Nonepileptic, Stereotypical, and Intermittent Symptoms After Subdural Hematoma Evacuation
| Autor: | Arvind Mohan, William Remley, Emma L. Leone, Varun Jain, Katharina M. Busl, Leonardo Almeida, Srishti Taneja |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
business.industry
seizure Neurosurgery General Engineering Ischemia Subdural hemorrhage cortical Global aphasia Subdural hematoma evacuation medicine.disease Therapeutic trial Patient care subdural nonepileptic depolarization intermittent Hematoma Neurology Radiological weapon Anesthesia nesis medicine spreading stereotypical business |
| Zdroj: | Cureus |
| ISSN: | 2168-8184 |
| DOI: | 10.7759/cureus.18361 |
| Popis: | Transient neurological deficits can occur in the setting of subdural hemorrhages with subsequent unremarkable electrodiagnostic and radiological evaluation. This scenario is rare and can be difficult for physicians to interpret. These transient neurological deficits are thought to result from relative ischemia, secondary to a lesser-known concept known as cortical spreading depolarization. These transient neurological deficits are thought to result from relative ischemia, secondary to a lesser-known concept known as cortical spreading depolarization, which may present clinically as nonepileptic, stereotypical, and intermittent symptoms (NESIS). In these instances, patients are often misdiagnosed as epileptics and committed to long-term antiseizure drugs. We present a 51-year-old patient developing acute global aphasia following the evacuation of a subdural hematoma, with no significant findings on laboratory, microbiological, electrodiagnostic, or radiological evaluation. The patient experienced spontaneous improvement and returned to baseline in the subsequent weeks. Increased awareness of NESIS as a cortical spreading depolarization phenomenon can improve patient care and prevent both unnecessary, extended medical evaluations and therapeutic trials. |
| Databáze: | OpenAIRE |
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