Nervous System Diseases Commons^™

Transcutaneous Electrical Nerve Stimulation For Fibromyalgia-Like Syndrome In Patients With Long-Covid: A Pilot Randomized Clinical Trial, Alejandro Zulbaran-Rojas, Rasha O Bara, Myeounggon Lee, Miguel Bargas-Ochoa, Tina Phan, Manuel Pacheco, Areli Flores Camargo, Syed Murtaza Kazmi, Mohammad Dehghan Rouzi, Dipaben Modi, Fidaa Shaib, Bijan Najafi

Faculty, Staff and Students Publications

This study investigated the effect of Transcutaneous Electrical Nerve Stimulation (TENS) for fibromyalgia-like symptoms including chronic widespread musculoskeletal pain, fatigue, and/or gait impairment in twenty-five individuals with long-COVID. Participants were randomized to a high dose (intervention group, IG) or low dose (placebo group, PG) TENS device. Both groups received daily 3-5 h of TENS therapy for 4-weeks. The Brief Pain Inventory assessed functional interference from pain (BPI-I), and pain severity (BPI-S). The global fatigue index (GFI) assessed functional interference from fatigue. Wearable technology measured gait parameters during three 30-feet consecutive walking tasks. At 4-weeks, the IG exhibited a greater decrease …

Relationship Between Gut Microbiota And Dementia, Saad Ahmed, Zack Harris, Russell David Levi

Rowan-Virtua Research Day

This paper explores the complex relationship between gut microbiota, dietary habits, and dementia, focusing particularly on Alzheimer's disease (AD). Growing evidence suggests a significant link between the composition of gut bacteria, dietary choices, and susceptibility to dementia. Notably, individuals with dementia demonstrate a noticeable reduction in gut bacteria diversity, highlighting the crucial role of a balanced microbiome in maintaining cognitive health. Conversely, dietary preferences characterized by excessive consumption of processed foods and sugars are associated with an increased risk of dementia, emphasizing the critical influence of diet on shaping gut microbiota and subsequent neurocognitive outcomes. Importantly, dietary interventions featuring a …

Cva In Patient With Systemic Sclerosis On Aspirin Therapy: A Case Report, Rahyan Mahmud, Bianna Koutsenko, Kenneth Goich, Usaid Hasan

Rowan-Virtua Research Day

Introduction

Systemic sclerosis is an autoimmune disorder characterized by microvascular damage and multiorgan fibrosis. These patients have a higher risk of cerebrovascular events, but it is difficult to develop strategies for prevention due to limited understanding of underlying pathophysiology.

Case Presentation

A 76-year-old female with a history of systemic sclerosis presented to the emergency department with acute onset slurred speech, facial droop, and left arm pain with a National Institutes of Health (NIH) Stroke Scale of 1. She was outside the thrombolytic window. Other history includes hypertension and hyperlipidemia; both were well controlled. MRI confirmed right frontal lobe ischemic stroke …

An Unexpected Outcome Of An Ischemic Stroke On Reward Pathways In The Human Brain, Karen Valdez-Cuen, Erica Kozorosky, Ferina Farahnik, Oscar Garcia

Central & West Texas GME Research Day 2024

No abstract provided.

Cured By Time? Exploring The Complexity Of Diagnosing Acute Encephalopathy, Charles F. Clinton, Avery Stokes, Candler Boyett, Bhuvaneshwari Muchandi, Mario E. Gonzalez

South Atlantic Division GME Research Day 2024

No abstract provided.

A Rare Case Of Anoxic Brain Injury Secondary To Masld-Induced Hyperammonemia, Renu Thomas, Nhu Chau T. Nguyen, Daniel Bao, Jonathan Tang, Uzma Ali, Damon Cao

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

Wilson’S Disease: A Late-Onset Presentation Of Polyneuropathy, He Wang, Austin Goff, Nathan Lowe, Sanaz Siran

Far West Division GME Research Day 2024

No abstract provided.

Beyond The Muscle: A Case Presentation On Interstitial Lung Disease In The Setting Of Dermatomyositis, Monique Shamoon, Daria Tarighy, Alejandro Hernandez, Mohamad Saad

East Florida Division GME Research Day 2024

No abstract provided.

Cefepime-Induced Neurotoxicity: A Case Report, Kelsey Decker, Shamael Johar, Vaishnavi Sirekulam, Kedareeshwar Arukala

South Atlantic Division GME Research Day 2024

No abstract provided.

A Challenging Case Of Bilateral Medial Medullary Infarction Resembling Guillain-Barré Syndrome, Alexis Bialousz, Havird Mclean Skalak, Nicholas Carbo, Amanda Westbrook

South Atlantic Division GME Research Day 2024

No abstract provided.

Stroke As A Result Of Caseous Mitral Annular Calcification, Ricardo Estrada-Montes, Sarah Barraza, George Matus, Asha Kurian

Central & West Texas GME Research Day 2024

No abstract provided.

Cerebrovascular Accident Complicating Pulmonary Tb: A Rare Co-Existence, Tesnim Hamdan, Iryna Witt, Nameer Ascandar, Srija Reddy

West Florida Division GME Research Day 2024

No abstract provided.

