Symptoms Of Nervous System Involvement Research Articles

Prognostic factors of nervous system damage in children with COVID-19

this work is devoted to the study of the features of the structure of symptoms related to the nervous system in children with coronavirus disease (COVID-19). During the COVID-19 pandemic, there is a rapid increase frequency of neurological lesions. The share of neurological manifestations in COVID-19 among adult patients is up to 82%, in children it ranges from 3% to 47%. The aim of the work was to study the frequency and structure of neurological symptoms in children who were hospitalized in an infectious disease hospital with a laboratory-confirmed diagnosis of COVID-19 during 2020-2022 and to determine prognostic factors of nervous system damage. Materials and methods: We retrospectively investigated 945 medical histories of children aged from birth to 18 years who were hospitalized at the Kyiv City Children's Infectious Disease Hospital ("KCCIDH") in Kyiv, Ukraine during the pandemic. Among them, we analyzed cases accompanied by neurological symptoms. Features of the clinical picture, laboratory and demographic-epidemiological data were determined. The statistical calculation of the obtained results was carried out by using the statistical package Statistical software EZR v. 1.54. Results: Neurological symptoms were detected in 142 (15%) children, the majority of them were adolescents (55.6%). The leading symptoms of nervous system involvement were headache, ageusia/anosmia, convulsive syndrome, acute polyneuropathy, and myalgia/arthralgia. According to the analysis of odds ratio developing of neurological symptoms among patients in our cohort, children of the older age group (10-18 years) had statistically greater chances developing of neurological manifestations. Odds ratio developing of the aforementioned symptoms depending on clinical syndromes were also analyzed. Among respiratory syndromes, the presence of cough (5.53; 95%CI 3.53-8.65) and signs of lower respiratory tract inflammation (1.8; 95%CI 1.21-2.67) were associated with a higher risk of nervous system symptoms damage. According to the study of laboratory indicators, an increased level of leukocytes (2.01; 95%CI 1.2-3.38) was associated with an increase frequency of neurological manifestations, and in groups of patients with an increased level of C-reactive protein (0.39; 95%CI 0.23-0.68) or procalcitonin (0.21; 95% CI 0.11-0.43), on the contrary, a lower frequency of neurological symptoms was observed. Conclusions: Neurological symptoms occur in 15% of children with COVID-19. According to the results of our work, the older age of the child, cough and symptoms of inflammation of the lower respiratory tract are the prognostic factors of the occurrence of neurological symptoms in children with COVID-19. In addition, our study demonstrated the prognostic value of the appearance of neurological symptoms with an increase in the leukocyte index, as well as the absence of a correlation of neurological symptoms with an increase in CRP and procalcitonin.

A Noteworthy Case Report of Neuroborreliosis in an Unvaccinated Pediatric Patient.

IntroductionLyme disease typically presents with viral-like symptoms and a pathognomonic rash. With disease progression, symptoms of nervous system involvement usually include facial nerve palsy and meningitis, but other atypical neurologic manifestations have less commonly been documented.Case ReportA six-year-old male presented with prolonged fevers, rash, headache, and non-specific neurologic symptoms. The diagnosis of neuroborreliosis with meningitis and polyradiculitis was confirmed with laboratory evaluation and lumbar puncture.ConclusionNeuroborreliosis is a disseminated form of Lyme disease. While meningitis is a common sign, the presentation of polyradiculitis in children is rare and can lead to misdiagnosis and delay in treatment.

Cognitive and cerebral hemodynamic impairment in scleroderma patients

Neurological involvement in systemic sclerosis is unusual despite the possible cerebral localization of vascular lesions. The aim of this study was to evaluate cognitive performances and cerebral vasoreactivity in young scleroderma patients without any signs or symptoms of nervous system involvement. Sixteen scleroderma patients and 16 sex- and age-matched healthy subjects without vascular risk factors were included. A neuropsychological assessment for the evaluation of different areas of cognition was performed. For an assessment of cerebrovascular reactivity (CVR), each subject was submitted to hypercapnia with transcranial Doppler ultrasonography using the Breath-Holding Index (BHI). Patients had significantly lower adjusted mean levels of performance with respect to controls in the Modified Card Sorting Test (P < 0.001) and in the Trail Making Test Parts A and B (P < 0.001 and P < 0.05 respectively). Regarding CVR, BHI values were significantly lower in patients with respect to controls: 0.82 +/- 0.44 vs. 1.34 +/- 0.18, P < 0.0001. These findings show the presence of reduced performances of executive functions in scleroderma patients. The associated alteration of CVR in the absence of other apparent causes of cerebrovascular impairment suggests that cognitive problems may be related to an alteration in cerebral perfusion regulation specifically linked to the disease. Further studies are needed to evaluate whether cognitive changes may be positively influenced by treatments aimed to improve vessels functionality in scleroderma patients.

