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master's thesis
Opsoclonus myoclonus sindrom u bolesnika s West Nile encefalitisom
Zagreb: University of Zagreb, School of Medicine, 2020. urn:nbn:hr:105:891545
Varga, Sara
University of Zagreb
School of Medicine
Department of Infectious Diseases

Institutional repository: Dr Med - University of Zagreb School of Medicine Digital Repository

Cite this document

Varga, S. (2020). Opsoclonus myoclonus sindrom u bolesnika s West Nile encefalitisom (Master's thesis). Zagreb: University of Zagreb, School of Medicine. Retrieved from https://urn.nsk.hr/urn:nbn:hr:105:891545

Varga, Sara. "Opsoclonus myoclonus sindrom u bolesnika s West Nile encefalitisom." Master's thesis, University of Zagreb, School of Medicine, 2020. https://urn.nsk.hr/urn:nbn:hr:105:891545

Varga, Sara. "Opsoclonus myoclonus sindrom u bolesnika s West Nile encefalitisom." Master's thesis, University of Zagreb, School of Medicine, 2020. https://urn.nsk.hr/urn:nbn:hr:105:891545

Varga, S. (2020). 'Opsoclonus myoclonus sindrom u bolesnika s West Nile encefalitisom', Master's thesis, University of Zagreb, School of Medicine, accessed 30 November 2024, https://urn.nsk.hr/urn:nbn:hr:105:891545

Varga S. Opsoclonus myoclonus sindrom u bolesnika s West Nile encefalitisom [Master's thesis]. Zagreb: University of Zagreb, School of Medicine; 2020 [cited 2024 November 30] Available at: https://urn.nsk.hr/urn:nbn:hr:105:891545

S. Varga, "Opsoclonus myoclonus sindrom u bolesnika s West Nile encefalitisom", Master's thesis, University of Zagreb, School of Medicine, Zagreb, 2020. Available at: https://urn.nsk.hr/urn:nbn:hr:105:891545

Metadata
TitleOpsoclonus myoclonus sindrom u bolesnika s West Nile encefalitisom
Title (english)Opsoclonus myoclonus syndrome in a patient with West Nile encephalitis
AuthorSara Varga
MentorDalibor Vukelić (mentor)
Committee memberAdriana Vince (predsjednik povjerenstva)
Committee memberJosip Begovac (član povjerenstva)
Committee memberDalibor Vukelić (član povjerenstva)
GranterUniversity of Zagreb
School of Medicine
(Department of Infectious Diseases)
Zagreb
Defense date and country2020-07-17, Croatia
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Infectology
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Neurology
Abstract
Opsoklonus mioklonus sindrom je rijedak i ozbiljan imunološki posredovan neurološki poremećaj kojeg karakteriziraju opsoklonus, mioklonus i ataksija. Uzroci su mu paraneoplastički, parainfekcijski, toksičko-metabolički te idiopatski. U ovom radu prikazan je slučaj sedamdesetogodišnje bolesnice sa encefalitisom uzrokovanim West Nile virusom, koja je 11. dan infekcije razvila intenzivnu glavobolju i fotofobiju, a u kliničkoj slici su zamijećeni nevoljni trzaji mišića gornjih ekstremiteta, tremor, vrtoglavica, ataksija i opsoklonus. Nalaz kompjutorizirane tomografije je bio u granicama normale. Analizom cerebrospinalnog likvora nađena je pleocitoza, blaža proteinorahija i normalna razina glukoze. Elektroencefalogram (EEG) je pokazivao difuzno usporenu moždanu aktivnost. Obrada na autoimune, parainfekcijske i paraneoplastičke uzroke encefalitisa je bila negativna, a dokazana su West Nile specifična IgM i IgG protutijela u serumu i pozitivan nalaz virusne RNA u urinu bolesnice. Pacijentica je liječenja empirijskom terapijom ceftriaksonom, ampicilinom i aciklovirom dok nismo isključili potencijalno liječive forme encefalitisa, nakon čega je empirijska terapija ukinuta i bolesnica je liječena suportivno. Na kontrolnom pregledu 2 mjeseca nakon otpusta, pacijentica je imala uredan neurološki status sa potpunim oporavkom neuroloških simptoma. Prema mom saznanju i pretraživanju literature, riječ je o 15. takvom do sada opisanom slučaju u svijetu.
Abstract (english)
Opsoclonus-myoclonus syndrome is a rare and serious immunologically caused condition, characterised by opsoclonus, myoclonus and ataxia. Aetiology of opsoclonus-myoclonus syndrome is paraneoplastic, parainfectious, toxic-metabolic or idiopathic. This graduation paper reports the case of 70-year-old woman with West Nile encephalitis, who on 11th day of illness developed intensive headache, photophobia, involuntary twitches of upper limbs, tremor, ataxia and opsoclonus. Brain computed tomography showed no significant abnormalities. Cerebrospinal fluid (CSF) analysis identified mildly elevated white blood cell counts and CSF proteins with normal CSF glucose levels. The electroencephalogram (EEG) showed diffusely slowed activity. Work-up for paraneoplastic, autoimmune and infectious causes of encephalitis was unremarkable, except for the positive IgM and IgG antibodies to West Nile virus and positive WNV-RNA in urine sample. Patient was given empiric therapy with ceftriaxone, ampicillin and acyclovir, which was discontinued after exclusion of potentially pharmacologically treatable encephalitides. After that, patient was treated with supportive measures. Two months after discharge, neurological examination was normal with complete recovery of neurological symptoms. According to my knowledge and review of the literature, this is 15th case of WNV associated OMS reported so far.
Keywords
Keywords (english)
Languagecroatian
URN:NBNurn:nbn:hr:105:891545
Study programmeTitle: Medicine
Study programme type: university
Study level: integrated undergraduate and graduate
Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resourceText
File originBorn digital
Access conditionsOpen access
Terms of useLicence In copyright icon
Created on2021-08-23 11:38:06