So we can all agree, based on the information above, that an unobstructed flow of CSF is necessary for optimal health. Discogenic pain may result from this condition as spinal discs are subjected to uneven pressure. At any rate, I will continue my path following what feels good to my body, and keeping conditioned simultaneously.
When teaching, it’s best to try to analyze or get the students to analyze if they have an anterior tilt to their pelvis. Corresponding author: Seong-Ho Park, Department of Neurology, Seoul National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam 463-707, Korea, Tel. KlA?ver-Bucy syndrome (KBS) is a constellation of cognitive dysfunction including the inability to recognize the emotional significance of objects, hypersexuality, altered emotional behavior (particularly placidity), hyperorality, hypermetamorphosis (the tendency to react to every visual stimulus) and amnesia (anterograde, retrograde or global).1,2 It has been reported in adult humans with structural lesions located in various locations of brain, bilateral or unilateral anterior temporal lobe,1,3 amygdala,4 and so on. A 31-year-old man who had no significant medical history presented with status epilepticus. This report describes a patient presenting as KBS after status epilepticus associated with MRI-documented structural lesions exclusively located in bilateral hippocampus.
After recovery from status epilepticus, many of the patients show postictal psychiatric phenomenon for a while.
This case suggests the possibility that the lesion limited to bilateral hippocampal area may result in the KBS.
We explained to the patient and his family that we will report his case and received consent from them.
While CSF pleocytosis suggestive of viral disease is more consistently seen with viral illness in older patients, it may not be helpful in neonates.
PCR have been utilized in the testing of specimens from the CSF, pharynx, serum, and urine.69 One study of 502 children, two-thirds of whom were less than 1 year of age, reported 100% sensitivity and 97% specificity when using CSF PCR compared to CSF viral culture,72 which has a sensitivity of 65% of 75%. Because there is no universal standard PCR kit, individual laboratories may use different methods for obtaining and interpreting the results. Recent studies are evaluating the use of serum markers in the evaluation of neonatal sepsis such as acute phase reactants and prolacitonin.60,80,81 The possibility of using these markers in identifying septic infants may help in the management of these patients. Teachers will even say that being able to lengthen the spine helps the cerebrospinal fluid to flow more easily. Cerebrospinal fluid is a fluid that circulates throughout the spinal canal and across the surfaces of the brain, which at any given moment is about 150 ml (in the subarachnoid space) in volume. As the anterior sides of the lumbar vertebrae move closer together, the pressure placed on the spinal disc may cause a rupture or bulge on the posterior side. The muscles that are tight are chronically strained and likely have knots called trigger points. As for the comment prior, I have a hard time with telling people to tuck the tailbone under, and get a little growly knowing Pure Barre (not yoga, I know, but it’s very popular and not well-supervised in terms of anatomical knowledge for the certification) is CONSTANTLY, in EVERY class, using the tucking motion. We report a case of KlA?ver-Bucy syndrome associated with isolated bilateral hippocampal atrophy without any abnormal lesion in other areas following status epilepticus. We report herein a case of patient with KBS related to isolated bilateral hippocampal atrophy (without any abnormal lesion in other areas) following status epilepticus.
He had headache, fever of 39A° and generalized tonic clonic seizure without recovery of consciousness. Electroencephalography (EEG) showed frequent spike and waves on bilateral fronto-temporal areas dominantly on temporal areas, so we started antiepileptic drugs (initial phenytoin loading with subsequent add-on of levetiracetam, oxcarbazepine and topiramate) and midazolam-coma therapy. Typically, the delayed postictal psychosis lasts between 12 hours and 7 days, but occasionally psychiatric symptoms may persist for up to 3 months.


