• Title/Summary/Keyword: Central nervous system involvement

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X-linked Charcot-Marie-Tooth disease case with a novel missense mutation in GJB1 gene

  • Lee, Jong-Mok;Shin, Jin-Hong
    • Journal of Genetic Medicine
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    • v.15 no.2
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    • pp.107-109
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    • 2018
  • X-linked Charcot-Marie-Tooth disease type 1 (CMTX1) is caused by the mutation in GJB1 gene, characterized by the transient central nervous system involvement and long standing peripheral polyneuropathy which does not fulfill the criteria of demyelination or axonopathy. We describe a 37-year-old man with progressive bilateral leg weakness since his early teen. He suffered transient right hemiparesis, followed by quadriparesis at 14 years of age. When we examined him at 37 years of age, he presented a distal muscle weakness on lower extremities with a sensory symptom. The nerve conduction study demonstrated a motor conduction velocity between 26 and 49 m/s. The whole exome sequencing revealed a novel variant c.136 G>A in GJB1. This report will raise awareness in this rare disease, which is frequently misdiagnosed early in its course.

Studies on the possible role of thiamine in the central nervous system

  • Iwata, Heitaroh
    • Archives of Pharmacal Research
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    • v.3 no.1
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    • pp.51-55
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    • 1980
  • Thiamine, in the form of its diphosphate (TDP), is well known to act as a coenzyme, and during the early stage in the study of thiamine it had been believed that the symptoms of thiamine-deficiency were resulted secondarily from the disturbance of metabolic processes in which TDP participated as a coenzyme. However, the neurological symptoms in thiamine deficiency are now separated from the metabolic disturbances in thiamine deficiency. On the other hand, the specific involvement of phosphorylated thiamine in nerve conduction has been suggested by von Muralt, but nature of this involvement has not been elucidated at a molecular level. Recently the possible significance of thiamine triphosphate (TTP) in nervous tissue was suggested by the demonstration that TTP is not present in the brain of patients with subacute necrotizing encephalomyelitis, a fatal disease associated with an abnormality in thiamine metabolism. Furthermore, the studies using membrane fragments of rat brain strongly indicated that ion movement across the nerve membrane is associated with dephosphorylation of phosphorylated thiamine.

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Relationships of autonomic dysfunction with disease severity and neuropathic pain features in fibromyalgia: is it really a sympathetically maintained neuropathic pain?

  • On, Arzu Yagiz;Tanigor, Goksel;Baydar, Dilek Aykanat
    • The Korean Journal of Pain
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    • v.35 no.3
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    • pp.327-335
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    • 2022
  • Background: The pathophysiology of fibromyalgia (FM) involves many mechanisms including central nervous system sensitization theory, autonomic nervous system (ANS) dysfunction, and recently small fiber neuropathy. While the small fiber neuropathy itself can cause ANS dysfunction and neuropathic pain (NP), it is still unknown whether ANS problems have an association with severity of disease and NP in patients with FM. The aim of this study was to evaluate ANS dysfunction in FM patients and to explore possible associations of ANS dysfunction with disease severity and NP. Methods: Twenty-nine FM patients and 20 healthy controls were included in this cross-sectional study. Participants were tested using sympathetic skin responses (SSR) and R-R interval variation analyses for sympathetic and parasympathetic ANS dysfunction, respectively. Disease severity and somatic symptoms of patients with FM were evaluated using the ACR-2010 scales and Fibromyalgia Impact Questionnaire, and NP symptoms were evaluated using the Pain Detect Questionnaire and Douleur Neuropathique questionnaire. Results: FM patients were found to have ANS dysfunction characterized by increased sympathetic response and decreased parasympathetic response. SSR amplitudes were found to be correlated with a more severe disease. Although nonsignificant, NP severity tended to be associated with a decrease in sympathetic and parasympathetic activities. Conclusions: ANS dysfunction may play a role in the pathophysiology of FM. The trend of decreased ANS functions in FM patients exhibiting NP contradicts the notion that FM is a sympathetically maintained NP and may be explained with small fiber involvement.