An Atypical Presentation Of Nms Complicated By Brain Lesion, Sunwoo Lee, Stephanie Tejada, Erkan Batti, Paul Cimoch, Marc Laroque, Mohamad Saad, Donald Kanu, Christopher Ochner

East Florida Division GME Research Day 2024

No abstract provided.

Acute Mesenteric Ischemia Secondary To Lupus Vasculitis, Karen Valdez-Cuen, Ammar Mahmood, Mohammad Ridha, Fahad Omar

Central & West Texas GME Research Day 2024

No abstract provided.

Intracrnial Hemorrhage And Ecg Changes, Negar Niknam, Eric N. Riha, Bushra Bangash, Parshvi Patel, Skantha K. Manjunath, Gnananandh Jayaraman, Ramesh Kesavan, Siva T. Sarva

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

Ciprofloxacin-Induced Peripheral Neuropathy: A Case Report, Alexander Refaeian, Eric L. Vest, Michael Schmidt, Jorge D. Guerra, Mohd N. Refaei, Michael Refaeian, Ryan A. Floresca, Manouchehr Refaeian

HCA Healthcare Journal of Medicine

Introduction

Fluoroquinolones, a class of antibiotics, are commonly employed in the treatment of a wide array of bacterial infections. Recognized for their effectiveness against a broad spectrum of pathogens, fluoroquinolones have played a pivotal role in managing conditions like urinary tract infections and respiratory diseases. Nevertheless, their usage is not without contention due to their association with a variety of adverse effects, including tendon rupture and the less frequently reported issue of peripheral neuropathy.

Case Presentation

We present the case of a 42-year-old male who developed peripheral neuropathy several days after completing a 10-day course of ciprofloxacin for gastroenteritis. The …

Rare Presentation Of Primary Malignant Peripheral Nerve Sheath Tumor Of The Femur In Neurofibromatosis-1, Akshaj Pole, Danielle Ford, Elizabeth Pollard

North Texas GME Research Forum 2023

Malignant peripheral nerve sheath tumors (MPNSTs) are rare sarcomas, most commonly seen in patients with Neurofibromatosis type 1 (NF1), that are characterized as aggressive with high rate of local recurrence. Among NF1 patients, the risk of developing MNPSTs is approximately 8-13% over a lifetime. Primary MPNST is exceedingly rare, of which the vast majority are concentrated in the head and neck region. Here, we present a case of a 40-year-old male with NF1 who presented with a giant MPNST that originated in the right proximal femur. The mass was treated with complete surgical resection with right hip disarticulation. In a …

Electrolyte Abnormalities And Seizure Like Activity Unmasking An Underlying Rare Genetic Disorder, Riddhiben Patel, Andrew Cushing, Amnah Andrabi, Sathish Karmegam

North Texas GME Research Forum 2023

Fahr's syndrome, or idiopathic basal ganglia calcification, is a rare neurological disorder that runs in families as an autosomal dominant trait. It is associated with a variety of other diseases, especially Parkinson’s disease, but the etiology remains a mystery. On imaging, it presents as abnormal calcium deposits found primarily in the basal ganglia and cerebral cortex, both of which are areas responsible for controlling movement. A 73-year old woman with a past medical history of hypertension and seizures presented to the emergency department due to altered mental status. The patient was indulged in a conversation with her daughter when all …

An Interesting Occurrence Of Bell’S Palsy With Atypical Presentation After Contracting Covid-19 Infection, Yen-Chung Wang, Yen-Hsiang Wang, Christian Sanchez

North Texas GME Research Forum 2023

Introduction: COVID-19 has been identified as primarily a respiratory illness, however, with its clinical manifestation of involvement with multiple organs, it is now considered a systemic illness. In particular, it also can elicit a broad spectrum of neurological symptoms. One of the proposed manifestations is Bell’s Palsy, an acute idiopathic facial nerve palsy that affects the lower motor neuron. Here we have a patient with recent COVID infection who presents with a unilateral facial droop along with unilateral weakness/tingling of extremities and was diagnosed with Bell’s Palsy.

Case Description: Patient is a 47-year-old male with a past medical history of …

A Case Of Unilateral Jerking Movements In A Patient With Uncontrolled Type 2 Diabetes Mellitus, Mark Cheneler, Tapannita Padhi, Khizir Qureshi, Carlos Bahrami

North Texas GME Research Forum 2023

Hemichorea-hemiballismus (HCHB) syndrome is a syndrome characterized by choreic movements which are irregular, nonrepetitive, and random movements and ballismus which are spontaneous, violent movements. HCHB syndrome is a rare presentation which can be precipitated by uncontrolled diabetes and is thought to have multiple plausible mechanisms. One mechanism of HCHB with uncontrolled diabetes is ischemic injury in the basal ganglia causing impaired gross motor control. Presented here is a case of HCHB syndrome initially seen on imaging and later correlated with physical examination. This patient presented for nonspecific complaints of fatigue, generalized weakness, and lower extremity weakness. On evaluation by EMS …

Cerebal Venous Sinus Thrombosis In A Patient With Smith-Magenis Syndrome, Hovra Zahoor, Ameer Hamza, Daniel Vather-Wu, Nilmarie Guzman

South Atlantic Division GME Research Day 2023

No abstract provided.

