Abstract
Context: Varicella-zoster virus (VZV) primary infection causes a diffuse vesicular rash and affects mainly young people. VZV-associated encephalitis is a rare complication since the advent of vaccination, and can present as different neurological syndromes. This report aims to describe a case of acute cerebellar ataxia after VZV-associated encephalitis in a child, admitted to the Onofre Lopes University Hospital (HUOL) in Natal, Brazil. Case report: We present the case of a 9-year-old girl referred to HUOL with polymorphic skin lesions for 8 days. She evolved with headache, vomiting, drowsiness and confusion. Upon admission, she was pale (+/4+), anicteric, confused (GCS=14), hemodynamically stable, SaO2=99%, with pupillary response and no meningism. Laboratory tests showed Hb 11.7g/dl, leukocytes 7,200/mm³ (93% segmented, 1% eosinophils, 5% lymphocytes and 2% monocytes), AST 38U/ml and ALT 46U/ml. Once clinical diagnosis of VZVencephalitis was made, the patient was admitted to the ICU for monitoring and treatment. Cranial CT showed hypodensities on the frontal and occipital lobes; CSF analysis: glucose=76mg/dl, proteins=24mg/dl, leukocytes=9/mm3 (monocytes 78%). She improved progressively and was transferred to the ward, evolving with ataxia, suggesting cerebellitis. Conclusions: This case describes a chickenpox rare complication nowadays: encephalitis. Along evolution, the patient presented acute cerebellar ataxia, a more prevalent condition in children, usually having a limited course.
Highlights
Capsaicin is able to induce mast cell degranulation, an event probably related to the pathophysiology of a migraine attack
The present review study aimed to address the mechanisms of action of capsaicin and other chemical inducers in mast cell degranulation and an interaction of nerves and events that happen in the dura mater with the activation of mast cells
Conclusion: the analyzed data indicate that the polymorphisms contributed to the susceptibility to Parkinson’s disease (PD), further studies related to the polymorphisms and their relationship to PD are still needed for more ethnic groups, and early diagnosis is possible
Summary
Capsaicin is able to induce mast cell degranulation, an event probably related to the pathophysiology of a migraine attack. Methods: A literature review and an observational, descriptive and transversal data collect on treatment for acute demyelinating polyradiculoneuritis, available at DATASUS from January 2008 to December 2020, and articles available at Scielo and PubMed. Results: There were 7,917 hospitalizations, representing a total expenditure of R$ 9,392,552.04, 2009 being the year with the highest number of hospitalizations (809) and 2017 with the highest amount spent during the period (R$ 967,284.65). Methods: A literature review and an observational, descriptive and transversal data collect on surgical treatment was carried out, available from January 2008 to December 2020 and articles available in Scielo, Lilacs and PubMed. Results: There were 15,148 hospitalizations for surgical procedures for the treatment of chronic subdural hematoma, representing a total expenditure of R$ 45,365,258.21, with 2018 being the year with the highest number of hospitalizations (1,418) and with the highest amount spent during the period (R$ 4,570,334.28). Conclusions: The “Coca-Cola Bottle sign” is a classic sign of Graves’ disease, some signs, such as, unilateral and single orbital musculature involvement, may be suggestive of involvement by other etiologies, suggesting the benefit of an early expanded investigation
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