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Microbiol Spectr 2023 Sep 26:e0238023. Epub 2023 Sep 26.

Reference and Research Laboratory for Taxonomy, National Centre of Microbiology, Instituto de Salud Carlos III, Majadahonda , Madrid, Spain.

To determine whether the neurotoxin BoNT/B2 causing botulism in Spain is clonal, the genetic diversity and phylogenetic relationships of from food-borne episodes and infant cases of the condition were explored. The botulinum toxin gene () subtype, the variable region of the flagellin gene (VR), and a seven-gene multi-locus sequence type were examined by sequencing 37 BoNT-positive cultures obtained over the period 2010 to 2022. Out of 37 botulism events, 16 food-borne episodes and 16 infant cases were associated with 2. Read More

J Oncol Pharm Pract 2023 Sep 26:10781552231203190. Epub 2023 Sep 26.

Department of Rheumatology, Kocaeli University Faculty of Medicine, Izmit, Turkey.

Objective: Myositis, an inflammatory disease affecting muscles, is a rare and potentially fatal immune-related adverse event associated with immune checkpoint inhibitors. There are limited data on its clinical features and management.

Case Presentation: Atezolizumab, in combination with etoposide and carboplatin, was initiated in the patient diagnosed with metastatic small-cell lung cancer. Read More

Mol Divers 2023 Sep 25. Epub 2023 Sep 25.

ICMR-National Institute of Traditional Medicine, Belagavi, Karnataka, 590010, India.

The WHO lists snakebite as a "neglected tropical disease". In tropical and subtropical areas, envenoming is an important public health issue. This review article describes the structure, function, chemical composition, natural inhibitors, and clinical applications of Elapids' Three Finger Toxins (3FTX) using scientific research data. Read More

Int J Infect Dis 2023 Sep 21. Epub 2023 Sep 21.

U.O.C. of Medicine and Pneumology, Fondazione Istituto G. Giglio, Contrada Pollastra, 90015, Cefalù, Italy.

Introduction: Botulism is a rare syndrome characterized by acute, flaccid paralysis with possible involvement of respiratory muscle-producing pump failure requiring mechanical ventilation. A predominance of autonomic involvement can occur.

Methods: We enrolled patients affected by foodborne botulism during an outbreak. Read More

Minerva Anestesiol 2023 Sep 21. Epub 2023 Sep 21.

Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.

Background: COVID-19 acute respiratory distress syndrome (ARDS) is often managed with mechanical ventilation (MV), requiring sedation and paralysis, with associated risk of complications. There is limited evidence on the use of high flow nasal cannula (HFNC). We hypothesized that management of COVID-19 ARDS without MV is feasible. Read More

Cureus 2023 Aug 18;15(8):e43728. Epub 2023 Aug 18.

Department of Pediatrics, Ministry of Health, Bisha, SAU.

Neonates can have ion channel abnormalities known as channelopathies, which can impact any organ system. These abnormalities cause seizures, which can result in developmental delays and lead to early death. For a child's long-term neurodevelopment, early identification as a channelopathy is essential to avoid any brain damage. Read More

Acta Neurol Taiwan 2023 Dec;32(4):207-211

Department of Medicine, Hospital Sibu, KM 5 1/2, Jalan Ulu Oya, 96000 Sibu, Sarawak, Malaysia.

Purpose: Guillain-Barré Syndrome (GBS) associated with SARS-CoV-2 vaccine administration is very rare. Early recognition of GBS at early stage could prevent extensive nerve damage with potential respiratory and autonomic failure.

Case Report: We report a case of paraparetic spectrum of GBS in a 53-year-old lady who presented with rapidly progressive acute flaccid paralysis involving both lower extremities with areflexia eight days after the first dose of Sinovac vaccine for SARS-CoV-2 in Malaysia. Read More

Neuromuscul Disord 2023 Aug 25. Epub 2023 Aug 25.

