The role of the ipsilaterally descending motor pathways in the recovery mechanisms after unilateral hemispheric damage is still poorly understood. Motor output reorganization was investigated in a 56-year-old male pat...The role of the ipsilaterally descending motor pathways in the recovery mechanisms after unilateral hemispheric damage is still poorly understood. Motor output reorganization was investigated in a 56-year-old male patient with acquired unilateral hemispheric atrophy due to Rasmussen encephalitis. In particular,the ipsilateral corticospinal pathways were explored using focal transcranial magnetic stimulation. In the first dorsal interosseous and wrist extensors muscles, the median amplitudes of the ipsilateral motor evoked potentials induced by transcranial magnetic stimulation in the patient were higher than those of 10 age-matched healthy control subjects. In the biceps brachii muscle, the median amplitudes of the ipsilateral motor evoked potentials were the second largest in the patient compared to the controls. This study demonstrated a reinforcement of ipsilateral motor projections from the unaffected motor cortex to the hemiparetic hand in a subject with acquired unihemispheric cortical damage.展开更多
Background:Surgical treatment for patients with adult-onset Rasmussen’s encephalitis(A-RE)is rarely reported.We investigated the clinical and surgical features of two patients with A-RE who underwent functional hemis...Background:Surgical treatment for patients with adult-onset Rasmussen’s encephalitis(A-RE)is rarely reported.We investigated the clinical and surgical features of two patients with A-RE who underwent functional hemispherectomy.Case presentation:The data of clinical manifestations,neuroimaging,surgical treatment and surgical outcomes of two patients with A-RE was reviewed.The two patients initially presented with recurrent partial seizures or secondly generalized tonic clonic seizures.Gradually,the patients showed unilateral limb paralysis as well as chronic focal epileptic status.Both patients underwent functional hemispherectomy and achieved seizure freedom in the followup.The contralateral neurological deficits improved gradually after rehabilitation and were acceptable for the selfcare of daily living.The living quality improved prominently after surgery.Conclusions:Despite the risk of hemiplegia,functional hemispherectomy may be a choice for patients with A-RE for favorable seizure control and improved quality of life in selected patients.展开更多
Objective： There is no report on Bickerstaff s brainstem encephalitis （BBE） patients in China. We here report the first case of BBE in China. Methods： Clinical features, results of electromyography, eleetroencepha...Objective： There is no report on Bickerstaff s brainstem encephalitis （BBE） patients in China. We here report the first case of BBE in China. Methods： Clinical features, results of electromyography, eleetroencephalography （EEG）, magnetic resonance imaging （MRI） and cerebrospinal fluid （CSF） examination were studied to clarify the characteristics of this syndrome. Results： A 44-year-old man presented himself at our inpatient department with somnolence and dizziness as his initial symptoms. He developed multiple cranial nerves paralysis especially internal and external ophthalmoplegia, ataxia and tetraparesis within 1 week. His condition rapidly deteriorated, and he experienced coma. Electromyography showed indications of peripheral nerve dysfunction, electroencephalography revealed loss of basic rhythm, MR1 demonstrated high-intensity abnormalities on T2-weighted images of medulla oblongata, and CSF albuminocytological dissociation was defined abnormally as high protein. Ten months later, he almost completely recovered. Conclusion： BBE, fisher syndrome （FS） and Guillain-Barre syndrome （GBS） are similar clinically; BBE and FS were proposed to be the variant of GBS.展开更多
Cat scratch's disease caused by Bartonella henselae, is known to be a self-limited benign process in immunocompetent children. The association with neurologic manifestations is very uncommon especially in patient ...Cat scratch's disease caused by Bartonella henselae, is known to be a self-limited benign process in immunocompetent children. The association with neurologic manifestations is very uncommon especially in patient with no immunologic defects and in cases without specific treatment. A 7 years old male patient, without any immunocromised defect, presented an atypic presentation of the cat scratch disease. The patient came to the hospital in two opportunities in a status epilepticus, in both cases the diagnosis was encephalitis by Bartonella henselae and the evolution with treatment was monitored with PCR(polymerase chain reaction) in cerebrospinal fluid and blood, as well as IFI(IgM, IgG) serology(indirect immunofluorescence). The patient had a favorable clinical and laboratory evolution for 6 months showing no recurrence of the disease.展开更多
文摘The role of the ipsilaterally descending motor pathways in the recovery mechanisms after unilateral hemispheric damage is still poorly understood. Motor output reorganization was investigated in a 56-year-old male patient with acquired unilateral hemispheric atrophy due to Rasmussen encephalitis. In particular,the ipsilateral corticospinal pathways were explored using focal transcranial magnetic stimulation. In the first dorsal interosseous and wrist extensors muscles, the median amplitudes of the ipsilateral motor evoked potentials induced by transcranial magnetic stimulation in the patient were higher than those of 10 age-matched healthy control subjects. In the biceps brachii muscle, the median amplitudes of the ipsilateral motor evoked potentials were the second largest in the patient compared to the controls. This study demonstrated a reinforcement of ipsilateral motor projections from the unaffected motor cortex to the hemiparetic hand in a subject with acquired unihemispheric cortical damage.
