A 75-year-old man with dementia, myoclonic jerks, and tonic-clonic seizures. (Case 27-1991) (Case Records of the Massachusetts General Hospital)
Article Abstract:
A case is described of a 75-year-old man, who was admitted to the hospital with impaired mental status, myoclonic jerks (quick muscle jerks caused by impaired neurologic function), and a tonic-clonic seizure (prolonged convulsion). The patient had a history of diabetes, hypertension (high blood pressure), and peripheral (in the extremities) nerve disease. A slow-growing tumor was detected in the membrane covering the brain. The patient was agitated, bewildered, and unable to give a coherent history or move his eyes to the right. Infection of the urinary tract was noted and treated with the antibiotic cefazolin. The patient's mental status shifted from sleepiness to alertness, and he was able to answer some questions. During his hospitalization, he experienced myoclonic jerks and a tonic-clonic seizure. Assessment of neurologic function indicated that he had severe dementia, or impaired intellectual function. The patient became progressively drowsy, reacted slowly, and answered questions only briefly. The diagnosis of his condition based on clinical findings was gliomatosis cerebri, a condition characterized by widespread formation of neuroglial tumors in the brain. Neuroglial tissue consists of the supporting cells and fibers within the brain. Gliomatosis cerebri may be associated with transient loss of consciousness, dizzy spells, mental deterioration, headache, and seizures. Based on anatomical or physical findings, the patient was diagnosed with cerebral amyloid angiopathy, a disease of elderly persons. Cerebral amyloid angiopathy may be characterized by bleeding within the brain due to weakness of the blood vessels walls, which results from the deposition of amyloid, a starch-like substance. The initial signs and symptoms may be acute dementia and seizures. The disease often develops after a head injury, but may be related to hypertension-induced blood vessel damage. In this case, cerebral amyloid angiopathy was associated with dementia, absence of bleeding, and disease within the white matter of the brain. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1991
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An 18-month-old immunosuppressed boy with bilateral pulmonary infiltrates
Article Abstract:
An 18-month-old boy was admitted to a hospital with chronic cough, wheezing, fever, nasal discharge and rapid breathing. He had a history of a brain tumor for which he was receiving chemotherapy. A chest X-ray revealed signs of a viral lung infection. Samples of nasal discharge on three separate occasions over a 2-month period had revealed the presence of parainfluenza virus type 3, which is common in infants but does not usually become chronic. Chemotherapy may have suppressed this boy's immune system. A lung biopsy confirmed the diagnosis. He was treated with intravenous ribavirin.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1996
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