F. Hoffmann-La Roche Ltd, Roche Innovation Center Basel, Grenzacherstrasse 124, Basel 4070, Switzerland.

Spinal muscular atrophy (SMA) is characterized by progressive muscle weakness and paralysis. Motor function is monitored in the clinical setting using assessments including the 32-item Motor Function Measure (MFM-32), but changes in disease severity between clinical visits may be missed. Digital health technologies may assist evaluation of disease severity by bridging gaps between clinical visits. Read More

Zhongguo Dang Dai Er Ke Za Zhi 2023 Sept 15;25(9):936-940

Division of Electromygraphy Testing, Department of Neurology, Hunan Children's Hospital, Changsha 410007, China.

Objectives: To study the clinical and neuroelectrophysiological features of botulism in children.

Methods: A retrospective analysis was conducted on the clinical data of eight children who were diagnosed with botulism in the Department of Neurology, Hunan Children's Hospital, from August 2015 to October 2022.

Results: All eight children were found to have symmetrical cranial nerve palsy and flaccid paralysis of the extremities, with a descending pattern. Read More

J Physiol 2023 Sep 8. Epub 2023 Sep 8.

Department of Physiology, School of Medicine, College of Medicine and Health, University College Cork, Cork, Ireland.

Despite profound diaphragm weakness, peak inspiratory pressure-generating capacity is preserved in young mdx mice revealing adequate compensation by extra-diaphragmatic muscles of breathing in early dystrophic disease. We hypothesised that loss of compensation gives rise to respiratory system compromise in advanced dystrophic disease. Studies were performed in male wild-type (n = 196) and dystrophin-deficient mdx mice (n = 188) at 1, 4, 8, 12 and 16 months of age. Read More

Front Neurosci 2023 23;17:1226660. Epub 2023 Aug 23.

Department of Rehabilitation Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.

Respiration is a crucial steady-state function of human life. Central nervous system injury can damage the central respiratory pattern generator (CRPG) or interrupt its outflow, leading to central respiratory paralysis and dysfunction, which can endanger the patient's life. At present, there is no effective means to reverse this process. Read More

J Med Case Rep 2023 Sep 6;17(1):381. Epub 2023 Sep 6.

Everest Hospital, New Baneshwor, Kathmandu, Nepal.

Background: Granulomatosis with polyangiitis (GPA) is a rare small vessel vasculitis predominantly affecting upper and lower respiratory tract and kidneys. Unilateral diaphragmatic palsy could be a rare manifestation of GPA. Here we report a case of GPA in a 45-year-old male with unilateral diaphragmatic palsy with pleuropericarditis. Read More

Intractable Rare Dis Res 2023 Aug;12(3):198-201

Department of Surgery, St. Mary's Hospital, Kurume, Fukuoka, Japan.

Hereditary motor and sensory neuropathy with proximal dominant involvement (HMSN-P) is an intractable neurological disease with autosomal dominant inheritance, four-limb weakness, sensory impairment, and a slowly progressive course. HMSN-P patients develop four-limb paralysis at the advanced-stage, as in amyotrophic lateral sclerosis (ALS). There is a natural 20- to 30-year course from initial painful muscle cramps and four-limb paralysis to respiratory dysfunction. Read More

Int J Surg Case Rep 2023 Sep 31;110:108734. Epub 2023 Aug 31.

Intensive Care Unit, Sichuan Province Orthopedic Hospital, Chengdu 610041, China. Electronic address:

Introduction And Importance: Nasogastric tube syndrome (NGTS) is a rare but potentially life-threatening complication. Patients receiving both tracheostomy and indwelling nasogastric tube (NGT) are not uncommon, however difficult tracheostomy decannulation due to NGTS has not been reported.

Case Presentation: A 65-year-old woman was hospitalized with cervical spine stenosis and cervical spinal cord injury after a fall. Read More

Virol Sin 2023 Aug 30. Epub 2023 Aug 30.

