Abstract Vogt-Koyanagi-Harada syndrome (VKHS) is an inflammatory syndrome affecting melanocyte-containing organs. The clinical onset is often acute with neurological and ophthalmological symptoms and there is considerable risk of sequelae if the condition is not promptly diagnosed and treated. We present a case illustrating that VKHS is a rare but important ...

Cryptococcus neoformans has a worldwide distribution. Meningoencephalitis is the most common manifestation of cryptococcosis. The outcome of a patient with cryptococcal infection depends on the immune status of the host. Patients with nephrotic syndrome are particularly susceptible to cryptococcal infection not only due to innate changes in their immune system ...

Haemolytic uraemic syndrome is an important cause of acute renal impairment in childhood. We review the incidence, and clinical and laboratory features of haemolytic uraemic syndrome in a Chinese population. Five patients were identified from 2006 to 2008. All patients were young children with associated invasive Streptococcus pneumoniae pulmonary infection. ...

Waterhouse-Friderichsen syndrome is one of the fatal complications of meningococcal infection. Here we report a fatal case of this syndrome due to Neisseria meningitidis in a 29-year-old male patient who was admitted with high-grade fever and chills and vomiting since 7 days, a skin rash over the abdomen and trunk, ...

Purpose. Abetalipoproteinemia is a very rare disease with multisystemic manifestations. Methods. Retrospective, case report. Results. We report a 9-year-old girl with a history of Bassen-Kornzweig syndrome diagnosed at the age of 3. The patient was referred to us by the pediatricians for ocular assessment. During the examination, an atypical pigmentary ...

Simultaneous or sequential involvement of lungs is frequently encountered with neurological syndromes like meningoencephalitis, cerebellitis, aseptic meningitis, transverse myelitis, or multiple cranial nerve palsies. However, pulmonary involvement is frequently overlooked when all the attention of physician is diverted to neurological disorder. Prompt and early recognition of such potentially treatable association ...

Objectives- The purpose of this study was to compare the screening efficiency for Down syndrome using likelihood ratios versus logistic regression coefficients. Methods- We conducted a retrospective study of women at increased risk for Down syndrome referred for a second-trimester genetic sonogram. Likelihood ratios were calculated by multiplying the risk ...

Cauda equina syndrome seems to be a very rare complication of spinal manipulations. Only few cases, in fact, were referred in literature in the past decades. Most of them are very old and poorly documented evoking doubts about the pathogenetic relationship between the spinal maneuvers and the onset of the ...

ABSTRACT: Study Design: Case seriesObjective: To describe the presentation, diagnostic challenges, and treatment of five patients with piriformis syndrome following lumbar artificial disc replacement.Summary of Background Data: Until recently, spinal fusion was considered the standard for surgical treatment of severe lumbar degenerative disc disease. However, artificial disc replacement now offers ...

The combination of acute urinary retention and aseptic meningitis has not been well recognized. This combination can be referred to as meningitis-retention syndrome (MRS), when accompanied by no other abnormalities. However, the responsible site of lesions for urinary retention in MRS remains obscure, despite the areflexic detrusor at the time ...

Fungal infections of the spine are very rare and usually seen in immunocompromised patients. Acute cauda equina syndrome presenting in an immunocompetent patient is usually due to a prolapse of the intervertebral disc. Infective pathology caused by Mycobacterium tuberculosis with epidural collection can also have a similar presentation. We present ...

Cauda equina syndrome (CES) is a rare condition with a disproportionately high medico-legal profile. It occurs most frequently following a large central lumbar disc herniation, prolapse or sequestration. Review of the literature indicates that around 50-70% of patients have urinary retention (CES-R) on presentation with 30-50% having an incomplete syndrome ...

We report on the case of a patient with acquired immune deficiency syndrome- and Cryptococcus neoformans meningitis-related mania in which olanzapine was successfully used adjunctively and transiently to antifungal therapy.