We wanted to observe the glucose metabolism of the temporal lobe and amygdala, but we could not perform the FDG-PET because of his low economic status.
However, we cannot exclude the microscopic or functional involvement of other areas beyond hippocampus such as amygdala that could not documented by MRI.
The criteria for assessment of the febrile neonate are beyond the scope of this discussion, but they are crucial in the management of these patients.
Although it is recommended as part of the workup of a neonate with a presumed infection, there is constant debate over the usefulness and predictability of WBC. CSF pleocytosis may be absent or it may reach high levels mimicking bacterial meningitis.56,64-66 For example, 1 study that included patients up to 90 days of age in sepsis evaluation showed that CSF pleocytosis occurred in 69 of 138 (50%) patients with enteroviral disease. According to this study, testing both blood and CSF specimens may increase diagnostic yield by approximately 20%. This leaves room for testing inaccuracies and variability on the amount of time in which the results may be available. For example, a neonate who presents with signs and symptoms of enteroviral infection affecting the liver should have an abdominal panel performed with transaminases, ammonia, coagulation panel, and bilirubin. While many of these tests have good sensitivity, their specificity and positive predictive values are not as impressive.60 The role of cytokines in sepsis caused by viral organisms has not been fully investigated. So then wouldn’t it be natural to assume  that humans have evolved (or were created, if you prefer) to structurally inhabit the movement of CSF in a way that most benefits us without having to consciously create an internal environment for that function. Disc herniation or bulging can irritate the nerves that travel through the lumbar spine to the lower body, causing sciatica pain. The weaker, overstretched muscles are also strained by the stretching they’ve endured; muscles contract as they’re stretched to protect themselves from tearing.
A 31-year-old man who had no significant medical history presented with status epilepticus after encephalitis of unknown etiology. Further serologic tests including polymerase chain reaction (PCR) for herpes species were negative and no bacteria and viruses were grown. However, the constellation of symptoms including hypersexuality, global amnesia, dysosmia, and hypermetamorphosis in this patient was compatible with KBS, and it lasts for a long time. The functional neuroimagings such as FDG-PET or SPECT may give us additional information of the relationship between human behavior and limbic system. These criteria have been established to predict low-risk patients less than 3 months of age with serious bacterial infections and include the Rochester, Philadelphia, and Boston criteria.3-5 The purpose was to screen young infants at risk for serious bacterial infections that included bacteremia, urinary tract infection, or bacterial meningitis. One study of WBC as an indicator of bacteremia analyzed infants 0 to 89 days old, 25% of whom were neonates with a fever greater than 38?C (100.4?F). Therefore, it is recommended to test both blood and CSF.65 Although testing both blood and CSF may improve results, this is not a widely accepted practice.
A consideration is to send the specimen of a neonate with suspected enteroviral infection to a laboratory that is adept at performing this test. A neonate with respiratory distress should have a chest x-ray performed to rule out pneumonia or cardiomegaly. Furthermore, the comparison between values in viral and bacterial infection has not been clarified.
The constant contraction of both the weaker and stronger muscles can cause pain, cramping and spasms. I do teach them to tuck, then stick it out, then find the happy medium and try to stay there. He had been recovered from status epilepticus three weeks later, but afterwards he developed KlA?ver-Bucy syndrome: hyperphagia, hypersexuality, hypermetamorphosis, anterograde amnesia and dysosmia.


On neurological examination, there was no abnormality except stuporous mental status between frequent generalized tonic clonic seizures. He recovered from status epilepticus three weeks later, but afterwards he developed KBS which is characterized by hyperphagia (he ate a large amount of food six to seven times a day), hypersexuality (he wanted to have a sex with the nurses, his ex-girlfriend and his mother), hypermetamorphosis, global amnesia (memory registration was normal, but recall was impaired) and dysosmia. This study showed that the total peripheral WBC is limited in its ability to screen for bacteremia.
Those that had enteroviral meningitis with positive CSF PCR were more likely to have CSF pleocytosis than enteroviral-positive infants with negative CSF PCR (54% compared to 29%). Testing for Enterovirus PCR in the blood is not a standard laboratory procedure and may be difficult to obtain. When considering sending a specimen for Enterovirus PCR, it is important to know whether the hospital?s laboratory is capable of running the specimen or whether it must be sent to another laboratory. In the presence of an abnormal cardiac examination, an electrocardiogram (ECG), echocardiogram (ECHO), and cardiology consultation should be ordered with a high suspicion of viral myocarditis.
Future research may be able to guide clinicians by utilizing these tools to distinguish various causes of sepsis and to impact future management of these patients.
Its function is to facilitate shock absorption of the brain and spinal cord from mechanical shock.
Initial brain MRI showed T2 hyperintensity and swelling of isolated bilateral hippocampus, especially CA1 region without any abnormal lesion in other areas. Initial blood tests showed no leukocytosis and normal level of inflammatory markers (C-reactive protein and erythrocyte sedimentation rate).
Although it may predict higher risk of bacteremia at extreme values, there was no threshold that was determined to help stratify according to risk of bacteremia.61 Another study attempting to use the peripheral WBC to identify febrile neonatal patients with bacterial infections could not find a threshold that would discriminate patients with bacterial infections. This workup should also be considered on a baby with tachycardia or tachypnea out of the normal range after accounting for changes secondary to fever. Since we considered that his symptoms occurred due to secondary temporal lobe epilepsy, we performed an EEG, but his EEG showed no definite epileptiform discharges. The challenge is in deciding what, if any, tests are needed in the afebrile non-toxic-appearing neonate who has a normal physical examination but questionable history.
This is a meaningful case report because this case differs from other reports of KlA?ver-Bucy syndrome in humans in that the anatomic abnormalities revealed by MRI were very selective. Forty-five days later, follow-up brain MRI showed isolated bilateral hippocampal atrophy (Fig. While there are no guidelines established to aid the clinician in these circumstances, a thorough neonatal history as previously described may reveal some pertinent clues that would encourage further workup. Actually, since CSF flows through the vertebral foramen, that space would be minimally affected by these movements.
Initial brain MRI showed T2 hyperintensity and swelling of isolated bilateral hippocampus, especially CA1 region without any abnormal lesion in other areas (Fig. So it is neither true that you need to lengthen the spine for optimal flow, nor is it necessary to be alarmed about CSF flow when changing the shape of your spine. Moreover, this report would give us additional information of the relationship between human behavior and limbic system. Finally, we concluded that he had a KBS, and the patient was discharged on the 58th day of hospitalization and his cognitive dysfunction is persistent with minimal improvement for six months follow-up.



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Comments

  1. 04.07.2014 at 19:24:37


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    Author: QaQaSh_099
  2. 04.07.2014 at 14:43:10


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  3. 04.07.2014 at 14:36:52


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