Encephalopathy
Complicaciones neurológicas post-vacuna COVID. Neurological complications post-COVID vaccine.
Post-vaccine SARS-CoV-2 neurological complications are rare. However, due to the SARS-CoV-2 pandemic, massive vaccination has been carried out worldwide, which is why we have seen a greater report of post-vaccination neurological adverse effects.
We present 4 cases, which after receiving the SARS-CoV-2 vaccine presented 4 different neurological pathologies at the Hospital Comarcal de Vinaroz during the year 2021.
A relationship between vaccination and the onset of neurological symptoms is observed. Three patients presented clinical manifestations in relation to the BNT162b2 vaccine. The first patient after administration of the first dose of the BNT162b2 vaccine presented diplopia and palpebral ptosis, a condition compatible with ocular Myasthenia gravis. The second patient had symptoms of acute sensory motor axonal polyneuropathy after the third dose. The third patient, who after the third dose of BNT162b2 presented lethargic encephalopathy. The fourth patient presented symptoms compatible with aseptic meningitis after AZD1222 and mRNA-1273 vaccination.
Due to the worldwide mass vaccination campaign, reports of accidentally related or causally linked neurological complications are emerging. These are very varied; they could be related to immunological and/or toxic mechanisms. Physicians must be aware of these possible adverse effects and rule out other causes. Studies should be carried out that allow us to clarify the pathological mechanisms in relation to post-vaccination complic ations.
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Encefalopatía Hepática: Diagnóstico y Tratamiento en 2019. Hepatic Encephalopathy: Diagnosis And Treatment In 2019
Hepatic encephalopathy is a clinical syndrome of neuropsychiatric disturbances secondary to the variable combination of hepatocellular dysfunction and portal hypertension. It is an ominous entity, which marks a high risk of death in patients with cirrhosis, since its appearance occurs in advanced stages of it. The spectrum of manifestations ranges from subclinical EH, which is only diagnosed by alterations in neuro-psychometric tests, to coma. Currently, the treatment has ammonium as a therapeutic target, either inhibiting or decreasing its production or modifying its extraction and the two most important complications are rifaximin and lactulose, which have proven efficacy both in the management of the acute episode and in preventing recurrence. In 90% of patients, a precipitating factor can be identified and makes part of the entity’s management treat that factor. Despite its wide recommendation, there are recommendations that lack enough evidence to be implemented. As with other complications of portal hypertension, hepatic encephalopathy is an indication of liver transplantation.
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Encefalopatía Posterior Reversible Asociada a Exacerbación de Enfermedad Pulmonar Obstructiva Crónica. Reporte de Caso y Revisión de la Literatura. Reversible Posterior Encephalopathy associated with Exacerbation of Chronic Obstructive Pulmonary Disease. Case Report and Review Of Literature
Posterior Reversible Encephalopathy Syndrome (PRES) is a reversible clinical and radiological entity. There are several entities that are associated with PRES. Chronic obstructive pulmonary disease (COPD) is a rare factor for the development of this condition. We present the case of a 71-years-old woman who was being treated for an acute exacerbation of COPD and developed sensory impairment and seizures. The findings of characteristic images, associated clinical symptoms and their medical history led to a diagnosis of PRES in our patient. Although the association of PRES and COPD is a rare entity, the diagnosis of PRES should be a differential if a patient develops encephalopathy or seizures in the exacerbation of COPD.
