在肝硬化患者中,美特罗尼达诱导的脑病变
Xinyu Ji1, Ke Xuan Li1, Leonardo Furtado Freitas2
1Faculty of Medicine, McGill University, Montreal, QC, Canada.
Radiology case reports
|November 9, 2023
概括
长时间使用甲尼达可以引起罕见的神经毒性,呈现为脑病变. 大脑MRI对于诊断至关重要,它显示出特定的脱髓化模式,在药物停止后完全恢复.
科学领域:
- 神经学 神经学
- 放射学 放射学是一门学科.
- 传染性疾病 传染性疾病
背景情况:
- 甲尼达是一种广泛使用的抗生素,有效对抗无氧细菌,原生动物和微空气性细菌.
- 长时间使用甲尼达可以导致罕见但严重的不良事件,包括脑病变和外围神经毒性.
- 这些神经系统并发症可能难以区分于危重病患者 Delirium 的其他原因.
研究的目的:
- 报告一种由甲尼达诱导的神经毒性的病例.
- 要突出脑磁共振成像 (MRI) 在识别特征性脱髓化病变的诊断作用.
- 强调识别这种罕见症状的重要性,以便及时干预和患者康复.
主要方法:
- 一个72岁的男性患有精神状态变化和神经缺陷的病例报告.
- 对临床表现,长时间的甲尼达暴露和诊断工作的审查.
- 临床发现与脑MRI结果的相关性,特别是脱髓化模式.
- 监测患者在停止美特罗尼达治疗后的反应.
主要成果:
- 患者在长期接受甲尼达治疗后出现精神状态变化和神经缺陷,该患者因脊髓瘤炎的细菌病症而出现神经缺陷.
- 大脑MRI揭示了对称的双边超信号脱髓化病变,这与甲尼达神经毒性的特征有关,涉及牙状核,大脑体的,中脑,背骨髓和.
- 患者经历了完全的临床和神经辐射学复苏,在停止服用美特罗尼达后.
结论:
- 甲尼达诱导的神经毒性是一种罕见但显著的不良影响,需要及时识别.
- 大脑MRI对于通过识别特定的脱髓化模式来诊断这种疾病至关重要.
- 早期诊断和停止使用甲尼达对于实现患者完全康复和预防长期神经系统损伤至关重要.
相关概念视频
01:20Antiepileptic Drugs: Potassium Channel Activators
191
Ezocgabine or retigabine, an antiepileptic drug of remarkable efficacy, has revolutionized the management of seizures. It is a potassium channel activator, explicitly targeting the family of Q subtype potassium channels. It enhances the transmembrane potassium currents, regulating neuronal excitability. This action stabilizes the resting membrane potential, a pivotal factor in mitigating the hyperexcitability that characterizes epilepsy.
Ezogabine has gained approval as an adjunctive treatment...
Ezogabine has gained approval as an adjunctive treatment...
191
01:25Factors Influencing Drug Absorption: Disease States and Pharmacology
535
Multiple disease states can significantly influence the oral drug absorption process by affecting blood flow and the functionality of the gastrointestinal (GI) system. Various GI diseases, including conditions that alter GI motility, such as diarrhea, decreased acid secretions (achlorhydria), and infections, have been associated with reduced drug absorption.
Substances such as alcohol and specific drugs, including antineoplastics, can also negatively impact drug absorption. For instance,...
Substances such as alcohol and specific drugs, including antineoplastics, can also negatively impact drug absorption. For instance,...
535
01:18Drugs Affecting GI Tract Motility: Antimicrobials as Antidiarrheal Agents
128
Acute diarrhea, a common gastrointestinal disturbance, is characterized by the rapid evacuation of fluid stools, leading to an excessive weight in fluid. This condition typically arises from disorders affecting intestinal water and electrolyte transport. It can be triggered by an increased osmotic load within the intestine, excessive secretion of electrolytes and water, mucosal exudation of protein and fluid, or altered intestinal motility. The primary risks of acute diarrhea are dehydration...
128
01:17Hepatic Drug Excretion: Enterohepatic Cycling
1.5K
Enterohepatic cycling involves the active secretion of drugs and their metabolites into the bile via transporters in the canalicular membrane of hepatocytes. This secretion is an integral part of the digestive process, releasing these substances into the gastrointestinal (GI) tract.
Post-release drugs and metabolites can be reabsorbed into the body from the intestine. For conjugated metabolites like glucuronides, reabsorption requires enzymatic hydrolysis by intestinal microflora. This...
Post-release drugs and metabolites can be reabsorbed into the body from the intestine. For conjugated metabolites like glucuronides, reabsorption requires enzymatic hydrolysis by intestinal microflora. This...
1.5K
01:20Antiepileptic Drugs: Modulators of Neurotransmitter Release Mediated by SV2A Protein
318
Antiepileptic drugs, such as levetiracetam (Keppra) and brivaracetam (Briviact), have emerged as crucial tools in managing epilepsy. These medications exert their therapeutic effects by targeting the synaptic vesicle protein SV2A, a transmembrane glycoprotein primarily found in the brain.
SV2A is a transmembrane glycoprotein located predominantly in the brain, modulating the release of neurotransmitters for neuronal communication. Both levetiracetam and brivaracetam exhibit a high affinity for...
SV2A is a transmembrane glycoprotein located predominantly in the brain, modulating the release of neurotransmitters for neuronal communication. Both levetiracetam and brivaracetam exhibit a high affinity for...
318
01:14Antiepileptic Drugs: Glutamate Antagonists
382
Glutamate is a fundamental neurotransmitter in the central nervous system, playing a vital role in neuronal communication and various cognitive processes. Glutamate stands as the principal excitatory neurotransmitter in the brain. Its presence is crucial for the communication between neurons, underpinning essential processes such as synaptic transmission, neuronal excitability, and plasticity. These functions are vital for higher-order cognitive processes, including learning and memory. The...
382