- 著者
- Sakiko Itaya Zen Kobayashi Kokoro Ozaki Nozomu Sato Yoshiyuki Numasawa Kinya Ishikawa Takanori Yokota Hiroshi Matsuda Shuzo Shintani
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- pp.0068-17, (Released:2018-02-09)
- 参考文献数
- 14
- 被引用文献数
- 4
A 58-year-old man consulted our hospital due to a 2-year history of dysarthria and a 1-month history of blepharospasm. In addition to the ataxic dysarthria and blepharospasm, a neurological examination demonstrated slight ataxia of the trunk and lower limbs. Brain MRI demonstrated atrophy of the upper portion of the cerebellar vermis. Gene analysis established a diagnosis of spinocerebellar ataxia type 31 (SCA31). SPECT with the three-dimensional stereotaxic ROI template (3DSRT) software program demonstrated hyperperfusion in the lenticular nucleus and thalamus. Although the association between SCA31 and blepharospasm in our patient remains unclear, we considered that this combination might be more than coincidental.
- 著者
- Soichiro Suzuki Shotaro Naito Yoshiyuki Numasawa Mizuho Asada Norikazu Shoji Moko Zeniya Daiei Takahashi Hidehiko Sato Soichiro Iimori Naohiro Nomura Eisei Sohara Tomokazu Okado Yasuyoshi Ishiwata Masashi Nagata Tatemitsu Rai Takanori Yokota Shinichi Uchida
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- vol.58, no.12, pp.1775-1779, 2019-06-15 (Released:2019-06-15)
- 参考文献数
- 23
- 被引用文献数
- 23
Encephalopathy is a rare side effect of cephalosporin treatment. We herein present a case of encephalopathy induced by ceftriaxone, a third-generation cephalosporin, in a patient with renal failure. An 86-year-old woman on maintenance hemodialysis received ceftriaxone for Helicobacter cinaedi bacteremia. Her mental status deteriorated during antibiotic treatment, and an electroencephalogram revealed triphasic waves predominantly in the frontal area. Her consciousness improved after the discontinuation of the antibiotic due to the suspicion of ceftriaxone-induced encephalopathy. This is the first reported case of encephalopathy associated with high plasma and cerebrospinal fluid ceftriaxone concentrations, and provides significant evidence for a causal relationship between the administration of ceftriaxone and the onset of encephalopathy.
- 著者
- Soichiro Suzuki Shotaro Naito Yoshiyuki Numasawa Mizuho Asada Norikazu Shoji Moko Zeniya Daiei Takahashi Hidehiko Sato Soichiro Iimori Naohiro Nomura Eisei Sohara Tomokazu Okado Yasuyoshi Ishiwata Masashi Nagata Tatemitsu Rai Takanori Yokota Shinichi Uchida
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- pp.1785-18, (Released:2019-02-25)
- 参考文献数
- 23
- 被引用文献数
- 23
Encephalopathy is a rare side effect of cephalosporin treatment. We herein present a case of encephalopathy induced by ceftriaxone, a third-generation cephalosporin, in a patient with renal failure. An 86-year-old woman on maintenance hemodialysis received ceftriaxone for Helicobacter cinaedi bacteremia. Her mental status deteriorated during antibiotic treatment, and an electroencephalogram revealed triphasic waves predominantly in the frontal area. Her consciousness improved after the discontinuation of the antibiotic due to the suspicion of ceftriaxone-induced encephalopathy. This is the first reported case of encephalopathy associated with high plasma and cerebrospinal fluid ceftriaxone concentrations, and provides significant evidence for a causal relationship between the administration of ceftriaxone and the onset of encephalopathy.
- 著者
- Nobuo Sanjo Satoko Kina Yukiko Shishido-Hara Yurie Nose Satoru Ishibashi Tetsuya Fukuda Taketoshi Maehara Yoshinobu Eishi Hidehiro Mizusawa Takanori Yokota
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- vol.55, no.12, pp.1631-1635, 2016-06-15 (Released:2016-06-15)
- 参考文献数
- 15
- 被引用文献数
- 13 14
A 53-year-old man was admitted for sub-acute progressive dementia and Gerstmann syndrome. MRI demonstrated lesions in the white matter involving the left parietal lobe, accompanied by speckled or faint linear peripheral enhancement. Brain biopsy revealed JC virus infection in oligodendrocytes and balanced infiltration of CD8+ and CD4+ T lymphocytes. We diagnosed progressive multifocal leukoencephalopathy (PML) with controlled inflammation. The finding of CD4/CD8 T cells in the infected PML brain suggested therapeutically valuable immune system involvement, which we decided to preserve by withholding corticosteroids. We treated the patient with risperidone, cytarabine and mefloquine to suppress virus replication, but not with the corticosteroid that is conventionally used in inflammatory PML cases. The patient was discharged three months after admission, and one year later, his score on the Mini-Mental State Examination had recovered to 26/30, from 5/30 on admission.
- 著者
- Kokoro Ozaki Takuya Ohkubo Tetsuo Yamada Kotaro Yoshioka Masahiko Ichijo Takamasa Majima Shunsuke Kudo Takumi Akashi Keiji Honda Eisaku Ito Mayumi Watanabe Masaki Sekine Miwako Hamagaki Yoshinobu Eishi Nobuo Sanjo Satoru Ishibashi Hidehiro Mizusawa Takanori Yokota
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- vol.57, no.23, pp.3451-3458, 2018-12-01 (Released:2018-12-01)
- 参考文献数
- 29
- 被引用文献数
- 1 8
Progressive encephalomyelitis with rigidity and myoclonus (PERM) is an autoimmune disorder involving the brainstem and spinal cord and is sometimes associated with thymoma. We encountered a 75-year-old woman with typical PERM features, glycine receptor antibody, and thymoma. Her neurologic symptoms improved after thymectomy, but she unexpectedly developed anasarca with massive pleural effusions and hypoalbuminemia and finally succumbed to death. The autopsy showed edema and mononuclear infiltration in the pleura but no neuropathological findings typical of PERM. Effective treatment of PERM can reverse the neuropathological signs of encephalomyelitis. The autoimmune nature of anasarca is possible but not proven.