What is Cogan syndrome?

Cogan syndrome or Cogan’s syndrome is a rare type of a rheumatic disorder. It is characterized by frequent inflammation of the ears and the front portion of the eye i.e., the cornea. These symptoms are also accompanied by frequent episodes of fever, loss of energy and fatigue, episodes of dizziness, weight loss and loss of hearing. If left untreated, the disorder can lead to permanent blindness or deafness. Cogan’s syndrome is also often associated with vasculitis or blood-vessel inflammation in other parts of the body which can ultimately lead to damaging of organs or in some rare cases even death. In most cases, the patients are young adults around 20s or 30s.

Cogan syndrome History

The disease is named after American ophthalmologist David Glendenning Cogan who in 1945 first described these “nonsyphilitic interstitial keratitis and vestibuloauditory symptoms”. A different form of Cogan syndrome known as the “Logan Syndrome” was described for the first time in 1963.

Symptoms of Cogan syndrome

The symptoms that are most commonly seen in a patient suffering from Cogan syndrome include

• Red, sore, painful eyes and blurred vision
• Partial or complete hearing loss; over time this can become permanent
• Vertigo or dizziness
• Lack of balance
• A tendency of nausea and vomiting
• Weight loss
• Fatigue
• Fever

Cogan syndrome can also adversely affect the functioning of various bodily organs and may even cause permanent damage to them. The symptoms related to the various organs and systems of the body are mentioned below:

• Nervous system – Headache, psychosis, encephalitis, meningismus, cavernous sinus thrombosis, cerebral infarction, psychosis, peripheral nerve involvement, shortness of breath
• Cardiac – Ventricular hypertrophy, arrhythmias, aortic insufficiency, valvular defects
• Pulmonary – Pulmonary nodules, Pleuritis
• Lymphoreticular – Lymphoadenopathy or enlarged lymph nodes, hepatomegaly, splenomegaly
• Gastrointestinal – Gastric hemorrhage, abdominal pain
• Skin – Nodules, palpable purpura, non-specific rash
• Musculoskeletal – Arm pain, myalgia or muscle pain, arthritis and arthralgia
• Genitourinary – Testicular pain, proteinuria, hematuria, abnormal urinalysis

Causes of Cogan syndrome

The exact cause for the development of Cogan syndrome is unclear. It is currently believed that the syndrome is caused by the disease of the autoimmune system. However, it is still unknown whether this autoimmune disease is arbitrated by humoral or cellular immunity.

Certain immunological and pathological factors, such as plasma cell infiltration in the cornea and cochlea, presence of antibodies i.e., Immunoglobulin G against the cornea and the inner ear, the beneficial influence of immunosupressants and corticosteroids as well as the presence of lymphocytes indicate towards an autoimmune pathogenesis. Also, the majority of the patients display involvement of multiple organs much like polyarteritis nodosa and collagen diseases that are caused by autoimmune problems.

Laboratory studies indicate that autoantibodies in the patients’ blood tend to attack inner ear tissue. Some patients have been found to be infected with the Chlamydia pneumoniae bacteria before they developed Cogan’s syndrome. This has led some researchers to hypothesize that the autoimmune disorder may have been caused by the bacterial infection. The Chlamydia pneumoniae bacteria generally cause mild pneumonia. However most of the patients infected by the Chlamydia pneumoniae bacteria are not found to develop Cogan’s syndrome.

Pathogenesis of deafness

Temporal bone pathology demonstrates different factors responsible for deafness. These include

• Endolymphatic hydrops
• Lymphocytic infiltration of spiral ligament and plasma cell
• Atrophication of the organ of Corti
• Osteogenesis of the round window
• Demyelinization of eight cranial nerve
• Stria vascularis degeneration
• Degeneration of the spiral ganglion cell
• Internal auditory artery vasculitis

Diagnosis of Cogan syndrome

Diagnosis of Cogan’s syndrome starts with assessment of problems relating to the diseases of the inner ear and the eyes. As long as both the inner ear and eye are not affected, the diagnosis remains a bit uncertain. The auditory and visual problems may develop simultaneously or either of the two areas may get affected first.

The doctor will first try to rule out the chances of any infections, especially the ones like tuberculosis, syphilis, Chlamydia, viral infections, leprosy and Lyme disease or any other rheumatic diseases, such as sarcoidosis, rheumatoid arthritis and Wegener’s granulomatosis as these may trigger the symptoms of the disease. The doctor will recommend the patient for an eye checkup by an ophthalmologist. A slit-lamp examination is necessary to observe any inflammations of the cornea, a condition generally known as interstitial keratitis. The doctor will also evaluate the nervous system and check on sensation, strength and reflexes as well as thoroughly check up the ears by evaluating inner ear function, balance and hearing. Other tests carried on the patient will include Doppler test, caloric test, echocardiography and angiography.

The results of erythrocyte sedimentation rate (ESR) test, white blood cells test and C-reactive protein test may produce abnormal results and there may be signs of anemia or thrombocytosis. However, none of these evaluations are conclusive enough to suggest the patient is suffering from Cogan’s syndrome. This syndrome is particularly difficult to diagnose in case of children.

Expected Duration of Cogan syndrome

Cogan’s syndrome is a chronic disorder. The symptoms of this disease often come and go in phases. A patient might respond well to proper medical care and attention, but normally the patients suffering from Cogan syndrome experience the health problems for a prolonged period of time, sometimes even for their entire lives.

Cogan syndrome Prevention

There are no known ways to prevent or protect an individual from getting infected by Cogan’s syndrome.

Treatment of Cogan syndrome

While treating ear problems that are a part of the Cogan syndrome, high doses of systemic oral corticosteroids (around 1-2 mg/Kg/day) are needed to be applied. The dosage needs to be lowered gradually based on the results of the audiogram tests.

If hearing becomes difficult and the drugs prescribed fail to ease the problem, using cochlear implants can act as a useful aid.

In cases where large quantities of steroids are needed or if the syndrome has reached a severe level and the response to steroid therapy is not meeting the expected results, certain other immunosuppressive medications are to be recommended. These immunosuppressive medications include cyclophosphamide (Neosar, Cytoxan), methotrexate (Rheumatrex),azathioprine (Imuran) or cyclosporine (Sandimmune, Neoral). A combination of medications mentioned above may also be used in some cases. If Cogan syndrome results in the damage of blood vessels, then surgery needs to be done to rectify the problem.

Diuretic medications are prescribed in cases where excess amount of fluid in the inner ear causes dizziness and balance problems. These drugs trigger urination, thus removing excess amount of fluid from the patient’s body. Drugs like benzodiazepines or antihistamines can be used along with bed rest to cure problems created by imbalance.

When to call a Professional

If you feel that you are experiencing significant auditory or visual problems or you are losing your balance and feeling dizzy, you should immediately consult your doctor or health care professional and get yourself evaluated, especially if the symptoms seem to be lingering.

Cogan syndrome Prognosis

The ophthalmic prognosis in patients having interstitial keratitis is generally considered to be quite positive and visual acuity impairment has been found in very few instances. Severe visual complications are found to occur mostly in patients having chronic inflammation of the posterior pole and victims of atypical disease.

Auditory prognosis, on the other hand, seems to be quite poor. In most cases of Cogan’s syndrome, complete and bilateral deafness seems to be the predominant outcome. Nearly 25% to 50% of all patients suffer from deafness even with prompt administration of corticosteroids, with around 95% of patients having moderate to complete auditory impairment after 5 years of medical attention. Vestibular signs and symptoms tend to improvise with time. However, persistent and lingering cases of oscilloscopia and ataxia have been recorded in around 15% of the total number of cases.

In less than 10% of cases the syndrome has led to fatal results. The majority of the patients are able to effectively manage the symptoms of the disease with regular treatment and limit all the associated complications.

Cogan syndrome is a disease that in most cases leads to complete loss of hearing and in some rare cases lead to damage of bodily organs. However, with regular medical attention and treatment the symptoms of this disorder can be kept well under control and the patient may lead a healthy and normal life.

References:

http://www.uveitis.org/medical/articles/case/cogan%27s.html

http://en.wikipedia.org/wiki/Cogan_syndrome

http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/35151.html

http://www.dizziness-and-balance.com/disorders/autoimmune/cogans_syndrome.htm

What is Dubin–Johnson syndrome?

Dubin–Johnson syndrome is a form of autosomal recessive disorder that increases the level of conjugated bilirubin in the blood serum without elevating the liver enzymes. This condition is much alike Rotor syndrome, as it is closely related to the hepatocytes’ inability to secrete conjugated bilirubin in the bile.

