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Alternating hemiparesis in the context of hemolytic uremic syndrome and COVID-19 positivity

Hemiparesis has been reported in hemolytic uremic syndrome (HUS), however electrophysiological findings associated with this syndrome have not been well-characterized, and alternating hemiparesis presentations have not been reported. We present detailed electrophysiological and clinical findings in...

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Autores principales: Simpson, Hugh D., Johnson, Erica, Britton, Jeffrey, Braksick, Sherri
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8256673/
https://www.ncbi.nlm.nih.gov/pubmed/34250459
http://dx.doi.org/10.1016/j.ebr.2021.100468
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author Simpson, Hugh D.
Johnson, Erica
Britton, Jeffrey
Braksick, Sherri
author_facet Simpson, Hugh D.
Johnson, Erica
Britton, Jeffrey
Braksick, Sherri
author_sort Simpson, Hugh D.
collection PubMed
description Hemiparesis has been reported in hemolytic uremic syndrome (HUS), however electrophysiological findings associated with this syndrome have not been well-characterized, and alternating hemiparesis presentations have not been reported. We present detailed electrophysiological and clinical findings in a case of alternating hemiparesis corresponding to alternating focal contralateral delta slowing on prolonged EEG monitoring in a case of HUS with COVID-19 positivity. A 24-year-old woman was admitted with bloody diarrhea, acute kidney injury, and focal seizures initially presumed due to Escherichia coli 0157:H7 Shiga-like toxin-related hemolytic uremic syndrome (ST-HUS). After admission, the patient tested positive for COVID-19. Continuous EEG monitoring revealed diffuse polymorphic delta slowing. Around 24 hours into the admission, the delta slowing became focal in the right hemisphere and was associated with a left hemiparesis. Around three days later, the clinical and EEG pattern reversed, showing left hemisphere slowing and an associated right hemiparesis. Additionally, 14 Hz positive spikes were observed throughout the recording period. Neuroimaging, including CT and MRI, was negative for acute ischemia throughout. The patient subsequently recovered over several days with no residual neurologic abnormalities.
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spelling pubmed-82566732021-07-06 Alternating hemiparesis in the context of hemolytic uremic syndrome and COVID-19 positivity Simpson, Hugh D. Johnson, Erica Britton, Jeffrey Braksick, Sherri Epilepsy Behav Rep Case Report Hemiparesis has been reported in hemolytic uremic syndrome (HUS), however electrophysiological findings associated with this syndrome have not been well-characterized, and alternating hemiparesis presentations have not been reported. We present detailed electrophysiological and clinical findings in a case of alternating hemiparesis corresponding to alternating focal contralateral delta slowing on prolonged EEG monitoring in a case of HUS with COVID-19 positivity. A 24-year-old woman was admitted with bloody diarrhea, acute kidney injury, and focal seizures initially presumed due to Escherichia coli 0157:H7 Shiga-like toxin-related hemolytic uremic syndrome (ST-HUS). After admission, the patient tested positive for COVID-19. Continuous EEG monitoring revealed diffuse polymorphic delta slowing. Around 24 hours into the admission, the delta slowing became focal in the right hemisphere and was associated with a left hemiparesis. Around three days later, the clinical and EEG pattern reversed, showing left hemisphere slowing and an associated right hemiparesis. Additionally, 14 Hz positive spikes were observed throughout the recording period. Neuroimaging, including CT and MRI, was negative for acute ischemia throughout. The patient subsequently recovered over several days with no residual neurologic abnormalities. Elsevier 2021-07-05 /pmc/articles/PMC8256673/ /pubmed/34250459 http://dx.doi.org/10.1016/j.ebr.2021.100468 Text en © 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Simpson, Hugh D.
Johnson, Erica
Britton, Jeffrey
Braksick, Sherri
Alternating hemiparesis in the context of hemolytic uremic syndrome and COVID-19 positivity
title Alternating hemiparesis in the context of hemolytic uremic syndrome and COVID-19 positivity
title_full Alternating hemiparesis in the context of hemolytic uremic syndrome and COVID-19 positivity
title_fullStr Alternating hemiparesis in the context of hemolytic uremic syndrome and COVID-19 positivity
title_full_unstemmed Alternating hemiparesis in the context of hemolytic uremic syndrome and COVID-19 positivity
title_short Alternating hemiparesis in the context of hemolytic uremic syndrome and COVID-19 positivity
title_sort alternating hemiparesis in the context of hemolytic uremic syndrome and covid-19 positivity
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8256673/
https://www.ncbi.nlm.nih.gov/pubmed/34250459
http://dx.doi.org/10.1016/j.ebr.2021.100468
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