China
Africa
Explore chapters and articles related to this topic
Case-Based Differential Diagnostic Mental Health Evaluation for Adults
Published in Kunsook S. Bernstein, Robert Kaplan, Psychiatric Mental Health Assessment and Diagnosis of Adults for Advanced Practice Mental Health Nurses, 2023
Kunsook S. Bernstein, Robert Kaplan
Final diagnosis is confirmed as possible major NCD due to AD without serious behavioral disturbance.Treatment PlanCollaborative approach with the PCP and a geriatric specialist for further evaluation, including medications and diagnostic markers for AD:CT or MRI to evaluate diffuse cortical atrophy, enlarged ventricle, and decreased brain acetylcholine metabolism.Amyloid-based diagnostic test, such as amyloid imaging on brain positron emission tomography scans.Cerebrospinal fluid test to determine any reduced levels of amyloid beta-42.Genetic testing, if requested by the client and family, for a mutation in one of the known causative AD genes: amyloid precursor protein, presenilin 1, or presenilin 2. Genetic testing for such mutations is available, at least for PSEN1.Referral to social services to coordinate issues relating to patient safety, finances, and legal planning.Recommend that the family seek additional supports and education from the local Alzheimer's Association chapter.
A diagnostic challenge of primary Central nervous system lymphoma: from the eyes to the brain
Published in International Journal of Neuroscience, 2021
Min Su, Dehui Huang, Liuqing Sun, Zhao Dong, Lei Wu, Shengyuan Yu
The patient presented with neurological deficits 3 months after onset, with enlarged bilateral basal ganglia lesions and new-onset lesions in the splenium of the corpus callosum and mesencephalon in MRI, but still no obvious enhancement (Figure 2A and B). Further CSF analysis remained negative, but brain positron emission tomography indicated multiple hypermetabolic regions in the bilateral basal ganglia (Figure 2C). Therefore, a stereotactic biopsy of the left caput nuclei caudati was taken 5 months after initial presentation (10 days after cessation of prednisone). However, no diagnostic evidence was achieved, with only scattered lymphocyte infiltration being observed, with this consisting primarily of T lymphocytes (Figure 3). The patient’s condition worsened further, and a dramatic change was found on MRI acquired 7 months after onset, with a diminished right basal ganglia lesion, but an apparently enlarged one in the left basal ganglia (Figure 2A and B).
A Case Study of Lance-Adams Syndrome
Published in The Neurodiagnostic Journal, 2021
Diagnostic imaging tests such as computed tomography (CT) and MRI of the brain are not very helpful in confirming a diagnosis of LAS, because CTs and MRIs only provide images of the brain structures and are useful when organ anatomy or blood vessels are in question. Instead, neuroimaging, such as single-photon emission computed tomography (SPECT) and brain positron emission tomography (PET), has provided insight into anatomical and pathophysiology bases for LAS. EEG was the primary diagnostic tool used for this case. It was able to show the generalized and mid-centrally dominant epileptiform activity accompanied by the myoclonic jerks captured on video. The physician was able to use the video on the EEG to determine if the discharges correlated with the clinical presentation (i.e., jerking), which in this case, some did. Follow-up EEGs also demonstrated the improvement in the patient’s background from diffuse slowing to a healthy alpha rhythm.
Apraxia of eyelid opening secondary to possible progressive supranuclear palsy: a case report
Published in International Journal of Neuroscience, 2021
Wei Jiang, Lin Gan, Yang Sun, Ming Dong, Peng Yu
Neurological examination revealed upward gaze palsy with no nystagmus. Bilateral pupillary reflex was normal and symmetrical. Bradykinesia and cogwheeling tone were observed; however, there were no resting tremors. Deep tendon reflexes in the upper limbs were normal, while those in the lower limbs were diminished. Rapid alternating movements were slower than normal. He had a medical history of hepatitis B and indulged in moderate smoking and occasional alcohol intake. Brain magnetic resonance imaging, laboratory tests for anti-muscle-specific tyrosine kinase and anti-acetylcholine receptor antibodies, and single-fiber electromyography were unremarkable. Brain positron emission tomography (PET) revealed a reduction in glucose metabolism in the left part of the medial frontal lobe, basal ganglia, and temporal, occipital, and cingulate cortex. According to the diagnostic criteria of the National Institute of Neurological Disorders and Stroke and the Society for Progressive Supranuclear Palsy (NINDS-SPSP), the patient was diagnosed with possible progressive supranuclear palsy (PSP) [1]. Here, we present a video showing AEO in this patient in order to provide a better understanding of the clinical manifestation of this rare condition (Supplementary Video).