Symptoms of Dubin–Johnson syndrome

The Dubin–Johnson syndrome is normally asymptomatic. However, the disorder can be diagnosed during early infancy by carrying out certain laboratory tests. The most common Dublin-Johnson syndrome symptoms are:

• Sporadic phases of jaundice which causes yellowing of the white portion of the eyes and the skin.
• Pain in the right hypochondrium
• Enlargement of liver
• Tenderness of the liver
• Black liver
• Presence of dark pigmentation in the parenchymal cells
• Presence of bilirubin in the urine
• Increased levels of conjugated bilirubin in blood

Genetics of Dubin-Johnson syndrome

Mutations in the gene ABCC2 causes Dubin-Johnson syndrome. The ABCC2 gene sends out necessary instructions for making a type of protein called MRP2 or the multidrug resistance protein 2. The MRP2 protein helps to excrete waste products from the body by transporting them out of the kidneys, liver, placenta or intestine. The MRP2 transports bilirubin out of the liver cells into the bile, which is a digestive fluid synthesized by the liver. Bilirubin is produced when the old red blood cells are broken down. It has an orange-yellow coloration.

ABCC2 gene mutations create a version of MRP2 which is unable to effectively pump waste substances out of body cells. These mutations mainly affect the transportation process of bilirubin into bile. This result in the accumulation of large amounts of bilirubin in the body which creates a condition called hyperbilirubinemia. This accumulation of bilirubin in the body causes yellowing of the skin and white portions of the eyes which is characteristically found in people suffering from Dubin-Johnson syndrome.

Pathophysiology of Dubin-Johnson syndrome

The conjugated hyperbilirubinemia is caused by defective exogenous and endogenous transport of anionic conjugates from the hepatocytes into bile. Deposition of pigments in the lysosomes results in blackening of the liver.

Causes of Dubin-Johnson syndrome

Dubin–Johnson syndrome is a type of autosomal recessive disorder, which means that both the copies of the gene in each cell produce mutations. Both the parents of an individual having this autosomal recessive condition carry one copy of this mutated gene. However, the parents generally do not display the symptoms and signs associated with this disorder.

Dubin–Johnson syndrome disturbs the body’s natural ability to remove bilirubin from liver. In cases where the bilirubin is not processed properly, it starts to build up in the blood, resulting in the yellowing of skin and eyes. When very high quantities of bilirubin are accumulated in the body, it can even lead to damaging of the brain and other bodily organs.

People having Dubin-Johnson syndrome tend to have lifelong recurrent episodes of mild jaundice that can be worsened by:

• Alcohol
• Pregnancy
• Birth control pills
• Infections
• Environmental factors which affect the liver

Dubin-Johnson syndrome Diagnosis

There are some tests which can help to diagnose this syndrome. These are:

• Liver biopsy
• Serum bilirubin
• Blood tests for checking liver enzyme levels
• Tests for checking urinary coproporphyrin levels

A significant feature of Dubin-Johnson syndrome is the odd ratio between the various byproducts resulting from heme biosynthesis.

• The ratio between coproporphyrin III and coproporphyrin I in subjects unaffected by Dubin-Johnson syndrome is approximately 3-4:1.
• In patients suffering from Dubin-Johnson syndrome, the ratio between coproporphyrin III and coproporphyrin I is reversed from that in normal patients and the proportion of coproporphyrin I is 3 to 4 times higher than coproporphyrin III. A study of the urine porphyrins demonstrates a normal level of coproporphyrin. However, the presence of coproporphyrin I isomer is almost 80%, unlike the 25% occurrence in unaffected patients.

During post-mortem autopsy, the liver is found to have a dark pink or black coloration resulting from pigment accumulation.

There is a good amount of canalicular multi-drug resistant protein which helps to transfer bilirubin to bile canaliculi. An isoform of the canalicular multi-drug resistant protein is confined to the apical hepatocyte membrane, which allows the transmission of glucuronide and helps in the conjugation of glutathione back into blood.

High levels of gamma-glutamyl transferase (GGT) aid in the diagnosis of pathologies which involves biliary obstruction.

Dubin-Johnson syndrome Treatment

Treatment for Dubin-Johnson syndrome will depend on the underlying causes for the disorder and may include various processes like phototherapy, albumin infusion, exchange transfusions as well as drug therapy. Phototherapy is used to treat physiological jaundice as well as pathological jaundice caused by erythroblastosis fetalis after the preliminary exchange transfusion. The process of phototherapy involves the use of fluorescent light for decomposing bilirubin present in the skin through oxidation. Phototherapy is normally discontinued after the bilirubin levels have come down below 10 mg/dl and continue to fall for 24 hours. However, this method is hardly the only form of treatment for a case of pathological jaundice.

The neonate’s blood is replaced with fresh blood through an exchange transfusion. This removes some of the unconjugated bilirubin in the blood serum. There are several possible signs for exchange transfusions. These include drug toxicity, polycythemia, erythroblastosis fetalis, hydrops fetalis, marked reticulocytosis and jaundice that affects the child within the first 6 hours after birth.

Another method of treating excessive bilirubin levels involves albumin administration (1 g/kg of 25% salt-poor albumin). This provides supplementary albumin which helps in binding unconjugated bilirubin and may be done around 1 to 2 hours before the exchange. It may also be used to replace a portion of plasma present in the transfused blood.

Drug therapy is rare and normally involves administration of phenobarbital to the mother prior to delivery and also to the newborn child several days after the delivery. The phenobarbital drug aids in the stimulation of the hepatic glucuronide-conjugating system.

Dubin-Johnson syndrome Prognosis

Prognosis of Dubin-Johnson syndrome is good and in most cases treatment of this disorder is unnecessary. Most of the patients do not show any visible symptoms in their lives and lead a happy, normal life. Life span of a person having Dubin-Johnson syndrome is also normal. Some newborns have symptoms of cholestasis. Hormonal contraceptive pills and pregnancy may aggravate conditions like jaundice and icterus.

Dubin-Johnson syndrome is an autosomal recessive disorder that can be easily dealt with. In many occasions people having this disorder do not display the symptoms their entire lives. Patients are commonly known to lead a long and happy life.

References:

http://www.rightdiagnosis.com/d/dubin_johnson_syndrome/treatments.htm

http://ghr.nlm.nih.gov/condition/dubin-johnson-syndrome

http://en.wikipedia.org/wiki/Dubin%E2%80%93Johnson_syndrome

http://www.nlm.nih.gov/medlineplus/ency/article/000242.htm

http://emedicine.medscape.com/article/928711-overview#showall

Cerebral Aneurysm Definition

It is one of the commonest cerebrovascular disorders characterized by a localized expansion or ballooning of a blood capillary in the brain. It results from a weakness or defect in the wall of a cerebral vein or artery.

The disorder is also known as “Brain Aneurysm” or “Aneurysm in the brain”.

Cerebral Aneurysm Incidence

The condition can arise in individuals of any age group. However, it is found to affect adults more than children. It is believed to have a sexual predilection as slightly more number of women is seen to suffer from the syndrome than men. Approximately 5-10% of the US population suffers from some form of brain aneurysm, though only a small number of these rupture or cause difficulties. Cerebral aneurysms are believed to affect one in every fifteen individuals.

It is difficult to determine the frequency of brain aneurysms due to variations in their size and diagnostic methods. Unruptured aneurysms are thought to account for half of all cases of aneurysms.

Cerebral Aneurysm Types

There are three primary types of cerebral aneurysms. These are:

Saccular aneurysms

These are tiny, pouch-shaped lumps usually found in the basal region of the brain known as the “Circle of Willis”. These are the most common form of brain aneurysms and tend to rupture if pulse pressure leads to the formation of a hole in the sac.

Fusiform aneurysms

These are long tube-like or spindle-shaped protrusion of vessels on the entire perimeter of the artery. These are localized dilations that rarely suffer a rupture.

Mycotic aneurysms

These are very rare type of brain aneurysms and arise due to an infection of the arterial wall, mainly by a gram-positive Cocci.

A berry aneurysm is another common type of aneurysms of the brain. It is a small saccular aneurysm of an artery of the cerebrum. Its appearance is similar to a berry hence the name. The dilated lumps can vary from a few millimeters to more than a centimeter in size. Giant berry aneurysms can be larger than 2 centimeters in size and more common in adults. Multiple berry aneurysms are acquired more often than other forms of aneurysms.

