RTT girls suffer periods of abnormal behavior from early infancy, including irritability and sleep disorders or anxiety in the first years of life, and a more depressed mood after adolescence, all of which influences ...RTT girls suffer periods of abnormal behavior from early infancy, including irritability and sleep disorders or anxiety in the first years of life, and a more depressed mood after adolescence, all of which influences their quality of life. An association between emotional and behavioral disorders and various neurochemical changes in the synapses of cortical and subcortical brain regions has been established;also, cortisol levels in the blood vary during stress. The main purpose of this study was to improve mood and behavior disorders in RTT patients with venlafaxine (SNRI), and compare the results with citalopram (SSRIs) during 6 - 8 weeks, to determine which drug offered greater efficacy and fewer side effects, as well as to compare them to risperidone, and to correlate cortisol levels in saliva with stress and drug response. Eleven patients, aged 5 to 26 years old, agreed to participate in this study;neuropsychological tests (Mullen and Vineland scales), quality of life and quality of sleep scales, blood tests, EKG and EEG were performed before and after treatment. Only 2 patients completed the three months trial. Improvement in mood and behavior was not statistically significant for patients;differences in neurodevelopment and quality of life or sleep scales were not significant either;no serious adverse effects were observed. Cortisol levels in saliva decreased in 50% of the patients after the first month of treatment, although this was not statistically significant.展开更多
Progressive multifocal leukoencephalopathy (PML) is a severe demyelinating disease of the central nervous system caused by the John Cunningham (JC) virus typically seen in immuno-compromised patients. Several drugs th...Progressive multifocal leukoencephalopathy (PML) is a severe demyelinating disease of the central nervous system caused by the John Cunningham (JC) virus typically seen in immuno-compromised patients. Several drugs that suppress that immune system have already been known to cause PML such as natalizumab and rituximab. We present a patient with sarcoidosis who develops PML in the rare setting of minimal immunosuppression with only hydroxychloroquine. There was significant delay in the diagnosis due to negative cerebrospinal fluid testing for JC virus and concern for neuro-sarcoidosis, but eventually a diagnosis of PML was made via brain biopsy.展开更多
文摘RTT girls suffer periods of abnormal behavior from early infancy, including irritability and sleep disorders or anxiety in the first years of life, and a more depressed mood after adolescence, all of which influences their quality of life. An association between emotional and behavioral disorders and various neurochemical changes in the synapses of cortical and subcortical brain regions has been established;also, cortisol levels in the blood vary during stress. The main purpose of this study was to improve mood and behavior disorders in RTT patients with venlafaxine (SNRI), and compare the results with citalopram (SSRIs) during 6 - 8 weeks, to determine which drug offered greater efficacy and fewer side effects, as well as to compare them to risperidone, and to correlate cortisol levels in saliva with stress and drug response. Eleven patients, aged 5 to 26 years old, agreed to participate in this study;neuropsychological tests (Mullen and Vineland scales), quality of life and quality of sleep scales, blood tests, EKG and EEG were performed before and after treatment. Only 2 patients completed the three months trial. Improvement in mood and behavior was not statistically significant for patients;differences in neurodevelopment and quality of life or sleep scales were not significant either;no serious adverse effects were observed. Cortisol levels in saliva decreased in 50% of the patients after the first month of treatment, although this was not statistically significant.
文摘Progressive multifocal leukoencephalopathy (PML) is a severe demyelinating disease of the central nervous system caused by the John Cunningham (JC) virus typically seen in immuno-compromised patients. Several drugs that suppress that immune system have already been known to cause PML such as natalizumab and rituximab. We present a patient with sarcoidosis who develops PML in the rare setting of minimal immunosuppression with only hydroxychloroquine. There was significant delay in the diagnosis due to negative cerebrospinal fluid testing for JC virus and concern for neuro-sarcoidosis, but eventually a diagnosis of PML was made via brain biopsy.