Dandy-Walker Malformation Associated with Neurocutaneous Melanosis

  • Cho, In-Yong;Hwang, Sung-Kyun;Kim, Sung-Hak
    • Journal of Korean Neurosurgical Society
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    • v.50 no.5
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    • pp.475-477
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    • 2011
  • Neurocutaneous melanosis associated with Dandy-Walker malformation is a rare dysmorphogenesis that is associated with single or multiple giant pigmented cutaneous nevi and diffuse involvement of the central nervous system. In this article, we present a 2-month-old patient with neurocutaneous melanosis associated with Dandy-Walker malformation. In addition, we reviewed the literature and discussed the pathogenesis based on the preferred hypotheses.

Three Cases of Hypokalemic Periodic Paralysis (저칼륨혈증성 주기성 사지마비환자 3례)

  • 손동혁;장인수;이영구;윤희식;변덕시;강현철;조기호
    • The Journal of Korean Medicine
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    • v.21 no.2
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    • pp.87-94
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    • 2000
  • Hypokalemic periodic paralysis(HypoPP) is characterized by an abrupt onset of flaccid paralysis with a clear mentality, but muscles of speech and swallowing are usually spared. We report on three patients who suffered attacks of acute paralysis. After exclusion of central nervous system involvement, the patients showing hypokalemia was diagnosed as hypokalemic periodic paralysis, which was completely reversible on parenteral potassium substitution.

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Mumps meningoencephalitis without parotitis, after secondary vaccination of Measles-Mumps-Rubella (MMR) : A Case Report (MMR 2차 예방접종을 받은 후 이하선염 없이 발생한 볼거리 뇌염 1례)

  • Choi, Pahn Kyu;Kang, Hyun Goo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.9
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    • pp.123-126
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    • 2017
  • Mumps, which are also known as epidemic parotitis,lead to viral infectious diseases that can cause complication such as pancreatitis, orchitis, hearing impairments, oophoritis, parotitis and meningitis. Central nervous system involvement has been reported in up to 65% of mumps patients, with most of these including meningitis. Meningoencephalitis is a rare central nervous system (CNS) complication of the mumps. Measles-Mumps-Rubella (MMR) vaccination has been reported protective effect against clinical complications and hospitalization. Here, we describe acute mumps meningoencephalitis in a 24-year-old female without parotitis who had received the MMR vaccination by age related schedule. She initially visited our hospital with aggravated cognition and confusion. After conservative viral treatment, she recovered cognitive function rapidly and complication was not remained. We report here a case of a patient with good recovery of mumps meningoencephalitis without parotitis after secondary vaccination for MMR.

Enhancement of Optic Nerve in Leukemic Patients: Leukemic Infiltration of Optic Nerve versus Optic Neuritis

  • Ra, Yo Han;Park, Sun Young;Im, Soo Ah;Kim, Jee Young;Chung, Nak Gyun;Cho, Bin
    • Investigative Magnetic Resonance Imaging
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    • v.20 no.3
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    • pp.167-174
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    • 2016
  • Purpose: To identify magnetic resonance imaging (MRI) findings of leukemic infiltration of optic nerve and optic neuritis in leukemic patients with emphasis of clinical findings as reference standard to differentiate them. Materials and Methods: MRI and clinical findings of 7 patients diagnosed as leukemic infiltration of optic nerve (n = 5) and optic neuritis (n = 2) in our institution between July 2006 and August 2015were reviewed retrospectively. In particular, MR imaging findings involved perineural enhancement and thickening of optic nerve and its degree, signal intensity, laterality (unilateral/bilateral), intraconal fat infiltration and its degree, and associated central nervous system abnormalities. Results: Of 5 cases of leukemic infiltration of optic nerve, 4 cases showed positive cerebrospinal fluid (CSF) study for leukemia relapse and 1 case was positive on bone marrow (BM) biopsy only. Moreover, of 5 leukemic infiltration of optic nerve, 2 cases showed the most specific MR findings for leukemic central nervous system involvement including 1 prominent leptomeningeal enhancement and 1 chloroma. However, other MR imaging findings of the patients with leukemic infiltration or optic neuritis such as thickening and perineural enhancement of optic nerves are overlapped. Conclusion: Enhancement and thickening of optic nerve were overlapped MR findings in leukemic infiltration of optic nerve and optic neuritis. Our findings suggest that enhancing optic nerve thickening with associated central nervous system MR abnormality favors the diagnosis of leukemic infiltration of optic nerve, especially in patients with history of acute lymphoblastic leukemia. However, CSF and BM study were required for differentiation between leukemic infiltration of optic nerve and optic neuritis.