Cerebral Aneurysm Symptoms

In most cases, the presence of a cerebral aneurysm is not known until it suffers a rupture. When this happens, hemorrhages occur in various parts of the brain. An affected person may pass out or experience other difficulties like:

• Severe headache
• Nausea
• Stiff neck
• Vomiting
• Loss of vision
• Double vision
• Eye pain
• Neck pain

Rupture may be minimal or severe. The acuteness of symptoms coincides with the amount of blood lost and the extent of brain damage in suffering individuals. Some patients may not experience any symptoms at all and suffer from death or a permanent vegetative state only when the condition turns most severe. Such types of aneurysm are generally detected when a CT scan or MRI of the brain is conducted for diagnosis of some other problem.

An aneurysm of the brain may begin to “leak” a little blood into the cerebrum. This occurs if the aneurysm exerts pressure on adjoining structures in the brain or causes a rupture (breaking open) of the blood vessels, thereby causing bleeding into the brain.

The symptoms experienced by an individual depend on factors like:

• Location of the aneurysm
• Whether or not the aneurysm ruptures
• Which part of the brain is being pressed upon by the aneurysm

Cerebral Aneurysm Rupture

The rupture of a brain aneurysm is primarily characterized by a severe headache that arises suddenly. Other symptoms of a brain aneurysm rupture may include:

• Drooping of eyelids
• Mental confusion
• Fatigue
• Sleepiness or stupor
• Muscular weakness or problems in moving any section of the body
• Reduced sensation or numbness in any region of the body
• Speech impairment
• Seizures
• Stiff neck (occasionally)
• Changes in vision

The “sentinel headache” is one of the worst symptoms of a cerebrum rupture. Often described as “the worst possible headache in life”, this painful symptom can be indicative of an impending rupture. In many cases, the rupture occurs a few days or weeks after the first instance of this headache. It is often accompanied by other discomforting symptoms, such as nausea and vomiting.

A cerebral rupture is a medical emergency. Family members of patients suffering from a rupture in the brain aneurysm should seek immediate medical attention. Delay in getting medical assistance may lead to death or permanent vegetative state of a sufferer.

Cerebral Aneurysm Causes

This type of aneurysm can arise from the weakening of an arterial wall due to a congenital defect or medical conditions like head trauma, infection or high blood pressure. An injury to a blood vessel due to a head trauma is one of the primary causes of Cerebral Aneurysm in later life.

Brain aneurysms typically develop due to degenerating or thinning of the artery walls. Aneurysms often form at branches or forks in arteries as these sections of blood vessels are found to be weaker. Aneurysms can develop on any region in the brain. However, they are most frequently found in arteries located at the base of the brain.

Cerebral Aneurysm Risk Factors

The risk factors for this condition are many in number. This is due to the fact that a number of factors can lead to weakness in an arterial wall and enhance the possibilities of getting a brain aneurysm. Some of these risk factors are present at birth (congenital), while others develop over time. These include:

Age

Older individuals are found to be more at risk from this condition. The condition is seen to affect adults more than children.

Gender

The gender, or sex, of a person is also considered to be a determining factor for this problem. Females are more at risk from this disorder than males.

Smoking

People who have a habit of smoking are also found to be more susceptible to a rupture of the Brain Aneurysm. The risk of a rupture is 10 times higher in smokers than in non-smokers.

High blood pressure (hypertension)

A number of studies have indicated hypertension patients to be at a higher risk of suffering from the development and rupture of a Cerebral Aneurysm.

Arteriosclerosis

This condition leads to a hardening of the arteries and increases the possibilities of getting an aneurysm of the brain.

Medicinal abuse

Drug abuse, especially the use of cocaine, can give rise to abnormal changes in the body and increase susceptibility to this problem.

Head injury

A trauma to the head often injures a blood vessel located in the brain. A cosiderable impact can cause brain hemorrhage and lead to blood release from the injured vessel, thereby resulting in a rupture.

Heavy alcohol consumption

It is not clear how exactly alcohol is responsible for aneurysm formation. However, excessive consumption of alcohol is also thought to increase the possibilities of a brain aneurysm.

Inherited conditions

Disorders acquired through gene, such as Ehlers-Danlos syndrome and Polycystic kidney disease, can impact blood vessels and increase blood pressure. This can directly lead to the formation of brain aneurysm. People with a family history of this condition, especially a direct relative such as a parent, sister or brother, are especially at risk from this disease.

Cerebral Arteriovenous Malformation

Also known as Brain AVM, it refers to an unusual connection between veins and arteries in the brain that breaks up the normalcy of blood flow between them.

Coarctation of the aorta

It is a complicated condition that leads to an abnormal constriction of the aorta, or the large blood capillary that supplies oxygenated blood to the body from the heart.

Cerebral Aneurysm Diagnosis

The diagnosis of this condition can be difficult. This is due to the fact that its symptoms generally do not get apparent until after the occurrence of a rupture. The protrusions in the blood vessels are often accidentally detected while some other condition is being diagnosed. If a cerebral aneurysm is suspected, doctors may carry out further scans to examine its current state. The diagostic tests, which are used to detect brain aneurysm and also find out the cause of bleeding in the brain, include:

• CT scan of the head
• MRI of the head
• Cerebrospinal fluid exam (spinal tap)
• Electroencephalogram (EEG)

A spiral CT scan angiography or Cerebral angiography helps reveal the size and location of the aneurysm. It involves use of a dye to scrutinize blood vessels.

An examination of the eye may also be conducted as a diagnostic test. This can help detect raised intracranial pressure (build up of pressure in the brain), including inflammation of the optic nerve or release of blood into the retina of the eye. A examination of the neurological system and brain may indicate abnormalities in strength, speech, sensation or eye movement.

Cerebral Aneurysm Treatment

The treatment of this condition depends on several factors, such as:

• Age of the individual
• His or her health
• Size of the aneurysm
• Location of the aneurysm

If doctors suspect a rupture of a brain aneurysm, they should immediately treat patients on an emergency basis. In such cases, treatment should primarily aim at stopping loss of blood as quickly as possible to prevent further damage.

An aneurysm is commonly repaired with the aid of two methods, which include:

Clipping

It is the most common method used to repair an aneurysm. It is performed at the time of an Open Brain Surgery.

Endovascular repair

It is a less invasive method used to cure some aneurysms and mostly involves coiling. This technique is preferred more for repairing a brain aneurysm rupture.

Once the cerebral aneurysm is repaired, it may be necessary to prevent occurence of stroke from a spasm of blood vessel. This can be done by using:

• Intravenous fluids
• Medicines that help reduce blood pressure and control headaches
• Anti-zeizure medications
• Drugs to control headaches

Patients may need complete bedrest. They may also be recommended to restrict all heavy activities that may increase the risk of complications.

Even if no symptoms are experienced, doctors may use treatment to prevent occurence of a potentially fatal episode of rupture in future.

Only a few types of aneurysms require immediate treatment. Lumps that are extremely small, and even less than 3 mm, are less likely to rupture. Doctors can help consider whether it is safer for patients to have an operation to shut off the aneurysm before it can break open. Surgery may be too dangerous to conduct in case of a badly located aneurysm or in people who are too ill to undergo the stress of an operative procedure.

Cerebral Aneurysm Home Remedies

Individuals having a nonruptured cerebral aneurysm or a family history of this condition can avert the risk of a brain aneurysm rupture by making a few changes in their manner of living. These include:

Giving up smoking

Not smoking or non-use of recreational drugs can help you a lot in avoiding this condition. If that is difficult for you, consider joining an appropriate treatment program that may help you quit the habit.

Following a good diet

A healthy diet, comprising of lots of fresh fruits and vegetables, can boost your system and strengthen your blood vessels.

Regular exercise

Exercising on a regular basis can help you maintain your blood pressure and improve your metabolism. However, you should avoid overstressing yourself with workouts as it will raise blood pressure.

Cerebral Aneurysm Prognosis

The outcome of this condition varies from person to person. It is better to avoid rupture of a brain aneurysm. Following an aneurysm rupture, patients who enter into deep comas usually show poor outcome than those with less acute symptoms. Of all cases of ruptured cerebral aneurysms, around 50% of sufferers die within 1 day to about 3 months. Approximately 25% of those who survive are found to suffer from some type of permanent disability.

