain MRI lesions,and treat the patient appropriately.展开更多
In this paper,a 41-year-old female with previous history of ependymoma is reported.The patient underwent gross-total resection of the tumor and ventriculo-peritoneal shunt placement,followed by radiotherapy to the pos...In this paper,a 41-year-old female with previous history of ependymoma is reported.The patient underwent gross-total resection of the tumor and ventriculo-peritoneal shunt placement,followed by radiotherapy to the posterior fossa and the upper-cervical spinal cord region.Three years later she developed numbness in her right arm,body and leg.Magnetic resonance imaging(MRI)of the entire neuraxis revealed no evidence of tumor recurrence,while a small enhancing area was noted in the left anterolateral spinal cord at the level of the C1-C2 vertebrae and a left posterior-lateral herniated disk in the C5-C6 level which was not present in the earlier MRI at initial diagnosis.Lumbar punctures were negative for malignant cells.The patient’s symptoms were first attributed to radiation-induced effect.Follow-up results of brain and the cervical spine MRI were performed which showed disappearance of the small abnormality in the left C2 spinal cord area but persistence of the herniated C5-C6 disk.Thus,the current diagnosis of right-sided numbness due to pressure of the left anterolateral spinothalamic tracts from the herniated C5-C6 disk was made.This is a unique case,in which herniated disk pressuring effects needed to be differentiated from both radiation-induced treatment effect and tumor recurrence.展开更多
文摘Is Borrelia burgdorferi responsible for the persistence of symptoms after the standard successful course of antibiotics in Lyme disease patients?This highly controversial issue,concerning the underlying mechanism of posttreatment Lyme disease syndrome(PTLDS),still seems to be a matter of intense conflict of opinion.PTLDS is the manifestation of nonspecific symptoms including fatigue,musculoskeletal pain,dysesthesias,and neurocognitive deterioration after the standard antimicrobial therapy administered to patients suffering from Lyme disease.In this article,we review the conflicting views and published highlights of recent human studies regarding PTLDS.
文摘Scleromyxedema is a rare dermatologic disorder,characterized by erythematous or yellowish lichenoid waxy papules.Neurological manifestations are rare but well-recognized.A 51-year-old woman,diagnosed with scleromyxedema,was admitted to the hospital with status epilepticus,caused by brain lesions,as disclosed in a brain magnetic resonance imaging(MRI).The patient was treated with anticonvulsants and corticosteroids and gradually recovered fully.A complete remission of the lesions was shown in a follow-up brain MRI.In cases with scleromyxedema and the presence of neurological manifestations,we need to pay attention to central nervous system involvement,especially when combined with brain MRI lesions,and treat the patient appropriately.
文摘In this paper,a 41-year-old female with previous history of ependymoma is reported.The patient underwent gross-total resection of the tumor and ventriculo-peritoneal shunt placement,followed by radiotherapy to the posterior fossa and the upper-cervical spinal cord region.Three years later she developed numbness in her right arm,body and leg.Magnetic resonance imaging(MRI)of the entire neuraxis revealed no evidence of tumor recurrence,while a small enhancing area was noted in the left anterolateral spinal cord at the level of the C1-C2 vertebrae and a left posterior-lateral herniated disk in the C5-C6 level which was not present in the earlier MRI at initial diagnosis.Lumbar punctures were negative for malignant cells.The patient’s symptoms were first attributed to radiation-induced effect.Follow-up results of brain and the cervical spine MRI were performed which showed disappearance of the small abnormality in the left C2 spinal cord area but persistence of the herniated C5-C6 disk.Thus,the current diagnosis of right-sided numbness due to pressure of the left anterolateral spinothalamic tracts from the herniated C5-C6 disk was made.This is a unique case,in which herniated disk pressuring effects needed to be differentiated from both radiation-induced treatment effect and tumor recurrence.