Meralgia paresthetica is a well-known sensory syndrome describing paresthesia and/or anesthesia in the anterolateral aspect of the thigh that is supplied by the lateral femoral cutaneous nerve. Compression of the nerve usually occurs at the point where it passes between the anterior superior iliac spine and the inguinal ligament. Proximal ...

The list of genetic causes of syndromes of dystonia parkinsonism grows constantly. As a consequence, the diagnosis becomes more and more challenging for the clinician. Here, we summarize the important causes of dystonia parkinsonism including autosomal-dominant, recessive, and x-linked forms. We cover dopa-responsive dystonia, Wilson's disease, Parkin-, PINK1-, and DJ-1-associated ...

Cigarette smoking is in general considered an aggravating factor for restless legs syndrome (RLS). The author presents a case in which cigarette smoking has produced for many years a consistent and effective alleviation of RLS symptoms.

Thomas de Quincey, a British writer of 19th century, suffered insomnia from the age of 17 years. In his famous "Confessions of an English-Opium Eater" (1822), he described a symptomatology that could concord with restless legs syndrome long before he became addicted to opium. In this report, we analyze his ...

We report a neonatal infection with Streptococcus dysgalactiae subsp. equisimilis occurring through maternal transmission and presenting as streptococcal toxic shock syndrome 12 hours after birth. Pediatricians and obstetricians should be aware of the possibility of this infectious disease when examining newborns with fever. These observations suggest that antenatal maternal screening ...

An otherwise-healthy, active 83-year-old Nigerian man developed reversible central cord myelopathy from a mild fall on a level surface. Cervical spine magnetic resonance imaging (MRI) revealed C5, 6, and 7 block vertebrae and marked disc extrusions only at the immediately adjoining upper and lower non-fused segments of the cervical spine. ...

Kawasaki disease is a common systemic vasculitis of childhood that may result in life-threatening coronary artery abnormalities. Despite an overlap of clinical features with toxic shock syndrome, children with Kawasaki disease generally do not develop shock. We report two cases of older children who presented with a toxic shock-like illness, ...

Wolff-Parkinson-White (WPW) syndrome is a ventricular preexcitation that presents as supraventricular tachycardia. Health care professionals can attain optimal results in caring for infants with WPW syndrome by understanding both its pathophysiology and proper management to prevent and treat complications associated with it. This article reviews the prevalence, pathophysiology, clinical manifestations, ...

Streptococcal Toxic Shock Syndrome (STSS) is a severe toxin-mediated disease with acute onset. A previously healthy 10-year-old boy presented with abdominal pain, vomiting, diarrhoea and fever for 3 days. He was admitted with signs of an acute abdomen. A treatment with ibuprofen had been started before admission. The child developed ...

We present a case of a 14-year-old young boy with ventricular noncompaction and coexistent Wolff-Parkinson-White syndrome who presented with syncope. Detailed testing was performed, and an ablation was successful for Wolff-Parkinson-White syndrome; however, because of patient/family desires, an implantable cardiodefibrillator was placed. A careful review of the literature highlights the ...

Data collected from medical literature indicate that dopaminergic agonists alleviate Restless Legs Syndrome symptoms while dopaminergic agonists antagonists aggravate them. Dopaminergic agonists is a physiological regulator of thyroid-stimulating hormone. Dopaminergic agonists infusion diminishes the levels of thyroid hormones, which have the ability to provoke restlessness, hyperkinetic states, tremors, and insomnia. ...

Restless legs syndrome is a distressing condition, with negative effects on sleep and daytime activities that affect personal, family and occupational life. The overall impact of restless legs syndrome on quality of life is comparable to that of chronic and frustrating conditions such as depression and diabetes. Misdiagnosis and inappropriate ...

Norman Geschwind's landmark paper in 1965, "Disconnexion Syndromes in Animals and Man," inspired a generation of investigators to consider the effects of focal brain lesions disrupting higher brain functions. Although Geschwind viewed disconnection as resulting from either white or gray matter lesions, his signature article drew upon the insights of ...