Cerebral Aneurysm Complications

The primary complications of this condition include:

• Stroke
• Seizures
• Increased pressure inside the skull
• Subarachnoid hemorrhage
• Loss of motion in one or more regions of the body
• Loss of sensation of any area of the face or body

Cerebral Aneurysm Prevention

There is no definite way to prevent the formation of a cerebral aneurysm. However, certain measures can help avoid the problem. These include:

• Managing high blood pressure
• Avoiding smoking
• Avoiding drug abuse

If you are suffering from a severe or sudden headache along with seizures, nausea or vomiting, seek immedaite medical attention. If unruptured aneurysms are timely detected, they can be cured before any problems arise.

References:

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002387/

http://www.mayoclinic.com/health/brain-aneurysm/DS00582

http://www.ninds.nih.gov/disorders/cerebral_aneurysm/cerebral_aneurysms.htm

http://emedicine.medscape.com/article/1161518-overview

Spasmodic Dysphonia Definition

It is a condition marked by speech difficulties caused due to Dystonia or spasms of the muscles controlling the vocal cords. It is a peculiar communication disorder that was once considered to be associated with psychological problems.

SD usually arises in individuals aged between 30 and 51. Women are likelier to suffer from this disease than men. The condition is also referred to as “Laryngeal Dystonia”.

Spasmodic Dysphonia Types

Medical researchers have classified Spasmodic Dysphonia (SD) into three primary types. These are

Adductor Spasmodic Dysphonia

In this variation, sudden uncontrolled muscular movements or contractions spasms make the vocal cords stiffen and stick together. These make vibration difficult for the vocal cords and consequently disturb voice production. Words are often interrupted. It also becomes difficult to utter words due to the spasms. This can make speech jerky and make the affected person sound as if he or she is stuttering. The voice of an individual affected by this condition is usually defined as strangled or strained. Stress is found to make the spasms more severe in nature.

Abductor Spasmodic Dysphonia

In this disease, rapid involuntary spasms or movements in muscles lead to the opening of the vocal folds. The vocal folds fail to vibrate while they are open. The open posture also lets air escape from the lungs while speaking. This often makes it sound as if affected individuals are talking in a weak voice or a breathy whisper.

Strangely in both Adductor and Abductor Spasmodic Dysphonia, the muscular spasms are generally found to be absent during

• Laughing
• Shouting
• Talking at a high pitch
• Talking while breathing

Spasm are also found to be absent while singing, though there can be a loss of range or an inability with projection or production of certain notes of a scale.

Mixed Spasmodic Dysphonia

It involves muscles that close the vocal folds as well as those that open them. As the name suggests, it includes symptoms of both of the other types of Spasmodic Dysphonia.

Spasmodic Dysphonia Symptoms

The three types of this disorder have varied effects on the way people speak, with each type causing slightly dissimilar speech problems. The typical symptoms of Spasmodic Dysphonia involve:

• Broken voice
• Hoarse or grating voice
• Stuttering speech
• High pitched voice
• Wavering voice
• Strangled or strained voice (as in Adductor Dysphonia)
• Breathy whispery tone (as in Abductor Dysphonia)

These symptoms may arise frequently or only from time to time, depending on the severity. Certain patients are found to experience problems in muscle tone (such as Writer’s Cramp) in other regions of the body.

Spasmodic Dysphonia Causes

SD was earlier believed to be a result of a psychological, rather than a physical problem. However, it is now commonly supposed to arise from a defect in the nervous system and the brain. Spasms in the vocal cord muscles cause them to get too far apart or too close while speaking. A dysfunction of larynx muscles (the muscles located in the larynx or voice box) is supposed to be the main cause of this problem. An involuntary movement of these muscles creates problems during speech.

SD can involve various muscles in the human body. The type of SD that a person suffers from depends on the different actions of these muscles.

Spasmodic Dysphonia Diagnosis

Patients of this condition usually consult general practitioners about the diagnosis of this problem. Physicians may refer them to speech language experts, neurologists or Otolaryngologists, better known as Ear-Nose-Throat (ENT) doctors. Spasmodic Dysphonia patients should initially consult ENT doctors who can look for any variations in the vocal cords and check the presence of other brain or neurological problems.

Otolaryngologists generally analyze the vocal folds to detect possible causes for the voice problems. Most of them use a method known as Fiberoptic laryngoscopy to assess vocal cord movement during voice communication. The procedure involves passing a small lighted flexible tube through the nose and ultimately entering it into the throat. Additional tests may involve use of Stroboscopy, which lets physicians look at the vocal cord vibrations in slow motion.

Speech-language pathologists evaluate the voice as well as voice quality of a patient. Neurologists make a careful assessment of the patient to look for symptoms of other movement disorders.

Unfortunately, diagnosis of this disorder often gets delayed. This usually occurs due to lack of identification of its symptoms by medical screening.

Spasmodic Dysphonia Treatment

Treatment approach used for this condition may vary. Standard cure may involve Speech Language Therapy. Some patients get relief with the aid of repeated Botox (Botulinum toxin) injections, which can soothe muscular spasms and make talking much easier. Botulinum toxin is elicited from a particular kind of bacteria. Very small quantities of this toxin may be injected into the muscles located around the vocal cords. The treatment often helps control speech problems for a span of 3 – 4 months.

Some other curative methods used are:

Voice Therapy

Voice therapy is a behavioral method that involves

• Vocal Hygiene
• Vocal exercises
• Vocal relaxation
• Respiratory support management
• Daily plan for averting straining, misuse and over-use of voice

Voice therapy is used as a standard mode of treatment for many voice disorders. It is conducted by licensed and certified speech-language pathologists after an examination of the vocal fold. It is generally used to restore voice quality to its highest level and is best used after a surgery or injury. However, voice therapy is not found to yield effective results in curing SD. Medicines and voice therapy are usually able to improve minor cases of the condition. More severe cases, where voice therapy or medications fail to improve symptoms, require surgical treatment.

Speech Therapy

Speech therapy offers moderate to good results. If used along with relaxation techniques, it may help improve Minor Adductor Overactivity.

Surgery

Vocal Cord Surgery, which involves cutting one of the nerves to the vocal cords, is another method for curing the disease. It is not usually preferred and kept as a later option. This is because the method provides affected individuals with temporary relief for a few months or few years. It may also damage the vocal cords and lead to permanent inability in verbally communication. Surgery, even when conducted, is not found to be very effective.

National Spasmodic Dysphonia Association

The NSDA is an organization that aims to improve the lives patients affected with SD. It promotes and supports medical research regarding the causes and treatments for the condition. It also advances public and medical awareness of the disease and provides support to individuals affected by SD.

The symptoms of SD arise slowly and worsen over time. Unfortunately, it cannot be totally cured as yet. However, Botulinum Toxin (Botox) injections have been proven to yield effective results in improving SD symptoms and have significantly changed its prognosis. If you have anyone displaying symptoms of the disease in your family, get immediate medical attention to achieve a faster relief from symptoms.

References:

http://www.nlm.nih.gov/medlineplus/ency/article/000753.htm

http://emedicine.medscape.com/article/864079-treatment#a1128

http://www.bcm.edu/neurology/parkinsons/?pmid=14196

http://www.dystonia-foundation.org/pages/more_info___laryngeal_dystonia__spasmodic_dysphonia_/52.php

What is Ischial bursitis?

Scientifically speaking, ischial bursitis is a swelling in ones bursa region which divides ordinary maximus muscle found in the buttock region from an underlying skeletal protrusion of the bone that we usually sit on, known as ischial tuberosity.

What is a bursa?

A bursa is a small sac filled with fluid that acts as a cushion to reduce the sliding friction between body tissues.

Alternate name for Ischial bursitis

It is mostly caused by extended sitting on rigid surfaces which press up against bones that are this area. Some people also call this disorder ‘weaver’s bottom’

Who may get affected with Ischial bursitis?

Though Ischial bursitis can affect anyone, the incidence is higher in athletes, almost 10% high in runners.

What are the causes of Ischial bursitis?

There are diverse causes of this ailment but the most common ones are infection, crystal deposits and traumatizing events.

• Traumatizing events- Physical trauma may lead to inflammatory ischial bursitis especially from recurrent injury. It leads to expansion of one’s blood vessels. This in turn will permit proteins as well as extracellular fluid to make their way into bursae area. Consequently, bursae will react against the perceived ‘foreign’ components by swelling up. Trauma can either be severe or acute and these two categories each have their own unique indicators.

