No abstract available.
Cerebellar Diseases ; Encephalitis ; Magnetic Resonance Imaging* ; Meningitis* ; Tuberculosis

Postural orthostatic tachycardia syndrome (POTS) refers to the presence of orthostatic intolerance with a heart rate (HR) increment of 30 beats per minute (bpm) or an absolute HR of 120 bpm or more. There are sporadic reports of the autonomic nervous system dysfunction in migraine and fibromyalgia. We report a case of POTS associated with migraine and fibromyalgia. The patient was managed with multidisciplinary therapies involving medication, education, and exercise which resulted in symptomatic improvement. We also review the literature on the association between POTS, migraine, and fibromyalgia.
Autonomic Nervous System ; Fibromyalgia ; Heart Rate ; Humans ; Migraine Disorders ; Mustard Compounds ; Orthostatic Intolerance ; Postural Orthostatic Tachycardia Syndrome

Fibromyalgia is a chronic pain syndrome of unknown etiology that is characterized by diffuse musculoskeletal pain, fatigue, sleep disturbance, memory disturbance, and exaggerated tenderness over particular paired locations. Fibromyalgia is found in 2% to 4% of the general population and more common in women, with symptoms usually appearing between 20 and 55 years of age. The diagnostic criteria for fibromyalgia syndrome established in 1990 by the American College of Rheumatology (ACR), includes widespread pain for at least 3 months and point tenderness upon the application of a 4 kg weight at 11 or more of the 18 characteristic tender points. The 2010 ACR preliminary diagnostic criteria have been developed, which are strongly correlated with the 1990 ACR criteria and provide an alternative approach to diagnosis. Patients with fibromyalgia syndrome have lower pain thresholds and experience an altered temporal summation to pain stimuli. The sensitization of pain perception occurs in the dorsal horn of patients with fibromyalgia. However, it is unknown whether sensitization is due to increased pain fiber facilitation, or decreased inhibition. Pregabalin is approved by the United States Food and Drug Administration for the management of fibromyalgia patients. Tricyclic antidepressants, cardiovascular exercise, cognitive behavioral therapy and patient education are also effective in reducing the pain experienced by fibromyalgia patients. This article provides an overview of fibromyalgia syndrome, which is currently thought to be partly responsible for chronic diffuse pain.
Animals ; Antidepressive Agents, Tricyclic ; Chronic Pain ; Cognitive Therapy ; Fatigue ; Female ; Fibromyalgia ; gamma-Aminobutyric Acid ; Horns ; Humans ; Memory ; Musculoskeletal Pain ; Pain Perception ; Pain Threshold ; Patient Education as Topic ; Rheumatology ; United States Food and Drug Administration ; Pregabalin

The binding of anti-GD1b IgG antibody to the cerebellar granular area or spinocerebellar Ia fibers in the peripheral nerves may cause the prominent cerebellar ataxia, mild quadriparesis and sensory dominant neuropathy. A 31-year woman presented with severe cerebellar ataxia and prominent apogeotropic positional nystagmus/vertigo. Increased anti-GD1b antibody IgG in her serum was noted. 18F-flurodeoxyglucose positron emission tomography (FDG-PET) showed decreased uptake in cerebellum. It is the first case of central positional nystagmus with anti-GD1b IgG antibody.
Cerebellar Ataxia ; Cerebellum ; Female ; Humans ; Immunoglobulin G ; Nystagmus, Physiologic ; Peripheral Nerves ; Positron-Emission Tomography ; Quadriplegia

A 59-year-old man was admitted because of progressive proximal muscle weakness over 4 months. Serum creatine kinase was markedly increased and electromyography revealed myopathic pattern. Muscle biopsy showed nonspecific myopathic changes. No inflammatory change was shown. Thyroid function tests revealed very low thyroxine and low triiodo-L-thyronine, whereas thyroid-stimulating hormone was greatly increased as well as serum anti-thyroglobulin and microsome antibodies. The patient had hypothyroid myopathy due to Hashimoto's thyroiditis, which improved with L-thyroxine replacement.
Antibodies ; Biopsy ; Creatine Kinase ; Electromyography ; Humans ; Hypothyroidism ; Microsomes ; Middle Aged ; Muscle Weakness ; Muscular Diseases* ; Thyroid Function Tests ; Thyroid Gland* ; Thyroiditis* ; Thyrotropin ; Thyroxine

We report unusual MRI findings (including those from diffusion-weighted imaging (DWI)) in a patient with recurrent Wernicke's encephalopathy with a remarkable cerebellar lesion. DWI showed high signal intensities in the superior portion of the cerebellar hemisphere and vermis area. After thiamine administration, clinical symptoms improved and the lesions with high signal intensities disappeared on follow-up DWI.
Cerebellum ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging* ; Thiamine ; Wernicke Encephalopathy*

No abstract available.
Levodopa* ; Neuroleptic Malignant Syndrome* ; Parkinson Disease*

Cerebrospinal fluid (CSF) leak or shunt overdrainage is a well-known cause of orthostatic headaches and low CSF pressures. We report two cases of orthostatic headache with pneumocephalus on brain imaging. The orthostatic headache developed after drainage of spinal operation site and epidural block. Brain MRI revealed characteristic findings of CSF hypovolemia including pachymeningeal enhancement and mild subdural fluid collections. Air was also observed in the ventricular or subarachnoid space in both patients, which might enter the subarachnoid or ventricular space during a procedure via the pressure gradient or an injection.
Brain ; Drainage ; Headache ; Humans ; Hypovolemia ; Neuroimaging ; Pneumocephalus ; Subarachnoid Space

We report a patient with a left anterior cerebral artery (ACA) infarct showing representational neglect. Representational neglect is some form of neglect to areas of imagined space. We believe that the description of our case gives further information about neglect syndrome and the functional asymmetry of the cerebral hemispheres because these observations are rare.
Anterior Cerebral Artery* ; Cerebrum ; Humans ; Infarction, Anterior Cerebral Artery*

We reviewed 27 patients wlth cerebellar infarction which was demonstrated by brain CT and/or MRI. Infarction occurred in the territory of posterior inferior cerebellar artery (PICAj in 16 patients, and the territory of the superior cerebellar artery(SCA) was involved in 5 patients. Antenor inferior cerebellar artery(AICA) infarcts occurred in 3 patients. Both PICA and SCA temtories were involved in 2 patients. In the remaining 1 patient, the infarct encompassed the borderzone between the SCA and PICA territories. The main symptoms and signs were sudden onset of vertigo, dizziness, nausea, vomiting, dysmetria, ataxia, nystagmus, and headache. There were signs of associated brain stem infarction or occipitotemporal infarction; rostral basilar artery syndrome, classic SCA syndrome, Wallenberg syndrome, internuclear ophthalmoplegia, facial palsy, hearing impairment. Presumed cerebral embolism was the main stroke mechanism in the SCA terntories. Six patients with brainstem compression or brainstem involvement showed consciousness deterioration, and only one of them died as a result of extensive cerebellar infarctions involving both SCA and PICA territories Cerebellar infarction may run a more benign course than previously thought.
Arteries ; Ataxia ; Basilar Artery ; Brain ; Brain Stem ; Brain Stem Infarctions ; Cerebellar Ataxia ; Consciousness ; Dizziness ; Facial Paralysis ; Headache ; Hearing Loss ; Humans ; Infarction* ; Intracranial Embolism ; Lateral Medullary Syndrome ; Magnetic Resonance Imaging ; Nausea ; Ocular Motility Disorders ; Pica ; Stroke ; Vertigo ; Vomiting