Abstract
Context: Osmotic demyelination syndrome (ODS) is rare, acute, severe and non-inflammatory. It is caused by the demyelination of neurons with the preservation of axons. It is called central pontine myelinolysis (CPM) when it affects the central pontine region and extra-pontine myelinolysis (EPM) when it affects other areas. Few cases of ODS due to non-electrolytic causes are reported. Case report: 54-year-old man with a history of heavy drinking. After about 24 hours of alcohol withdrawal, he developed generalized tonic-clonic seizures, associated with a lower level of consciousness. Protective orotracheal intubation was performed and the use of anti-crisis drugs was initiated. After sedation was switched off and mechanical ventilation was set to minimum parameters, the patient remained comatose and with convergence-retraction nystagmus movements. A skull MRI was performed, which showed lesions compatible with CPM and EPM. There was no variation in the patient’s plasma sodium during hospitalization. Conclusion: this is a patient with no evidence of any significant hydro-electrolyte disturbance and who presented a compatible neurological condition and neuroimaging characteristic of CPM / EPM. There is no specific clinical treatment for this pathology. Furthermore, the patient presents with the finding of convergence-retraction nystagmus, possibly explained by atrophy of the dorsal midbrain region.
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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