Acute

This can result from minor traumatic incidents which can occur on ones bursa as a result of recurrent motion. For instance, kicking a simple baseball. Prepatellar bursitis is yet another example in this category, and it results from extensive and recurrent kneeling upon a hard plane. Like when one is preparing to lay or scrub a piece of carpet.

Chronic

It results from a straight forceful blow at the affected region. For instance, when one accidentally knocks his/her knees upon a table. It can further cause ones blood to leak up at the bursa area. This swift collection generally results to perceptible ache and swelling of the affected area.

• Over use of joint- Over use can be a cause of ischial bursitis as there is continuous pressure on the join.

• Infections. When appears close to your skin’s surface then bursae can lead to a condition commonly referred to as ‘septic bursitis.’ Individuals suffering from alcoholism and also diabetes are much more prone to this condition. Those who may have ever experienced trauma in the course of their lives also bear a higher risk. Around 85% of reported septic bursitis incidents affect men.
• Systemic diseases- systemic diseases like arthritis, scleroderma, whipple disease, systemic lupus erythematous etc may predispose to Ischial bursitis.
• Crystal deposits. Individuals with particular diseases like scleroderma, gout or adverse rheumatoid arthritis can also develop bursitis as a result deposited crystals. Very little research has been carried out to determine the main cause of this form of crystal disposition. However, uric acid has been quickly pointed as one of the reasons behind this condition since it’s a consequence of daily metabolic reactions in the body. Individuals suffering from gout may be unable to successfully break down any uric acid deposits. These residues would be crystallized and then placed in ones adjacent joints thereby leading to bursitis.

General symptoms of Ischial bursitis

Ischial bursitis can lead to soreness and also tenderness at the compromised bone and surrounding tendons. The victims’ bursae sacs can bulge and make movement quite difficult.  There are many forms of bursitis but the Ischial variety is the one of most common.

Ones subdeltoid bursa region usually separates the key tendon called supraspinatus from other overlying bones or deltoid muscle. Swelling of your bursa is usually due to injury of adjacent structures, which in most cases are the delicate rotator cuffs. This can result to pain at the affected region. When this occurs some of the below Ischial bursitis symptoms can be witnessed.

• Discomfort when it comes to walking and also running.
• Extreme pain particularly during the night.
• Compromised range of active movement and extreme tenderness at particular spots.
• Extreme pain when the joint is bent in any way. This is mainly due to increased tension at the affected region.
• Infection is also common when the condition isn’t treated within the shortest possible time.
• This pain may readily radiate over to other adjacent regions and can be increased when one climbs stairs.

Ischiogluteal bursitis may cause severe swelling of ones ischial bursa that is found between the sides of your pelvic and extended gluteus maximus fibers. Apart from extensive sitting, inflammation may also happen due to repetitive and prolonged bicycling. As a result the person will experience Ischial bursitis symptoms like:

• Sharp pain when direct pressure is applied to the region. This particular ache may exude down to your thigh’s back region.
• Soreness becomes worse when one is reclining and his/her hip is reflexively bent.
• The patient will experience great difficulty standing upright or tiptoeing using the affected area.
• There would be tenderness at the pubic bone that can be worsened through extending ones legs.
• In rare instances tenderness can spread over to the groin region.
• At times a mass can be experienced that resembles a small hernia. An individual can also feel numbness as well as tingling sensation incase adjacent nerves are squeezed by the swollen bursa.

Diagnosis of Ischial bursitis

The diagnosis of Ischial bursitis is based on the symptoms and several questions that the physician ask the patient a bout his/her medical history. The diagnostic tests to confirm Ischial bursitis include;

• Blood test
• X-ray to look for the deformities in bone
• Aspiration of the fluid from infected bursa to check for infection

Treatment for Ischial bursitis

Ischial bursitis treatment at home

Most physicians recommend a simple home based remedy known as PRICEM which includes protection, ample rest, ice application, gentle compression, moderate elevation and also a few medications for Ischail bursitis treatment.

These home based ischial bursitis treatment steps are discussed in detail below:

• Protection. Here, the procedure involves padding of certain bursae protrusions which are nearer surfaces of ones skin.
• Rest. This should be a relative course and should be done in regular intervals. One should effectively select alternative categories of exercises which would get rid of throbbing motions. Controlled swimming can also help to ease off the condition instead of aggravating it as some people may falsely think.
• Ice. This is an extremely effective anti-swelling and pain-relieving instrument. Little ice packs like packages of ice-covered veggies, or pure water that has been frozen up in standard foam coffee mugs can be placed at the affected region for a minimum of 10 minutes. When done twice daily this can effectively reduce inflammation.
• Compression and appropriate elevation. These are useful when it becomes feasible to constrict the affected region. A supple bandage may be tied around the affected area. The individual needs to ensure that the region is specially elevated above his/her heart region such that blood may not pool in the area.
• Medications. Common over-the-counter drugs like ibuprofen and also aspirin can be very helpful in cutting down inflammation.

One should never forget to appropriately seek advice of his/her physician before having these drugs as they can lead to serious complications if misused. This is particularly imperative for those that have a history of recurrent stomach ulcers, or are under any form of blood-thinning prescription drugs.

Medical Ischial bursitis treatment procedures

• Incase ones bursitis infection is by no means infectious then the physician can decide to inject corticosteroid to the inflammation area which would work in reducing swelling.
• The results can last for diverse time frames. Due to latent complications. Vaccinations are generally given duration of at least three times each year, and this should take a minimum of 30 full day apart from one injection to the other.

Those with infectious bursitis can have their bursa drained up using a simple needle. The physician will recommend antibiotics that must be consumed in the form of tablets. If ones infection is severe and has failed to respond to standard oral antibiotics, or when the immune structure has been weakened for whichever reason, then the person can be admitted to respective hospitals where IV antibiotics may be administered to the patient. Nonetheless, many causes of contagious bursitis may be safely managed right from home.

Ischial bursitis exercises

Once the pain and inflammation are under control, the patient can start with certain Ischial bursitis exercises to tighten the muscles and ligaments. Knee to chest Ischial bursitis exercise in lying or standing position and light stretching exercises are highly effective in regaining the movement of the joint. The patient must limit the exercise to a minimal time initially as heavy Ischial bursitis exercises may cause joint pain.

Sleep posture and Ischial bursitis pillows

Lying down straight with a pillow under the knees during sleep help to reduce pain.

Follow up procedurals that should be adhered to

• When one has already left his/her physician’s office then it’s imperative that the person should endeavor to change whatever factor that led to bursitis during the initial instance.
• You must effectively rest the region and then apply some ice for an instance of around twice each day. Ensure that the region is sufficiently elevated wherever possible.
• One may further schedule up a follow-up visit with his/her physician within a week’s time. Incase the bursitis has been termed as infectious then a follow-up appointment in around 3-4 days would be suitable for re-evaluation and apparent fluid removal.

How to avoid Ischial bursitis from taking root

• If there are particular activities you engage that are very likely to be the cause of your disorder then it’s vital that you refrain from engaging in them henceforth. Alternatively, you may employ defensive measures or limit the intensity of activity.
• Workers like plumbers, carpet layers and also roofers must take extra-precautionary measures since their vocation makes them prone to acquiring this disorder.
• One can further improve his/her flexibility and further strengthen muscles which are concerned in joint movement by means of rehabilitative sports.
• Patients should be concerned as appertains their muscle tone incase they have a bursitis which has the propensity of coming back.
• A standard physical therapeutic program will also effectively guide one in the proper cardiovascular exercises that will work towards strengthening of certain weaker muscles.

Ischial bursitis can be cured if one identifies it early and also seeks therapeutic intervention promptly. Many individuals respond to Ischial bursitis treatment within 4 days but they should follow it up by checking with their physician within a week’s time.

References: http://www.dynamicchiropractic.ca/pdf_out/DynamicChiropractic.ca-Ischial-BursitisTendinitis-an-Associated-Disorder-1299097090.pdf

http://www.stacommunications.com/journals/cme/images/cmepdf/june01/tendinitisbursitis.pdf

Do you have a small, painless lump in the scrotum? You may be having a medical condition known as Spermatocele. Know all about Spermatocele – its causes, symptoms and treatment.

Spermatocele Definition

Spermatocele is an abnormal cyst that appears on the testis or the epididymis. It looks like a lump and usually consists of a milky white fluid that may contain male sperm. It is due to the finding of sperm in the fluid that Spermatoceles are also known as Epididymal Cysts.

This unnatural cyst is commonly seen in men who are between 40 and 60 years of age. It is a very common disease affecting about 1/3^rd of the male population.

