Brain and nerve = Shinkei kenkyū no shinpo
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Deep brain stimulation (DBS) has proved highly effective in the treatment for Parkinson's disease and dystonia. Presently, many types of dopamine agonists, monoamine oxidase B (MAOB) inhibitors, catechol-O-methyltransferase (COMT) inhibitor or other antiparkinsonian drugs are being developed. However, it is still very difficult to medically treat motor complications associated with levodopa therapy. ⋯ The brain mechanism underlying the improvement of pallidal DBS in dystonia has been unclear. Many studies on DBS in Parkinson's disease and dystonia have been carried out to elucidate the clinical outcomes and/or the underlying neurophysiological mechanisms. In this review, the clinical outcomes of DBS for Parkinson's disease and dystonia will be focused on.
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Pseudomeningocele is a rare complication of head trauma. An 7-year-old male child who fell from playground equipment was admitted to hospital with lambdoid sutural diastatic fracture. ⋯ In addition, the scalp just over the fractured segment was compressed by band after drainage whereby the CSF leak was stopped. On the basis of our experience with this case, we suggest that appropriate management enables repair of posttraumatic pseudomeningocele in early stages of injury.
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Case Reports
[Case of gluteal compartment syndrome associated with bilateral sciatic nerve palsies].
A patient presented with a rare case of bilateral gluteal compartment syndrome. A 39-year-old male, who experienced unconsciousness in a sitting position attributable to a drug overdose, suffered from right dominant bilateral gluteal compartment syndrome with bilateral leg paralysis due to sciatic nerve palsy, involving rhabdomyolysis and acute renal failure. Since the pressure in the right gluteus maximus compartment in the buttocks was recorded as 20 mmHg, he was administered conservative treatment. Within 12 months, he recovered his ability to walk; however, right foot paralysis and right sciatic nerve irritation were observed to persist.
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Review Case Reports
[Case of paraneoplastic limbic encephalitis associated with malignant B cell lymphoma].
We report a case of a 62-year-old man with limbic encephalitis associated with diffuse large B cell lymphoma. He was hospitalized for the assessment of cognitive disturbance and changes in characteristics. Neurological examination revealed disturbance of recall and recent memory. ⋯ We investigated 7 previously reported cases of paraneoplastic limbic encephalitis associated with malignant lymphoma in Japan. We suggest that an early diagnosis of paraneoplastic limbic encephalitis with progressive symptoms such as changes in characteristics is important. Early diagnosis and treatment of malignant tumors is desirable to facilitate clinical recovery and improve prognosis.
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It has been reported that amebic meningoencephalitis is caused by some rhizopods, which are taxonomically different from Entamoeba histolytica which is well known as the causative agent of amebic dysentery. Different types of human meningoencephalitis have been reported to be caused by amphizoic amebae, which are not obligatorily parasitic (endozoic) but are usually free-living (exozoic) in nature, i.e., in environmental water and soil: Naegleria fowleri causes acute primary amebic meningoencephalitis (PAM). Acanthamoeba spp. and Balamuthia mandrillaris produce chronic and opportunistic granulomatous amebic (meningo) encephalitis (GAE). Further, most recently, Sappinia diploidea has been identified as an agent that causes comparatively acute type of encephalitis.