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Adelina Simona Serban-Pereteanu

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Articles signed on Romanian Journal of NEUROLOGY:

WHERE IS THE BRAIN?

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Romanian Journal of Neurology, Volume XIII, No. 4, 2014
ISSN 1843-8148  |  e-ISSN 2069-6094
ISSN-L 1843-8148
DOI: 10.37897/RJN

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WHERE IS THE BRAIN?

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We present the CT of a 26-year-old female patient with infant encephalopathy and hydrocephalus, referred to the Neurology emergency room from "Prof. Dr. Matei Bals" Institute of Infectious Diseases, where she was brought for high temperature and increased frequency of tonic-clonic seizures. Physical examination revealed neck stiffness, tetramelic hypotrophy and flexion of the upper limbs, extension, and internal rotation of the lower limbs, fever 38 degrees Celsius. Brain CT revealed massive hydrocephalus.

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FROM HEADACHE TO BINSWANGER

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Romanian Journal of Neurology, Volume XIII, No. 4, 2014
ISSN 1843-8148  |  e-ISSN 2069-6094
ISSN-L 1843-8148
DOI: 10.37897/RJN

Indexată BDI  |  IDB Indexed

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FROM HEADACHE TO BINSWANGER

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We present the case of a 66-year old female, with hypertension, who presents headache for about 1 year, emotional unsteadiness, and anxious states. Clinical examination revealed nystagmus, upper limb dysmetry, and has a MMSE score of 26 points. Brain MRI emphasized multiple hyperintense lesions on T2 sequences distributed supratentorially, and affecting the cerebral white matter. The differential diagnosis was established between Binswanger disease (subcortical atherosclerotic encephalopathy) and CADASIL syndrome (cerebral autosomal dominant encephalopathy with subcortical infarcts and leucoencephalopathy. The last was ruled out because the patient had no family history of such syndrome.

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ANTI-NMDA-RECEPTOR ENCEPHALITIS IN A YOUNG WOMEN: A DIAGNOSTIC CHALLENGE

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Romanian Journal of Neurology, Volume XIII, No. 4, 2014
ISSN 1843-8148  |  e-ISSN 2069-6094
ISSN-L 1843-8148
DOI: 10.37897/RJN

Indexată BDI  |  IDB Indexed

DOI - Crossref
Similarity Check by iThenticate, worldwide No 1 professional plagiarism checking system
DOAJ
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Ebsco Host - Medline
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Semantic Scholar

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Plagiatul – în actualitate

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ANTI-NMDA-RECEPTOR ENCEPHALITIS IN A YOUNG WOMEN: A DIAGNOSTIC CHALLENGE

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ABSTRACT

A 42-year-old women is admitted in the Psychiatric Department with signs of acute psychosis. She had orolinguofacial dyskinesias, episodes of bilateral rigidity, oculocephalogyric crisis and becomes stuporous. The cerebral MRI highlighted two supratentorial demielination lesions. The CSF examination shows clear CSF with moderate pleocitosis and the predominance lymphocyte. Viral and bacterial cultures were negative. The patient is transferred to our Department of Neurology after 5 days, and runs a fever. Also, orolinguofacial dyskinesias, hypersalivation, puppet’s eye syndrome, swallowing disorders, bilateral jerks osteotendinous reflexes, and coma state (GCS=5) are present. A second cerebral MRI was performed, which suggested two hypersignal lesions, T2, FLAIR and T1 hyposignal present, with no diffusion restriction, one being 0.9 cm, situated subcortically and to the right, the other of 0.5 cm being located on the left subcortical parietal, without gadolinium enhancement. The native pelvic CT scan marked out a 4.9 cm left annex cyst present. Anti-NMDAR antibodies were present in the CSF. As the patient was comatose, an interventional genital procedure is contraindicated. The patient was given iv Immunoglobulis, Methylprednisolone, Cyclophosphamide, anticonvulsives, and large spectrum antibiotics. She manifested multiple oculocephalogyric crisis, in both directions, bronchopneumonia, respiratory failure, requiring mechanical ventilatory support. The patient dies three weeks after the onset of the symptoms. The pathological examination revealed a left mature ovarian teratoma. The anti-NMDAR encephalitis is a life-threatening condition consisting of memory and psychiatric disorder, alteration of consciousness and hypoventilation, common associated with ovarian teratomas. The fast diagnosis and an early specific treatment can strongly influence the antiNMDAR encephalitis’s natural evolution.

Keywords: Anti-N-methyl-D-aspartate-receptor (NMDAR) encephalitis, autoimmune encephalitis, paraneoplastic syndrome, ovarian teratoma

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