Spermatoceles are generally less than half an inch in diameter. But they can also be larger in size.

Spermatocele Location

For Spermatocele epidydymis is the most common location. Spermatoceles are usually found at the upper part of the epididymis, the small coiled tubular structures located in the higher part of the testicle. These are also seen in the sides or rear position of the testes. Spermatoceles generally lie separate from the testicles.

Spermatocele Symptoms

Spermatoceles have quite a lot of symptoms associated to them. Some of the notable symptoms of Spermatocele are

Discomfort

What does a Spermatocele feel like? A person affected by this condition normally experiences no discomfort. In people with Spermatocele discomfort may arise if the lump grows too large. It can create problems in wearing dresses, especially undergarments. A swollen Spermatocele can rub with the cloth of the underwear and create great discomfort.

Pain

Spermatoceles are generally painless. People having Spermatoceles do not experience any pain from these testicular lumps. But in a few cases of Spermatocele painful sensation arises, mainly when the Spermatocele size becomes too large.

Heaviness

People with a much swollen Spermatocele can experience heaviness in the testicles.

Cancer

In rare cases of Spermatocele cancerous conditions may also arise. This happens when malignant tumors are mistaken as Spermatoceles.  A Spermatocele may also mask other serious complications like Epididymitis, Inguinal Hernia, Varicocele and Hydrocele. Because of a Spermatocele Hydroceles are often difficult to diagnose.

Spermatocele Causes

The exact reason behind the appearance of Spermatocele is still unclear. Medical experts however, believe that the lump arises due to a blockage in any of the tubes that supplies spermatozoa into the epididymis from the testicles.

The cysts are also believed to develop due to an injury or swelling on the skin. A scar on the skin tat obstructs a part of the epididymis can lead to a formation of Spermatocele.

Spermatocele Diagnosis

Mere observation with naked eyes is often enough to diagnose this condition. But for a proper diagnosis of the disease and to differentiate it from other similar conditions, it is important to perform an ultrasonography of the scrotum. Testicular screening exams should also be carried out to rule out the presence of any cancerous conditions.

A manual examination of Spermatocele consists of holding a light up to the scrotum. If the lump is a Spermatocele, light rays will pass through. But cancerous tumors or hernia bums are solid masses and allow no light to go through the. This is usually enough to separate a Spermatocele from a cancerous condition.

Spermatocele Treatment

Unless the Spermatocele lump causes pain or any discomfort, no treatment is needed. Regular scrotal check-ups and self-exams are necessary for the patient to find out if there is a worsening in the condition of the Spermatocele. In case of a negative change in Spermatocele condition, treatment becomes necessary.

Cure is required if the patient feels pain in the groin. Mild cases of pain in the testicles can be treated with over-the-counter medications.

If the Spermatocele lumps become too large and cause much discomfort, Spermatocele removal should be carried out as soon as possible. A Spermatocelectomy is required to surgically separate the spermatocele from the epididymis. The groin region is made numb with an anesthetic. A small incision is made in the scrotum. The spermatocele is isolated from the epididymis by tying it away with a suture.

The treatment can also be done through Spermatocelectomy. In this method, the scrotum is cut open and the Spermatocele cyst is removed through the opening. This can cause pain after operation and also lead to bruising and even infertility.

Sclerotherapy is a less common way used for Spermatocele cure. In this process, a tiny incision is made in the scrotum and a needle is inserted into the lump to drain out the fluid contained in it. A chemical is passed on into the empty sac with the help of an injection. This helps the scar tissue to grow within the sac and prevents the build-up of fluid again. The process can however give rise to risks like bleeding, infection and infertility.

In case of a multicystic Spermatocele ultrasound guidance may be applied by the surgeon. This ensures that all the cavities are sucked out.

Spermatocele Surgery Recovery

Chances of recovery are quite high after Spermatocele operation. Patients are usually discharged after being applied a pressure dressing over the operated area. Ice packs are pressed upon the operated region for several times for 2-3 days after the operation to minimize inflammation.  Oral medications are also administered for 1-2 days after the surgery to reduce pain. Patients take bath from 2 days after surgery. They have to go for a follow-up visit about 2 weeks after the operation and have to wear a scrotal support in the interim period.

Will Spermatocele go away?

Spermatocele Epididymal cysts generally vanish after a proper surgical operation or drainage. Recurrence of the condition is very low and happens in about 10 to 25% cases of Spermatocele.

Spermatocele and Infertility

There are many popular theories regarding Spermatocele and fertility. Spermatocele does not usually lead to infertility. However, infertility arises normally after a surgical operation has been carried out on the cyst. As aforementioned, there are risks of infertility from Spermatocelectomy and Sclerotherapy. In case of Spermatocele in children and young males, it is not advisable to carry out such surgeries. It should normally be recommended to people who are old enough to be a father or who have no intention of becoming a parent. A physician should have a clear discussion with the Spermatocele patient before carrying out any Spermatocele repair that may affect the latter’s fertility. Surgeries should be avoided in men who desire to become a parent.

An untreated Spermatocele can grow too large for comfort and also invite other complications like infection, fever, pain and bleeding. So it is best to treat the condition as soon as you detect it. Timely treatment will help you recover much early and live life in the pink of health.

References:

http://en.wikipedia.org/wiki/Spermatocele

http://www.wisegeek.com/what-is-a-spermatocele.htm

http://www.medhelp.org/medical-information/show/1066/Spermatocele

http://urologyhealth.org/adult/index.cfm?cat=11&topic=530

http://www.healthscout.com/ency/68/407/main.html

http://emedicine.medscape.com/article/443432-treatment

http://www.healthcaremagic.com/articles/Spermatocele/7436

http://georgiahealthinfo.gov/cms/node/144420

http://www.freemd.com/spermatocele/

http://www.healthizen.com/health-articles/diseases-conditions/spermatocele.aspx

Neuroleptic Malignant Syndrome Definition

Neuroleptic Malignant Syndrome (NMS) is a neurological disease that results as a side-effect of drugs used for curing psychological or neurological disorders. It affects the nerves of people and gives rise to a number of symptoms which include even death. This is a rarely known disease that has serious, life-threatening consequences for the affected person in the absence of treatment.

Neuroleptic Malignant Syndrome Symptoms

Neuroleptic Malignant Syndrome is characterized by several symptoms. These include

Fever

There can be no Neuroleptic Malignant Syndrome without fever. People having this condition normally suffer from high temperatures that can impair daily activities and make him or her seek bed rest.

Sweating

Fever is accompanied by sweating. Sufferers of Neuroleptic Malignant Syndrome are often seen to perspire profusely due to systemic abnormalities.

Rigidity of Muscles

Muscular rigidity is one of the most widely known symptoms of this condition. The affected person experiences a sudden, unnatural firmness in muscles.

Tremors

Patients suffer from muscle tremors that create many difficulties in proper functioning. Simple activities like walking or talking can be affected.

Blood pressure Changes

Affected people also suffer from rapid changes in blood pressure which can be very discomforting. The blood pressure level shoots up causing patients to suffer delirium and even lose consciousness.

ANS Abnormality

The person also suffers from instability of Autonomic Nervous System (ANS). This gives rise to abnormalities like poor secretion of tears, numbness from pain and frequent attacks of bronchial pneumonia.

Delirium

The sufferer also experiences mental confusion that is often accompanied by hallucinations.

Increased WBC

The white blood cell (WBC) count of the suffering persons shows a rapid increase.

Increase of Creatine Kinase

The patient also suffers from an increase in Creatine Kinase (CK), an enzyme that is found in brain, heart and skeletal muscle. A rise in Creatine Kinase leads to muscular and kidney damage bringing on serious complications. If there is a rapid increase of Creatine Photokinase in sufferers of Neuroleptic Malignant Syndrome kidney failure is also very likely.

Neuroleptic Malignant Syndrome Causes

Neuroleptic Malignant Syndrome is mainly seen to arise as a side effect of certain medications. Some types of antipsychotic or neuroleptic drugs normally give rise to this disorder. The disease usually arises within 2 weeks of starting the treatment. However, it may appear at any time during the period of therapy.

The disease is also found in patients suffering from Parkinson’s disease. In such cases, the cause of the disorder is anti-Parkinsonism medicines like Dopaminergics. Sudden discontinuation of these drugs is found to result in this illness.