We report the identification and characterization of three Staphylococcus aureus isolates recovered from throat and vaginal cultures, as well as from an axillary abscess, of a 17-year-old female who died of tampon-related toxic shock syndrome. The three S. aureus isolates were unrelated as determined by pulsed-field gel electrophoresis. The vaginal ...

Toxic shock syndrome is an uncommon condition in patients with neutropenia. We describe a 44-year-old man who developed toxic shock syndrome caused by hospitalacquired methicillin-resistant Staphylococcus aureus while pancytopenic after chemotherapy. He died of multiorgan failure despite high-level intensive care support and treatment with appropriate antibiotics and intravenous immunoglobulin. This ...

Concealment of an accessory pathway is caused by its ability to conduct retrogradely only. This variant of accessory pathway conduction could not be confirmed until invasive electrophysiology was introduced in the 1970s. As a rule, it is reported that concealed accessory pathways were predicted from animal experiments in 1971. However, ...

This study aimed to assess thermal and mechanical perception and pain thresholds in primary idiopathic restless legs syndrome and secondary restless legs syndrome associated with small fibre neuropathy. Twenty-one patients (age: 53.4 + or - 8.4, n = 3, male) with primary restless legs syndrome and 13 patients (age: 63.0 ...

Systemic capillary leak syndrome (SCLS) is a very rare disorder also known as Clarkson's disease. The condition is characterized by recurrent episodes of severe capillary hyperpermeability resulting in severe hemoconcentration, hypoalbuminemia, hypovolemia and shock. We describe a 41-year-old previously healthy man who was admitted to hospital on several occasions with ...

The goal of Parkinson syndrome diagnostics is twofold: early diagnosis on the one hand, and accurate differentiation among idiopathic and atypical Parkinson syndromes on the other. (123)I-metaiodobenzylguanidine scintigraphy is the only method that can distinguish with a high degree of sensitivity and specificity between atypical Parkinson syndromes and Parkinson's disease ...

We describe a 7-year-old boy with staphylococcal toxic shock syndrome who presented with acute respiratory distress and cor pulmonale. We wish to highlight this unusual presentation as the diagnosis of toxic shock syndrome depends chiefly on a high degree of clinical suspicion. Early diagnosis and prompt institution of appropriate therapy ...

Identical location of accessory pathways in family members with Wolff-Parkinson-White syndrome, although theoretically possible, has never been described. A 37-year-old woman and her 18-year-old son were referred for electrophysiological study due to fast rate palpitations and pre-excitation on baseline electrocardiogram. After mapping during pre-excitation, successful radiofrequency application was located at ...

Staphylococcal toxic shock syndrome (TSS) has rarely been reported without rash and desquamation. This study describes a patient who met all criteria for TSS except erythroderma and desquamation. The associated staphylococcal superantigen was enterotoxin B. We demonstrate that erythroderma depends on preexisting T cell hypersensitivity amplified by superantigenicity.

The case report describes a 39-year-old woman with restless legs syndrome (RLS) and trichotillomania (TTM). She was treated with venlafaxine and clonazepam with partial remission of RLS and no response for TTM. When aripiprazole was added to the clonazepam both RLS and TTM fully remitted. We suggest that aripiprazole might ...

Streptococcal toxic shock syndrome (STSS) can be defined as a septic shock syndrome resulting from infection with toxin-producing group A streptococci (GAS). STSS can sporadically present as primary peritonitis in previously healthy persons. Signs of STSS are non-specific and patients generally present with flu-like symptoms and can develop a life-threatening ...

There may be a relationship between proton pump inhibitors (PPIs) and iron absorption. PPIs may decrease the amount of iron absorbed gastrointestinally specifically due to alteration of the pH in the duodenum. Restless legs syndrome (RLS) is a sensorimotor disorder that includes an urge to move legs, accompanied or caused ...