Hepatocellular carcinoma presenting as nervous system involvement

To analyze the clinical features of hepatocellular carcinoma (HCC) in patients with signs and symptoms of nervous system involvement as the initial presentation. Over a period of 11 years (January 1993 to December 2003), 15,008 HCC patients were identified at the Chang Gung Memorial Hospital in Kaohsiung, Taiwan. Amongst them, 42 cases had nervous system involvement, of which six had nervous system involvement as their initial presentation. These six cases were enrolled in this study and their clinical and laboratory data were analyzed. The clinical features of the other 36 HCC cases with nervous system involvement were also analyzed for comparison. The six cases were all males, aged 36-68 years old. The involved parts of the nervous system were the cerebellar hemisphere (one), the frontal lobe (one), the sphenoid sinus, sellar turcica, and cavernous sinus (one), the cervical spine (one), and the thoracic spine (two). Their corresponding neurologic presentations were back pain, headache, consciousness disturbance, visual disturbance, and limb weakness. Whilst three out of six patients presenting with nervous system manifestations were found to have concurrent systemic metastases in other expected sites (lung, bone), three had isolated nervous system involvement even after extensive work up. The associated medical conditions of the six cases included hepatitis B (three), hepatitis C (one), liver cirrhosis (two), portal vein thrombosis (three), and diabetes mellitus (two). All the six died within 9 months after the detection of nervous system involvement. The prevalence of nervous system involvement in HCC patients is 0.28% (42/15,088), with 0.04% (6/15,088) having this as their initial presentation. The prognosis of HCC with nervous system involvement is grave. Their clinical and laboratory data are not unique but the diagnosis could only be confirmed by hepatic and nervous system imaging studies, histopathologic examination, and serum alpha-fetoprotein detection. This consideration should be emphasized especially in areas that are hyperendemic for HCC and if the original focus of metastatic lesion is obscure.

Clinical and molecular analysis of 11 Sicilian SCA2 families: influence of gender on age at onset.

Autosomal dominant cerebellar ataxias (ADCAs) are a complex group of slowly progressive neurodegenerative disorders characterized by gait and stance ataxia, dysarthria and other symptoms of nervous system involvement. ADCA type I is the commonest form and is genetically heterogeneous; several loci have been identified. Spinocerebellar ataxia type 2 (SCA2) has been mapped to chromosome 12, with expanded cytosine-adenine-guanine (CAG) repeats being identified as the mutational cause of the disease. We investigated 15 families, all originating from mid-eastern Sicily, with ADCA type I; molecular studies performed in 12 families showed the SCA2 mutation to be present in 11 of them (91.6%) - the highest occurrence so far reported in the literature. The CAG repeat of the affected alleles varied between 34 and 44 repeats. Age at onset and repeat length revealed an inverse correlation. Mean age at onset was 37.32 +/- 16. 74 years, and occurred earlier in males than in females. There were no differences in mean CAG repeat units between the sexes. However, a higher instability of CAG repeats was observed for paternal transmission than for maternal transmission. Age at onset and anticipation were not related to parental transmission. Our data suggest that in SCA2 an unknown sex-linked factor may play a role in the modulation of toxic effects of the polyglutamine tract.

The Essential Amino Acid Requirements of Infants: IX. Isoleucine

The isoleucine requirement of six normal infants has been studied and has been found to lie between 79 and 126 mg. per kg. per day. The withdrawal of isoleucine from the diet led to marked impairment of nitrogen retention and in some instances to symptoms of nervous system involvement. A reduction in the plasma cholesterol was observed in several instances. The amino acid pattern of the plasma was markedly altered, the concentration of isoleucine itself being reduced and that of certain other amino acids increased. Noteworthy were the increased levels of tyrosine, phenylalanine, valine, serine and lysine.

Studies of dengue fever virus (Hawaii mouse adapted) in lactating hamsters.

Summary From this observation it appears that dengue fever virus (Hawaii mouse adapted) may be transmitted from lactating hamsters to suckling hamsters. None of the mothers showed symptoms of nervous system involvement over a 21 day observation period. Mouse tests of their brains were negative. Four out of 32 suckling hamsters developed symptoms of nervous system involvement and their brains were shown to contain dengue fever virus by neutralization tests conducted intracerebrally in Swiss albino mice. The control sucklings and sucklings from the exposed mothers showing no signs of central nervous system involvement were sacrificed and their brains tested by the intracerebral mouse test, but no virus was demonstrated.