Increase in body temperature is supposed to be caused due to obstruction of Hypothalamic Dopamine Receptor by medicines. The increase in Creatine Photokinase and White Blood Cells as well as muscular rigidity is believed to be the result of Antipsychotic Drugs. In patients of Neuroleptic Malignant Syndrome hyperthermia is caused due to increased release of calcium triggered by Antipsychotic Drugs. Anti-dopaminergic medicines like metoclopramides are found to induce this syndrome.

As causes of Neuroleptic Malignant Syndrome lithium and amoxapines, drugs that are supposedly anti-dopaminergic, are also pinpointed.

Neuroleptic Malignant Syndrome incidence has dropped in recent years, thanks to increased knowledge and the intelligent way of physicians’ prescribing medications to avert side-effects. However, it is still a threat to patients who are undergoing antipsychotic treatment.

Is Neuroleptic Malignant Syndrome Genetic?

According to medical researchers, Neuroleptic Malignant Syndrome is also caused by genetic factors other than drugs. Neuroleptic Malignant Syndrome case reports have found the disease occurring in mothers and daughters and also in identical twins.

Neuroleptic Malignant Syndrome Differential Diagnosis

Differential diagnosis of Neuroleptic Malignant Syndrome is very necessary to rule out the presence of other condition that might be possible reason of symptoms arising in the patient. Proper diagnosis is carried out to ensure that the patient is not suffering from any other drug-related illness like

Serotonin Syndrome

Patients suffer from muscular rigidity and other symptoms like diarrhea, nausea, vomiting and hyperthermia.

Malignant Hyperthermia

This rare hereditary disease gives rise to hyperthermia and rigidity of muscles.

Malignant Catatonia

The disease leads to psychosis, muscle rigidity, hyperthermia and agitation.

Neuroleptic Malignant Syndrome Treatment

Neuroleptic Malignant Syndrome Treatment is carried out by a number of ways. These include

Stopping Drugs

If the condition is found to be caused by Neuroleptic or Antipsychotic medicines, it is necessary to stop the use of the causative drugs as soon as possible. An alternative medicine is usually prescribed as a cure.

Muscle Relaxant

The muscular rigidity is typically cured with the help of a muscle relaxant.

Aggressive Cure of Hyperthermia

In patients of Neuroleptic Malignant Syndrome fever can be extremely dangerous. If the patient suffers from abnormally high body temperature (a condition known as “Hyperthermia”) it should be brought down as early as possible. Doctors normally use cooling blankets and even ice packs to bring down body temperature.

Anti-anxiety Drugs

Medicines like Benzodiazepines may be used to control agitation in sufferers of Neuroleptic Malignant Syndrome.

In serious cases, the patient needs immediate hospitalization. The sufferer requires ventilator and circulatory support. It should be always remembered that Neuroleptic Malignant Syndrome is a serious condition. It needs to be treated as early as possible. A delay in treatment can bring on serious complications including death.

Neuroleptic Malignant Syndrome Risk Factors

If not treated in time, Neuroleptic Malignant Syndrome can give rise to severe health problems. Some of the major Neuroleptic Malignant Syndrome complications include

Severe Muscular Rigidity

The muscles can suffer from severe tautness and lead to immobility of the limbs.

Dehydration

The immobility of muscles gives rise to reduced oral intake. This causes dehydration and may eventually lead to acute kidney failure.

Brain Damage

Due to untimely treatment of Neuroleptic Malignant Syndrome brain damage may take place. This happens because of degeneration of the neurons (nerve cells) in the brain.

Neuroleptic Malignant Syndrome Management

People who have had this condition once must be careful during the use of Neuroleptics. They should carefully monitor their health and take steps in case of any symptom arising due to the medication. Former patients of this disease should inform their doctors before undergoing any surgical operation. This is because for sufferers of Neuroleptic Malignant Syndrome anesthesia use can be very risky.

Neuroleptic Malignant Syndrome Long Term Effects

Neuroleptic Malignant Syndrome is completely curable. Chances of recovery from this disorder are very high if treatment begins in the early stages. But a delay in cure can be life-threatening and may cause death. Mortality rate from this condition is said to be as high as 70%.

If the doctor suspects a Neuroleptic Malignant Syndrome onset, it is highly advisable that you go for an immediate medical treatment. If you are not suffering from the condition yourself but finding the characteristic symptoms of the disease in any of your family members, you must seek prompt medical help. Time plays a crucial role in curing a health condition and when a disease is as serious as this, it makes sense to carry out treatment at the Neuroleptic Malignant Syndrome onset.

References:

http://en.wikipedia.org/wiki/Neuroleptic_malignant_syndrome

http://www.wisegeek.com/what-is-neuroleptic-malignant-syndrome.htm

http://www.merckmanuals.com/home/print/sec06/ch084/ch084a.html

http://www.ninds.nih.gov/disorders/neuroleptic_syndrome/neuroleptic_syndrome.htm

http://counsellingresource.com/medications/medication-types/about-nms.html

http://psychservices.psychiatryonline.org/cgi/content/full/49/9/1163

http://www.uptodate.com/home/content/topic.do?topicKey=medneuro/5946

http://ajp.psychiatryonline.org/cgi/content/full/155/9/1275

http://emedicine.medscape.com/article/288482-overview

Having red papules on your skin surface? Are you suffering from fever and stomach ailments? It may be a case of Bacillary Angiomatosis that you are having. Read on to know all about Bacillary Angiomatosis, its causes, symptoms, diagnosis and cure.

What Is Bacillary Angiomatosis?

Bacillary Angiomatosis is a type of Angiomatosis that affects the entire body system. It is an infectious disease that causes rapid multiplication of the small blood vessels of the skin. This is a rare illness but is potentially risky to sufferers.

Who Gets Bacillary Angiomatosis?

It affects only a small percentage of people around the world. The condition shows a preference for white race followed by people of black and Hispanic background. It also mostly affects men. About 90% of sufferers in the US are found to be people belonging to male sex. The disease affects kids very rarely.

Bacillary Angiomatosis Symptoms

Bacillary Angiomatosis is mainly characterized by the appearance of lesions or nodules of varying sizes all over the skin. The lesions are typically very small but can grow up to about 4 cm in diameter. These usually arise in groups. You can find as many as 50 papules at one time. These can vary in color and are generally bright red or almost black in appearance.

The nodules continue to grow in size and often rupture to bleed from time to time. These are accompanied by several other symptoms like fever, body aches, dyspepsia and inflammation of glands.

What Causes Bacillary Angiomatosis?

Bacillary Angiomatosis is caused by bacterial infection resulting from exposure to Bartonella Henselae and Bartonella Quintana. Humans generally get infected by Bartonella Henselae due to cat bite or cat scratch. Bartonella Quintana is typically transmitted by lice.

Bacillary Angiomatosis Bartonella Infection also affects people with compromised immunity as in AIDS sufferers. It rarely arises in people with strong immune systems. The disease is mostly seen in HIV sufferers. It is only in rare instances that a non-HIV sufferers also get this condition.

The condition also arises in sufferers of Chronic Lymphocytic Leukemia and Cytotoxic Chemotherapy. People who have organ transplants recently are also at risk of having Bacillary Angiomatosis.

Bacillary Angiomatosis of Liver

In people with Bacillary Angiomatosis liver often gets enlarged and inflamed. Bacillary Angiomatosis may also be accompanied by peliosis hepatis, a condition that forms blood-filled cavities in the liver.

Bacillary Angiomatosis of Spleen

In sufferers of Bacillary Angiomatosis spleen is another of the internal body regions where nodules appear. This usually occurs in people with Splenic Bacillary Angiomatosis.

Bacillary Epithelioid Angiomatosis

Bacillary Epithelioid Angiomatosis is a bacterial infection of lymph nodes in a localized region of the body. It is caused by infection from exposure to gram-negative bacterium AFIPIA felis. The disease mainly occurs after a scratch from a cat. The first symptom of this disease is the appearance of elevated nodules over the location of scratch. This is a self-limiting condition, meaning it resolves itself after a point of time.

Bacillary Angiomatosis Treatment

Antibiotic drugs are usually helpful in treating Bacillary Angiomatosis cases. Erythromycin courses usually make skin lesions fade away within four weeks. Erythromycin and Doxycycline are two main antibiotics used for Bacillary Angiomatosis cure. If a patient fails to respond to these drugs, Tetracycline may be used.

A severe Bacillary Angiomatosis is usually treated by a combination of antibiotics and Bactericidal drugs.

Bacillary Angiomatosis Differential Diagnosis

The Differential Diagnosis for Bacillary Angiomatosis involves differentiating the disease from other conditions like Histoplasmosis, Catscratch Disease, Angiosarcoma, Cryptococcosis, Sporotrichosis and Kaposi Sarcoma.

