YokoCo

Ten to 12 percent of the adult population globally suffers from migraine, which is the second most frequent type of primary headache, according to the American Academy of Neurology. Even though pain and attack-related impairment scored first, cognitive symptoms were the second most common. ; The current study intended to measure the latency of P300 wave during and after an acute attack of migraine among a group of patients known to have migraine in order to introduce an objective method to measure the cognitive function of migraineurs during migraine attack. ; This is a potential cohort study conducted at the neurological outpatient's clinics of Basra hospitals to the period from January until August 2021. The total number of subjects included in the study were forty-eight (48), thirty (30) patients and eighteen (18) age and gender matched control subjects. Patients were examined and selected by senior neurologist and diagnosed as having common migraine, then refereed to the neurophysiology clinic to perform cognitive function tests, for each patient two tests were done; first one during the acute migraine attack and second one after one month far ahead from the end of the migraine attack. In addition, one cognitive function test was done for the control group.; We discovered a highly important variance of the mean P300 latency of the patients during the acute attack of migraine as compared to the same group of the patients after repeating the exam one month far ahead from the end of the last migraine attack and one week ahead of being medication free. Also, we found the mean P300 latency of the patients during the acute attack of migraine is significantly higher than the mean P300 latency of the control subjects (P. value <0.00).; We found that all migraineurs in our study are having higher P300 latency values than control group during moderate migraine attack and this difference was significant which indicates that during moderate migraine attacks there is obvious impairment of cognitive performance abilities of those patients.

Background In this study, we aimed to describe eight cases of dengue encephalitis along with their magnetic resonance imaging (MRI) findings. Dengue encephalitis is caused by an arbovirus that has four strains DENV1-DENV4. The dengue virus is usually non-neurotropic but DENV2 & DENV3 are neurotropic. Dengue encephalitis is characterized by headaches, seizures, and altered consciousness. Methodology At our facility, we performed 3T MRI on eight suspected cases of dengue encephalitis using the criteria established by Varatharaj et al. We were able to diagnose dengue encephalitis based on the proposed criteria which included symptoms, serology, cerebrospinal fluid (CSF) analysis results, MRI findings, and routine blood laboratory workup in dengue encephalitis. Because numerous brain regions are potentially impacted in severe cases of dengue encephalitis, an MRI of the brain can reveal the severity of the condition. In deteriorating situations, it may detect whether or not further regions are being impacted. Hence, MRI should be done in all suspected cases of dengue encephalitis. Results The changes observed on MRI of the eight cases were in the supra-tentorium (deep periventricular white matter, subcortical white matter, and deep gray matter of the brain, which includes basal ganglia and thalami), infra-tentorium (cerebellar white matter and brainstem, which includes pons), and occasionally in cortical gray matter. The MRI showed mild-to-moderate hyperintensities on T2-weighted images and fluid-attenuated inversion recovery sequence (FLAIR); diffusion restriction is seen on diffusion-weighted images. The neurological clinical features included non-localizing signs and symptoms such as altered mental status, headache with vomiting, and fever. Conclusions The commonly affected areas of the brain in dengue encephalitis are the basal ganglia, thalamus, brainstem, cerebellum, cortical white matter, periventricular white matter, and cortical gray matter, which are all hyperintense on T2-weighted images and FLAIR. The lesions are iso or hypointense on T1-weighted images and micro-hemorrhages appear as blooming on susceptibility-weighted MRI. MRI is a crucial initial investigation in suspected cases of dengue encephalitis and known cases of dengue fever experiencing worsening neurological conditions.

Drug-associated adverse events can present with varying symptoms, such as dizziness and pruritus. A 48-year-old woman initiated rosuvastatin to treat her elevated triglycerides. She developed rosuvastatin-associated adverse events, which included dizziness and pruritus within two weeks after starting treatment. After stopping the medication, the dizziness immediately cleared; the pruritus diminished during the next two weeks and eventually resolved completely. Side effects associated with rosuvastatin are discussed. The possibility of a medication-related etiology should be entertained when an individual suddenly develops either dizziness or pruritus or both.

Trigeminal postherpetic neuralgia has been reported to cause chronic headaches and facial pain. There are various modalities of treatment ranging from pharmacological to surgical treatment. However, these are frequently accompanied by undesirable side effects and minimal efficacy. Pulsed radiofrequency has been used to treat chronic pain but it is often seen as an unconventional treatment for postherpetic neuralgia. Nonetheless, the literature supports its use for alleviating pain with minimal complications. This case demonstrates that pulsed radiofrequency can successfully treat intractable pain secondary to postherpetic neuralgia affecting all three trigeminal dermatomes.