Relapsed plasmacytoma in central nervous system after complete remission of extramedullary plasmacytoma (완전관해 후 중추신경계에 재발한 골수외 형질세포종)

  • Kang, Sun Mi;Kim, Seong Gyu;Seo, Ji Ho;Kim, Ji Yoon;Sung, Woo Jung;Bae, Sung Hwa;Ryoo, Hun Mo
    • Journal of Yeungnam Medical Science
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    • v.31 no.1
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    • pp.43-47
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    • 2014
  • Extramedullary plasmacytoma (EMP) is a rare disease that occurs in 3% to 5% of patients with plasma cell disorder. It occurs most commonly in the upper respiratory tract and the oral cavity. Very few EMP cases have been reported in the central nervous system (CNS). We report herein an unusual case of EMP in the nasal cavity that recurred in the CNS without systemic involvement. A 67-year-old man visited our hospital due to a month-long bout with exophthalmos. He was diagnosed with EMP in the nasal cavity, paranasal sinus, and orbital cavity. He received radiotherapy to which he had complete responses. After 2 years, he visited our hospital because of a month-long headache. He was diagnosed with EMP recurrence in the CNS via brain magnetic resonance imaging and cerebrospinal fluid analysis. He was treated with whole brain radiotherapy and intrathecal chemotherapy with methotrexate, but he expired due to pneumonia.

A Case of Incontinentia Pigmenti with Developmental Brain Malformation (중추 신경계 발달이상을 동반한 색소실소증 1례)

  • Kang, Suk Ho;Kim, Soon;Jung, Seung Hee;Lee, Sang Geel
    • Clinical and Experimental Pediatrics
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    • v.45 no.4
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    • pp.535-539
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    • 2002
  • Incontinentia pigmenti is a rare neurocutaneous syndrome characterized by vesiculobullous skin disease in neonates and infants, a noninfectious disease that should be distinguished from infectious diseases with the neonatal seizure or encephalopathy. This disease is X-linked dominant with Xq28 region abnormalities and often associated with developmental defects of the ocular, skeletal, dental, and central nervous system. Central nervous system involvement in the neonatal period, or complicated by encephalopathy, may cause severe neurologic impairment, retardation or even death. We experienced a case of incontinentia pigmenti in a three-day-old female patient who had characteristic papulovesicular skin lesions and partial seizures with secondary generalization. Histopathological examination favored the diagnosis of incontinentia pigmenti and a brain MRI showed undifferentiated white matters with periventricular nodular lesions.

Intracranial Plasma Cell Granuloma

  • Kim, Dae-Jin;Choi, Yu-Seok;Song, Young-Jin;Kim, Ki-Uk
    • Journal of Korean Neurosurgical Society
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    • v.46 no.2
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    • pp.161-164
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    • 2009
  • Plasma cell granuloma is a tumor-like disease characterized by non-neoplastic polyclonal proliferation of plasma cells and other mononuclear cells. This disease occurs most frequently in the lung and upper respiratory tract, while the involvement of the central nervous system is very rare. A 44-year-old female patient presented with nausea and progressive visual disturbance. Brain magnetic resonance imaging (MRI) revealed the mass along the right tentorium with low signal intensity in the T2 weighted image (T2WI) and fluid-attenuated inversion recovery (FLAIR) sequence, and an isosignal intensity in T1 weighted image (T1WI), the latter of which was enhanced after administration of gadolinium-diethylenetriamine penta-acetic acid (Gd-DTPA). The thickest portion of the tentorium was partially excised via the combined suboccipital and infratentorial approach. The histopathological examination indicated a diagnosis of plasma cell granuloma. Postoperative steroid therapy was administered for remnant tumor control. Although a follow up MRI scan taken 20 months after the operation showed a slight decrease in tumor size, the lesion had extended to the falx and left frontal convexity along with parenchymal edema at 32 months after the operation and the clinical status was aggravated. The mass was removed from the left frontal convexity. Radiation therapy was given, together with steroid administration.