Complaints Of Tremor Research Articles

6770 Graves’ disease induced by COVID-19 infection in a 49 year old male

Abstract Disclosure: N. Al-hosainat: None. A. Al Najada: None. T. Salar: None. S. Iqbal: None. K. Abdel Gadir: None. Introduction: Graves’ disease is an autoimmune disease causing hyperthyroidism, characterized by elevated thyrotropin-receptor antibodies. COVID-19 infection has been increasingly reported as a trigger of thyroid illness including Graves’ disease. We present a unique case of 49-year-old patient who was diagnosed with Graves’ disease after COVID-19 infection. Case description: A 49-year-old male patient with history of prediabetes presented with complaints of tremor, fatigue, generalized itching, and unintentional weight loss (30 Ibs in 6 months). He had COVID-19 infection 3 months prior. The remainder of review of systems was negative. No family history of thyroid disease. On exam, the patient had sinus tachycardia with otherwise normal vital signs. Diffuse thyromegaly was noted along with an intermittent fine tremor of the extremities. Blood work was notable for low TSH <0.01 uIU/mL, elevated free T4 (3.4 ng/dL), free T3 (17.6ng/dL), and TSH receptor antibody (12 IU/L). Thyroid ultrasound showed mild goiter with 2 nodules, one of which was TIRADS 4 and 1.5cm. This nodule was biopsied and found to be benign. Radioactive iodine uptake scan revealed homogeneous diffuse increased thyroid uptake. The diagnosis of Graves’ disease was made, and the patient was started on propranolol and methimazole with significant improvement of his symptoms and his laboratory tests normalizing. Discussion: Graves' disease is an autoimmune disease, characterized by hyperthyroidism, goiter, occasional orbitopathy and dermopathy. Caused by antibodies against thyroid-stimulating hormone receptors which stimulate thyroid hormone secretion and thyroid growth. Treatment is aimed to decrease thyroid hormone synthesis by either a Thionamide, radioiodine ablation, or surgery. Remission rates with antithyroid drugs average under 40 percent after one to two years of treatment and could exceed 80 percent after 5 to 10 years of treatment. COVID-19 is a multi-system disease, caused by SARS-CoV-2 virus, transmitted by large droplets and small particle aerosols, was declared a pandemic in 2020 and affected millions of people worldwide. There is emerging data showing the association of COVID-19 with various thyroid diseases including thyroiditis and relapse of known Graves' disease after the infection. We present a case of newly diagnosed Graves’ disease after COVID-19 infection in a patient with no personal or family history of such disease which raises the concern of autoimmune pathway activation induced by the infection. The onset of Graves’ disease after COVID-19 infection does not depend on the presence of pre-existing thyroid pathology and in this case responded well to antithyroid medication. Conclusion: COVID-19 can lead to the development of a range of medical illnesses. In patients who develop symptoms of thyrotoxicosis, Graves’ disease should be suspected, investigated, and treated appropriately Presentation: 6/3/2024

Management of Parkinson’s Disease (Kampavata) Through Panchakarma

Parkinson's disease is a progressive degenerative neurological disorder mainly affecting geriatric population. The most crucial signs and symptoms of Parkinson’s disease arise while the nerve cells in basal ganglia, an area of mind that controls the movement grow to be impaired or die. When these neurons die or get impaired, they generally tend to produce much less amount of vital chemical in the brain known as Dopamine which causes numerous signs and symptoms like tremors, rigidity in muscular tissues, akinesia and postural disability related to numerous cognitive, behavioural and other mental signs. In Ayurveda due to similar disease presentation, Parkinson's disease can be compared with Kampavata. Kampavata has been described under Vataja Nanatmaja Vyadhi. Various Panchakarma therapies have been mentioned in classics for the treatment of Kampavata like Abhyanga, Swedana, Niruha Basti, Anuvasana Basti, Shirobasti and Virechana. In this case study, a 68 years old male patient came to ITRA Hospital having complaints of tremors in both upper limbs, difficulty in speech and slowness of movements since last 10 years. He was already diagnosed with Pankinson's disease and is receiving allopathy treatment for the same since last 10 years. Here he was given treatment like Abhyanga, Swedana, Matra Basti and Nasya for 21 days. The patient got moderate improvement in his signs and symptoms. It was concluded with the study that Panchakarma therapies has been found beneficial in improving quality of life of patient.

Management of Parkinson's disease through Ayurvedic approach

Parkinson's disease (PD) is a disease with insidious onset and slow progression. It is a neurologic condition that causes motor manifestations, namely, bradykinesia, rigidity, resting tremor, flexed posture, and nonmotor symptoms such as depression and dementia. PD can be correlated with Kampavata in Ayurveda based on similar symptomatology. The modern treatment provides some symptomatic relief but no proven means of slowing progression have yet been found. This present case is of a 72-year-old male patient who presented with complaints of tremors in both hands, and difficulty in speech and movement for 11 months which was increasing progressively and was hindering his routine activities. He was administered Kapikachhu and Ashwagandha for 60 days with follow-up after every 20 days. In every follow-up, the patient reported significant relief in his symptoms and after two months, he was able to perform his routine activities without any help. Kapikachhu and Ashwagandha are two easily available, noncontroversial Ayurvedic herbs, which can be used in the management of PD.

