Der Nervenarzt
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Review Case Reports
[Bacterial meningitis as a complication of Fusobacterium necroforum infection in adults].
Fusobacterium necrophorum, an anaerobic, gram-negative rod, belongs to the physiological flora of the oropharynx. It causes Lemierre's syndrome characterized by oropharyngeal infection, septic thrombophlebitis of the neck, in particular of the internal jugular vein, and metastatic abscesses, predominantly in the lungs. Rarely, and mainly in children, it causes meningitis. ⋯ After the identification of F. necrophorum, the antibiotic treatment was changed to meropenem, which led to continuous improvement of the clinical symptoms. Due to persistent signs of inflammation in the CSF, metronidazole was added to the antibiotic regime. This case report demonstrates that F. necrophorum should always be considered in the diagnostic workup of bacterial meningitis in adults.
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Primary headache syndromes, such as cluster and migraine, are widely described as vascular headaches, even though there is considerable clinical evidence to suggest that both conditions are primarily central, that is regulated by the brain. The shared anatomical and physiological substrate for both clinical syndromes is the neural innervation of the cranial circulation. ⋯ This article reviews findings in the physiology of the trigeminovascular system which demand renewed consideration of the neural influences in many primary headaches and the physiology of the neural innervation of cranial circulation. Primary headaches should thus be regarded as neurovascular headaches to emphasize the interaction between nerves and vessels which is their underlying characteristic.
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We describe a case of delirium due to olanzapine overdose. After ingestion of 280 mg of olanzapine, a 19-year-old schizophrenic patient developed a delirium (ICD-10: F 05.0) with consciousness disturbance, disorientation in time, space, and situation, acoustic and visual hallucinations, and agitation. The symptoms lasted for approximately 36 h. ⋯ There were no abnormalities in ECG, EEG, or routine blood tests. Approximately 36 h after the intoxication, the patient recovered fully. Until now, there have been no reports of delirium from this cause.
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German psychiatry has been using parent-child treatment for only a few years-in contrast to Anglo American countries. Now, however, similar modalities are now on the rise in Germany, and it is time to list experiences and considerations of possible quality standards for such treatment units. To account for the necessary broadening of perspectives including the whole family system, the term "parent-child treatment" is used instead of the frequently used "mother-child treatment."