Continuous spinal anesthesia (CSA) is a mode of anesthesia and analgesia that has various therapeutic advantages. CSA allows the anesthesiologist to titrate tiny doses of a local anesthetic to achieve the desired degree of spinal anesthesia. The duration can be extended to accommodate the demands of the protracted operation. Due to a lack of equipment and financial restraints, particularly in resource-constrained areas, and worries of neurologic consequences such as cauda equina syndrome, CSA is yet to acquire general acceptability among anesthesiologists. In terms of postoperative pain management, CSA can be comparable to epidural analgesia and is considered far superior to abdominal wall blocks when correctly applied. Here we discuss a case wherein a standard epidural catheter in subarachnoid space was used to successfully perform an emergency exploratory laparotomy.

The therapeutic significance of carbamazepine in individuals with trigeminal neuralgia, epilepsy, and bipolar disorder is well recognized. Although it has high effectiveness, it raises the patient's risk for some adverse effects. The relationship between carbamazepine usage and agranulocytosis is well-established. Agranulocytosis is characterized by an unusually low number of neutrophils. This disorder poses a grave hazard to the patient since they are more likely to get potentially lethal bacterial or fungal infections. Moreover, carbamazepine is one of the most common causes of Stevens-Johnson syndrome (SJS), a severe skin condition with a high mortality rate. In cases where agranulocytosis and Stevens-Johnson syndrome coexist, the prognosis is relatively poor. We report a rare case of a patient who developed agranulocytosis and Stevens-Johnson syndrome after taking carbamazepine. Neutrophils accounted for 2.1% of the patient's differential leukocyte count. Furthermore, Naranjo's scale found a score of 8 for Stevens-Johnson syndrome, placing it in the "probable" category, while a score of 9 for agranulocytosis indicated that it was a confirmed adverse reaction to carbamazepine.

This study aimed to investigate the personality traits, anxiety sensitivity (AS), anxiety, and depression levels in patients diagnosed with psychogenic pruritus (PP). Certain personality traits may come to the fore in psychosomatic disorders; these traits are thought to make the person vulnerable to psychosomatic diseases. This study aimed to investigate the personality traits, anxiety sensitivity (AS), anxiety, and depression levels in patients diagnosed with psychogenic pruritus (PP).

The coronavirus pandemic has caused a devastating impact across the planet. Millions of lives lost and economic structures are struggling to remain afloat. Clinical effects of SARS CoV-2 virus include tiredness, fatigue, headache, cough, loss of appetite, fever, loss of sensations of taste, and smell as well as other respiratory difficulties. Pulmonary complications of coronavirus infections result in severe pneumonia with the final sequelae being sepsis, and end-stage respiratory failure. Further cardiovascular, neurological, hematological, and gastrointestinal complications build up to cause the demise of the immune system ultimately leading to death of the affected individual. The attack of the virus and the resultant reaction of the epithelial cells lining the respiratory tract have been in the limelight of most studies pertaining to the pandemic. However, a lesser number of studies have detailed the muscular and osseous pathologies that appear post-coronavirus infection. Inflammation post-infection, across the organ systems, may appear as a link to bone and joint pathology. Myalgia is a typical COVID-19 infection symptom. On the contrary, other musculoskeletal signs have very seldom been reported. Multimodality imaging techniques stand a chance at showing the diagnosis and the degree of follow-up after evaluation. Apart from myalgia, there are cases of arthralgia, myopathies, and neuropathies. According to numerous reports, there is the possibility of a link between the current drug regimen used to treat the SARS-CoV-2 infection and the musculoskeletal manifestations observed. In this study, we aim to shed light on the coronavirus pandemic and its association to various musculoskeletal manifestations, provide a different perspective of the infected patients, and address the major points that a clinician must take care while administering care to the patient. We will also address the present treatment in line with the various musculoskeletal symptoms observed.

Hyponatremia is defined as a serum sodium concentration of less than 135 mEq/L. Severe hyponatremia is defined as a serum sodium concentration of less than 125 mEq/L and is a life-threatening complication that must be managed promptly to avoid irreversible neurological damage. One particular cause of hyponatremia is the ingestion of recreational drugs, such as 3,4-Methylenedioxymethamphetamine (MDMA), also known as Ecstasy. Another drug with limited understanding of its adverse effects on specific individuals and is widely available to purchase legally is Kratom (). Here, we present the case of severe hyponatremia secondary to the ingestion of Kratom. Kratom is believed to act on various pain-modulating receptors and may explain its role in causing hyponatremia. Unfortunately, Kratom remains poorly understood and underreported. Our case illustrates the need for further in-depth studies to determine the complete toxic profile of Kratom, providing awareness to clinicians in anticipation of severe complications that may develop.

Injection therapy in refractory cases of lateral epicondylitis might relieve symptoms, although no consensus exists on which material to use. Corticosteroids are widely used but recent literature indicated possible tenotoxic effects and inefficacy in mid- and long-term follow-up (FU). Hyaluronate/hyaluronic acid (HA) might be of better clinical efficacy. Magnetic resonance imaging (MRI) might reflect the clinical changes in the short-term FU.