Asymptomatic meningitis diagnosed by positron emission tomography in a patient with syndrome of inappropriate antidiuretic hormone secretion: a case report

BackgroundSyndrome of inappropriate antidiuretic hormone secretion can be caused by arginine-vasopressin-producing tumors or enhanced arginine vasopressin secretion from the posterior pituitary gland due to central nervous system disorders and intrathoracic diseases.Case presentationA 53-year-old Asian man was hospitalized with complaints of tremor and hiccups. Laboratory examination revealed findings suggestive of hypotonic hyponatremia due to syndrome of inappropriate antidiuretic hormone secretion. The patient did not complain of headache or photophobia, and showed no signs of meningeal irritation. Positron emission tomography–computed tomography revealed 18F-fluoro-deoxy-glucose accumulation along the cervical spinal cord, based on which the patient was diagnosed as having aseptic meningitis. The hyponatremia was treated successfully by fluid restriction, and optimum plasma sodium concentration was maintained by tolvaptan administration.ConclusionsThis case underscores the need to consider the possibility of mild meningitis as the cause of syndrome of inappropriate antidiuretic hormone secretion in patients without other identifiable cause.

Bipolar Bozukluğu Olan Bir Hastada Hemikore ve Tardiv Diskinezi Birlikteliği

Chorea consists of random, involuntary, continous, abrupt, short, jerky movements with different severity that can pass through one part of the body to the other parts. Hemichorea mostly occurs after the contralateral thalamic stroke, but may also occur in lesions involving the basal ganglia, white matter tracts, and the pons. Case. A 60 year old, married, primary school educated, housewife, female patient was refered to our clinic. In 1993, she had the complaints of being followed, crying, decreased self-esteem and aggression. With the diagnosis of bipolar disorder mixed episode, sertraline 50 mg/day and risperidone 4 mg/day treatment was initiated and used about 12 years for this treatment. In that time, exacerbation was not observed. In 2009, she had the complaints of tremors on the left side, involuntary movements of the arms and legs, speech disorders and balance disorders. Brain magnetic resonance imaging showed ischemia in the basal ganglia. Due to hemichorea (involuntary movements of the arms and legs), haloperidol 10 mg/day treatment was started. Nearly 4 years later, she emerged the symptoms of tardive dyskinesia.When haloperidol treatment was decreased gradually hemichorea symptoms increased whereas increasing the dose of haloperidol treatment symptoms of tardive dyskinesia increased. In this article, the difficulties in diagnosis and treatment of tardive dyskinesia and hemichorea in a bipolar patient were discussed.

MALIGNANT GASTROINTESTINAL STROMAL TUMOR OF THE STOMACH WITH DISSEMINATION-A CASE REPORT-

A 68-year-old man was admitted to our hospital with complaints of tremor and bilateral arm numbness. An MRI of the head showed multiple cerebral infarctions. Abdominal CT scanning detected a cystic tumor of the upper abdomen and angiography revealed that the tumor was fed by the splenic artery. Intraoperative findings determined that the tumor originated from the stomach with signs of dissemination. Total gastrectomy, distal pancreatectomy, splenectomy, and transverse colon resection were performed. The resected specimen was 30×23×10cm with signs of central necrosis. Histological and immunohistochemical studies of the specimen disclosed many mitosis, and that it was negative for vimentin, s-100, SMA, some areas were partially positive for NSE, and positive for CD34. This tumor was identified as a maligmant gastrointestinal stromal tumor, uncommitted type.

Relationship between hypoglycemic symptoms and blood glucose levels due to self-monitoring in summer camp for diabetic children in Japan

In a summer camp for 47 diabetic children in Kinki district, Japan, in 1984, the relationship between hypoglycemic symptoms and blood glucose levels by self-monitoring was analyzed. During the 7-day camp, self-monitoring of blood glucose (SMBG) was carried out 599 times in total, 12.7 times per camper. SMBG due to hypoglycemic complaints amounted to 371. 154 measurements out of 371 indicated blood glucose levels under 80 mg/dl, but 78 monitorings were found to be over 200 mg/dl. Fatigue or weakness were the most frequent hypoglycemic symptoms, as was hunger sensation, each reaching approximately 40% in frequency. In most complaints of tremor, the blood glucose level was critically low. Prompt measurement of blood glucose is indeed necessary to properly treat diabetic children with 'hypoglycemic' symptoms.