Multiple Sclerosis In A 32-Year-Old Female With History Of Prolactinoma, Aleeza Ali, Jesse Simon, Adekunle Bamgboye

East Florida Division GME Research Day 2023

Among disorders affecting the central nervous system (CNS), excluding trauma, multiple sclerosis (MS) is the most common cause of permanent disability in young adults. This condition is characterized by IgG autoantibody-mediated destruction of oligodendrocytes in the brain and spinal cord. Although the origin of MS is not fully understood, some suggest that prolactin may be involved in the development of the disease process evidenced by the fact that it predominately affects women of childbearing age, and the diverse role of prolactin (PRL) as a peptide hormone, cytokine, and immune modulator. Here we review the case of a 32-year-old female with …

Left Atrial Enlargement In Primary Cryptogenic Strokes Without Atrial Fibrillation, Hytham Rashid, Jonathan Brown, Negar Niknam, Tusharkumar Pansuriya, Sivatej Sarva, Syed Danyal Raza

Gulf Coast Division GME Research Day 2023

No abstract provided.

Challenges Of Cerebral Hyperperfusion Syndrome: A Clinical Case Report, Ruth Williams, Ranga Rathakrishnan

East Florida Division GME Research Day 2023

Introduction: Cerebral Hyperperfusion syndrome (CHS) is a clinical syndrome of hypertension, headache, neurological deficits, with or without seizures, following a revascularization procedure. It is characterized by an excessive and sudden increase in cerebral blood flow. The mechanism is largely not understood but theories involve impaired cerebrovascular autoregulation (thought to be mitigated by collateral circulation), free radical damage, and baroreceptor reflex damage, possible from the procedure itself1 . Common presentations include severe ipsilateral headache to the side of the lesion with typical onset within 12 hours to 6 days, but can occur up to one month, after carotid revascularization processes2 . …

A Rare Case Of Pres In A Patient On Bevacizumab-Awwb Chemotherapy, Alexander Rhodes, John Punla, Aswin Srinivasan, An Dao, Syed Raza

Gulf Coast Division GME Research Day 2023

No abstract provided.

Moyamoya Disease Presenting As An Intracranial Hemorrhage In A 69-Year-Old Male, Jorge Rodriguez, Brittany Chandani, David G. Gelikman, Ankur Garg, Olga Karasik

North Florida Division GME Research Day 2023

No abstract provided.

Wernicke Encephalopathy: Interplay Between Magnesium And Thiamine, Richard Allen Gorman Ii, Mark Stine, Rafael Vaello, Patrick J. Stocker

West Florida Division GME Research Day 2023

No abstract provided.

Late Onset Sheehan Syndrome 23 Years After Post-Partum Hemorrhage, Igbayilola Dosunmu, Ali Tariq Alvi, Sarah Kaufman, Ayesha Malik

East Florida Division GME Research Day 2023

Please see supplemental content for full abstract with figures and references.

Sheehan syndrome is defined as ischemic necrosis of pituitary gland following massive postpartum hemorrhage leading to panhypopituitarism. It has an insidious course with multitude of presentations. The majority of cases remain undiagnosed for many years after the delivery with average time following postpartum hemorrhage to diagnosis of Sheehan syndrome is believed to be almost 13 years according to one study. Here, we present a unique case of late onset of Sheehan syndrome 23 years after the last childbirth which was complicated by hemorrhage. To our knowledge, this is the …

A Young Case Of Giant Cell Arteritis, Tricia O'Brien, Philip Mesquita, Zahid Chaudhry

East Florida Division GME Research Day 2023

Introduction: Giant Cell Arteritis is condition that commonly affects patients between the ages of 70 and 80 years old. It rarely affects those younger than 50 years of age.

Description: A 40-year-old African American woman, who had previously been diagnosed with Giant Cell Arthritis via temporal artery biopsy at age 33, presented to the emergency department due to facial and arm numbness and throbbing headache. Her ESR was markedly elevated and she was placed on prednisone.

Discussion: The incidence of Giant Cell Arthritis is between 5.8 to 31.3 per 100,000 in the population. This disease affects women 2-3 times more …

Subacute Stroke Like Presentation Likely Due To Disseminated Histoplasmosis In An Immunocompromised Patient, Ashley R. Diaz, Priya Mohan, Utmitha Konda, Alfonso Manotas, Issac Ichoa

East Florida Division GME Research Day 2023

Histoplasmosis capsulatum is an opportunistic fungal infection that is largely asymptomatic and found to have nonspecific signs and symptoms. It predominates in Central and North America, and is one of the leading causes of hospitalization among the fungal family. However, in the right host, such as in this case, a patient with significant immunosuppression can develop serious manifestations as it disseminates outside of the pulmonary system. The challenging element of disseminated histoplasmosis is that despite proper treatment immunocompromised patients will frequently relapse with worsening presentation. There is limited literature on subacute stroke-like presentation in a patient with chronic infection of …