Bacillary Angiomatosis Diagnosis

Diagnosis for Cutaneous Bacillary Angiomatosis involves skin biopsies and blood tests. Samples of material from the papules may be examined in a laboratory to check for abnormalities. This also helps detect any cancerous condition.

Blood tests help doctors examine any antibodies in the bloodstream. It is mainly used to detect the presence of Bartonella Quintana and Bartonella Henselae bacterium.

In some cases, tissue staining is also proved to be quite helpful in making detection.

Bacillary Angiomatosis Prognosis

Prognosis in case of Bacillary Angiomatosis has a high success rate. But it can be potentially dangerous if not well-treated or treated in time. It may even result in death of sufferers. In the absence of diagnosis, AIDS sufferers may find them to be in a stage too late for treatment.

Bacillary Angiomatosis Healing Time

On proper treatment, Bacillary Angiomatosis does not give rise to any more complications. The symptoms take up to a month to make a complete disappearance.

Bacillary Angiomatosis Complications

Bacillary Angiomatosis can cause lethal complications if not treated in time. Delay in diagnosing the disease and making a treatment makes the illness very severe. In worse cases, an untreated patient may suffer from failure of respiratory system. There can also be multi-organ failure leading to the death of the sufferer. The disorder gives rise to nodules on the outside of the body surface as well as the inside. The appearance of papules on various organs inside the body is the cause of organ dysfunction.

Bacillary Angiomatosis Pictures

Want to get an idea about the appearance of Bacillary Angiomatosis? Here are some useful Bacillary Angiomatosis photos. Take a peek at these Bacillary Angiomatosis images and know about the symptoms of this medical condition.

Picture 1 – Bacillary Angiomatosis
Source – dermaamin.com

Picture 2 – Bacillary Angiomatosis Picture
Source – skincareguide.com

If you or anyone in your family is having symptoms similar to Bacillary Angiomatosis, it is time for you to call your health provider immediately and go for a diagnosis. Early diagnosis and timely treatment can cure many complex diseases. So make sure that you act at the first glimpse of symptoms of this condition.

References:

http://emedicine.medscape.com/article/212737-overview

http://en.wikipedia.org/wiki/Bacillary_angiomatosis

http://www.wrongdiagnosis.com/sym/bacillary_angiomatosis.htm

http://www.wisegeek.com/what-is-bacillary-angiomatosis.htm

Are you suffering from boils and painful swellings on your skin surface? Have you been experiencing vomiting sensations lately? You may be having a condition called Myiasis.

What Is Myiasis Disease?

Myiasis is a disease caused by parasitic infection. The disease appears when parasitic dipterous fly larvae start feeding on the dead or living tissues of the host, which can be a human or an animal. Myiasis worm typically affects the eyes, ears, nose and the skin on any part of the body.

Myiasis Definition

Famous Entomologist Fritz Zumpt of Germany while talking about Myiasis defined it as the infestation of vertebrate animals and humans with larvae of the Diptera variety. The larvae feed on the consumed food, body fluids or living and dead tissues of the host for a time period.

Myiasis is correctly pronounced as “My-ah-siz”.

Myiasis Flies

Flies of Diptera genus cause Myiasis. There are about 100 kinds of Myiasis causing flies, such as human botfly, tumbu fly and sheep botfly that give rise to Myiasis in humans and animals. A Myiasis fly enters the human body through consumption of infected meat products, open wounds and even infection of apparently intact skin surface.

Myiasis Geography

Myiasis prevalence is mainly in the developing and underdeveloped nations and also tropical and subtropical regions such as Central America, South America, tropical Mexico, sub-Saharan Africa and Trinidad.

Types of Myiasis

Myiasis in humans is generally of four types. Myiasis forms actually depend on the site of the human body that is being infected.

Cutaneous Myiasis

This arises when Myiasis larvae affects the living or dead tissues in the skin surface. The condition results in long-lasting, painful sores or ulcers over the skin surface. The larvae usually enter the skin surface through a cut, lesion or an open wound though even unbroken skin may be affected.

Nasal Myiasis

The condition develops from parasitic infection of the nasal passage. This may give rise to severe irritation, nasal obstruction, facial edema, vomiting and even fever. If left untreated, it may also cause death in some cases.

Aural Myiasis

This particular variation of Myiasis results from parasitic infection of the ear. The patient hears buzzing sounds and suffers from smelly discharge from the ear from time to time. If the site of infection is the middle ear, the larvae may reach the brain and infect it causing Cerebral Myiasis that may lead to serious complications.

Opthalmomyiasis

This is a common variation of Myiasis and affects the eyes. It gives rise to irritation and pain in the eye and can also result in edema in serious circumstances.

Myiasis Symptoms

The symptoms of Myiasis differ depending on the location of parasitic infection. Infection of the eye can produce symptoms quite different from infection of the ear or any other area of the body.

Some of the major Myiasis signs and symptoms are :

Irritation

Myiasis parasitic infection of the eye can lead to severe irritation in the eye. There is usually redness in the ocular region. The eye can also hurt a bit.

Swelling

There can also be an inflammation in the eyes. Infection makes the affected eye quite swollen and the vision unclear. Tears can also be discharged from the eye from time to time.

Nasal Obstruction

Myiasis infection of the nose can also result in blockage of the nasal passage.

Foul Discharge

Nasal infection can also lead to the release of a foul smelling discharge from the nose from time to time. People affected with this condition also suffer from frequent bleeding through the nose. Infection of the ear can also result in the release of smelly discharge from the ear.

Impaired Aural Sensation

People suffering from a parasitic Myiasis ear infection suffer from hearing disturbances. They experience crawling sensation in the ear and can also feel like hearing buzzing noises.

Skin Lesions

Myiasis Infection of the skin usually gives rise to sores and ulcers gradually over the skin. During Myiasis human skin, mainly the spots with lesions can be painful to touch. Myiasis body sores can remain for a long time.

Myiasis Causes

Myiasis is caused by parasitic infection. It occurs when larvae of parasitic flies of the Diptera genus start consuming the living and dead tissues of the body of a human or any lower animal.

Myiasis Diagnosis

Myiasis is usually diagnosed by physical observation of the symptoms. In some cases, biopsy of the skin may be required. The symptoms of the sufferer are asked for. The medical history of the patient is also taken into account for a proper diagnosis.

Myiasis Treatment

Myiasis therapy usually involves surgical removal of the larvae. Myiasis removal is followed by careful cleaning and disinfecting of the Myiasis wound. The larva is usually forced out of the body by applying pressure around the skin lesions with the aid of forceps.

Myiasis in cattle is treated in a different way. Drugs containing Ivermectin is released into the system of the infected Myiasis animals to prevent development of larvae and aid Myiasis cure. Infected Sheep may be drenched into insecticide to kill chances of larvae growth.

Myiasis Prevention

Myiasis cases can be avoided by eliminating the possible sources of infection. Any region that is warm and humid is ideal for the breeding of Myiasis flies. Such places must be destroyed by using insecticides and disposing waste materials in the proper manner.

Proper hand washing, good sanitation and maintaining proper personal hygiene also helps prevent a Myiasis infection.

People living in tropical and sub-tropical countries should also iron their clothes before wearing. Heat helps kill the egg of flies causing Myiasis.

Is Myiasis Contagious?

Myiasis is not a contagious disease. Myiasis wounds do not transmit infection from person to person.

Is Myiasis Fatal?

Myiasis can give rise to fatal symptoms in a few cases of nasal infection or infection of brain by larvae.

Myiasis Pictures

Want to know how in Myiasis living tissues and infected spots look like? Take a look at these Myiasis photos. Here is an assortment of some useful Myiasis pics that can help you get an idea about the appearance of the body parts affected by Myiasis.

Picture 1 – Myiasis
Source - uiowa

Picture 2 – Myiasis Picture
Source – uiowa

If you suspect yourself or any family member to be having a Myiasis infection, you should seek medical treatment as early as possible. Left untreated, Myiasis can give rise to life-threatening complications and early treatment can help you avoid it. It is always advisable to go for fast treatment where the safety of your health is concerned.

References:

http://en.wikipedia.org/wiki/Myiasis

http://emedicine.medscape.com/article/1491170-overview

http://www.wrongdiagnosis.com/m/myiasis/intro.htm

http://www.wisegeek.com/what-is-myiasis.htm