Group A streptococcus-associated severe invasive infection (streptococcal toxic shock syndrome) has been described. Streptococcal toxic shock syndrome occurs when the infecting strain of group A streptococcus produces superantigens. Confusion and combativeness are well known as the common symptoms of streptococcal toxic shock syndrome. We encountered a child who suffered from ...

We report a patient with Wolff-Parkinson-White syndrome, in whom orthodromic atrioventricular reciprocating tachycardia directly passed over to atrioventricular nodal re-entrant tachycardia during radiofrequency ablation of the accessory pathway. After the accessory pathway ablation, there were no tachycardia recurrences.

BACKGROUND: In Brugada syndrome implantable cardioverter defibrillator (ICD) therapy is associated with a high rate of inappropriate therapies, mainly due to supraventricular tachyarrhythmias (SVT) (2.7-14.1%/year). Aim of the present study was to evaluate a single ventricular fibrillation (VF) detection zone with a high cut-off rate with respect to prevention of ...

Toxic-shock syndrome is primarily caused by the Toxic-shock syndrome toxin 1 (TSST-1), which is secreted by the Gram-positive bacterium Staphylococcus aureus. The toxin belongs to a family of superantigens (SAgs) which exhibit several shared biological properties, including the induction of massive cytokine release and V(beta)-specific T-cell proliferation. In this study ...

Preexcitation syndromes are a common cause of paroxysmal tachycardias presenting to the ED. Emergency physicians should be familiar with the common electrocardiographic manifestations of preexcitation, particularly the Wolff-Parkinson-White abnormality, as these conditions require specific therapeutic management. This article reviews the pathophysiology of preexcitation, along with the electrocardiographic findings of Wolff-Parkinson-White ...

Restless legs syndrome (RLS) is a neurological disorder related to abnormal and unpleasant sensations and movements in the legs. It usually occurs at nighttime and thus has a detrimental impact on the ability to sleep, leading to poor patient quality of life. UCB has been developing rotigotine transdermal patch system ...

A case of Wolff-Parkinson-White syndrome with atrial fibrillation (AF) is reported in a patient who presented with syncope, tachycardia, and hypotension. The electrocardiogram (ECG) showed a fast irregular rhythm with wide polymorphic QRS tachycardia without the QRS twisting around the isoelectric baseline, diagnostic of AF and Wolff-Parkinson-White syndrome. The patient ...

Risk stratification in patients with Wolff-Parkinson-White (WPW) syndrome is an important clinical problem given a small, but significant risk of sudden death. It has been widely accepted that intermittent pre-excitation is associated with a low-risk pathway. We report a case of WPW with intermittent pre-excitation at baseline, but with marked ...

To diagnose restless legs syndrome (RLS), start with the 4 "essential criteria": (1) a powerful urge to move the legs that is (2) rest-induced, (3) improves with activity, and (4) worsens in the evening. Carefully screen for secondary causes of RLS, including renal failure, pregnancy, iron deficiency, and medications that ...

Toxic shock syndrome is a rare toxin-mediated condition that can rapidly produce multiorgan failure and severe shock. Toxic shock syndrome has been previously recognized in various clinical situations relating to surgery, nasal packing, abscesses, burns, and most notably menstrual-related cases. This case report describes a previously healthy 33-year-old woman presenting ...

In a prospective matched case-control study of sporadic pediatric hemolytic uremic syndrome related to Shiga-toxin producing Escherichia coli infection in France, eating undercooked ground beef, contact with a person with diarrhea, and drinking well water during the summer period were identified as risk factors. Prevention efforts in France should focus ...

Several previous studies have shown that Attention Deficit Hyperactivity Disorder (ADHD) is common in children with Restless Legs Syndrome and ADHD is more common in adults with this syndrome. This pilot study examined the prevalence of Restless Legs Syndrome in adults with ADHD, showing six of 30 adult ADHD participants ...