基金supported by National Natural Science Foundation of China(Grant No.81771395).
文摘Background:Surgical treatment for patients with adult-onset Rasmussen’s encephalitis(A-RE)is rarely reported.We investigated the clinical and surgical features of two patients with A-RE who underwent functional hemispherectomy.Case presentation:The data of clinical manifestations,neuroimaging,surgical treatment and surgical outcomes of two patients with A-RE was reviewed.The two patients initially presented with recurrent partial seizures or secondly generalized tonic clonic seizures.Gradually,the patients showed unilateral limb paralysis as well as chronic focal epileptic status.Both patients underwent functional hemispherectomy and achieved seizure freedom in the followup.The contralateral neurological deficits improved gradually after rehabilitation and were acceptable for the selfcare of daily living.The living quality improved prominently after surgery.Conclusions:Despite the risk of hemiplegia,functional hemispherectomy may be a choice for patients with A-RE for favorable seizure control and improved quality of life in selected patients.
文摘Objective： There is no report on Bickerstaff s brainstem encephalitis （BBE） patients in China. We here report the first case of BBE in China. Methods： Clinical features, results of electromyography, eleetroencephalography （EEG）, magnetic resonance imaging （MRI） and cerebrospinal fluid （CSF） examination were studied to clarify the characteristics of this syndrome. Results： A 44-year-old man presented himself at our inpatient department with somnolence and dizziness as his initial symptoms. He developed multiple cranial nerves paralysis especially internal and external ophthalmoplegia, ataxia and tetraparesis within 1 week. His condition rapidly deteriorated, and he experienced coma. Electromyography showed indications of peripheral nerve dysfunction, electroencephalography revealed loss of basic rhythm, MR1 demonstrated high-intensity abnormalities on T2-weighted images of medulla oblongata, and CSF albuminocytological dissociation was defined abnormally as high protein. Ten months later, he almost completely recovered. Conclusion： BBE, fisher syndrome （FS） and Guillain-Barre syndrome （GBS） are similar clinically; BBE and FS were proposed to be the variant of GBS.
基金supported by the Programa Nacional de Innovación para la Competitividad y Productividad(Innóvate Perú)under the contract 116-PNICP-PIAP-2015
文摘Cat scratch's disease caused by Bartonella henselae, is known to be a self-limited benign process in immunocompetent children. The association with neurologic manifestations is very uncommon especially in patient with no immunologic defects and in cases without specific treatment. A 7 years old male patient, without any immunocromised defect, presented an atypic presentation of the cat scratch disease. The patient came to the hospital in two opportunities in a status epilepticus, in both cases the diagnosis was encephalitis by Bartonella henselae and the evolution with treatment was monitored with PCR(polymerase chain reaction) in cerebrospinal fluid and blood, as well as IFI(IgM, IgG) serology(indirect immunofluorescence). The patient had a favorable clinical and laboratory evolution for 6 months showing no recurrence of the disease.