School of Life Sciences, Tianjin University, Tianjin, 300072, China; Institute of Tianjin Key Laboratory of Function and Application of Biological Macromolecular Structures, Tianjin, 300072, China. Electronic address:

Enterovirus D68 (EV-D68) can cause respiratory diseases and acute flaccid paralysis, posing a great threat to public health. Interferons are cytokines secreted by host cells that have broad-spectrum antiviral effects, inducing the expression of hundreds of interferon-stimulated genes (ISGs). EV-D68 activates ISG expression early in infection, but at a later stage, the virus suppresses ISG expression, a strategy evolved by EV-D68 to antagonize interferons. Read More

Front Cell Neurosci 2023 15;17:1226194. Epub 2023 Aug 15.

United States Army Medical Research Institute of Chemical Defense, Gunpowder, MD, United States.

Introduction: Botulinum neurotoxin (BoNT) causes neuroparalytic disease and death by blocking neuromuscular transmission. There are no specific therapies for clinical botulism and the only treatment option is supportive care until neuromuscular function spontaneously recovers, which can take weeks or months after exposure. The highly specialized neuromuscular junction (NMJ) between phrenic motor neurons and diaphragm muscle fibers is the main clinical target of BoNT. Read More

Rinsho Shinkeigaku 2023 Sep 29;63(9):572-576. Epub 2023 Aug 29.

Department of Pathology, Brain Research Institute, Niigata University.

A 74-year-old male patient developed multiple infarcts of the brainstem and cerebellum, followed 14 months later by palatal tremor and bilateral vocal cord abduction paralysis, resulting in death due to type 2 respiratory failure. Pathologic analysis revealed old infarcts extending from the bilateral cerebellar cortices to the dentate nucleus, being more extensive on the right side, accompanied by Wallerian degeneration involving the left red nucleus, right central tegmentum tract, and inferior cerebellar peduncle, followed by pseudohypertrophy of the bilateral inferior olivary nuclei. These lesions, involving the Guillain-Mollaret triangle, may have been responsible for the palatal tremor. Read More

Microsurgery 2023 Aug 30. Epub 2023 Aug 30.

Division of Plastic Surgery, Seattle Children's Hospital, Seattle, Washington, USA.

Acute flaccid myelitis (AFM) is a polio-like condition predominantly affecting children that is characterized by acute-onset, asymmetric flaccid paralysis, often preceded by a prodromal fever or viral illness. With prompt diagnosis and early surgical referral, nerve transfers may be performed to improve function. Highly selective nerve transfers are ideal to preserve existing functions while targeting specific deficits. Read More

Cureus 2023 Jul 28;15(7):e42604. Epub 2023 Jul 28.

Internal Medicine, Byramjee Jeejeebhoy (BJ) Medical College, Civil Hospital Asarwa, Ahmedabad, IND.

Sjogren's syndrome (SS) is an autoimmune disorder characterized by the destruction of exocrine glands by lymphocytic infiltration. Children and teenagers are less commonly affected. The initial symptoms of SS in teenagers might vary, depending on whether parotitis or other systemic organ involvement is present. Read More

Spine Surg Relat Res 2023 Jul 13;7(4):333-340. Epub 2023 Mar 13.

Department of Orthopedic Surgery, Hokkaido Spinal Cord Injury Center, Bibai, Japan.

Introduction: Pneumonia is one of the leading causes of acute- and chronic-phase mortality in patients with cervical spinal cord injury (CSCI) with quadriplegia. The risk factors for chronic-phase pneumonia recurrence in CSCI are still unknown. This study aimed to investigate the incidence of pneumonia in the chronic phase after injury and to identify its risk factors. Read More

Rev Neurol (Paris) 2023 Oct 25;179(7):727-740. Epub 2023 Aug 25.

Sleep-Wake Disorders Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU de Montpellier, Montpellier, France; National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome, Montpellier, France; Institute of Neurosciences of Montpellier, University of Montpellier, Inserm, Montpellier, France. Electronic address:

Narcolepsy type 1 (NT1) and type 2 (NT2), also known as narcolepsy with and without cataplexy, are sleep disorders that benefited from major scientific advances over the last two decades. NT1 is caused by the loss of hypothalamic neurons producing orexin/hypocretin, a neurotransmitter regulating sleep and wake, which can be measured in the cerebrospinal fluid (CSF). A low CSF level of hypocretin-1/orexin-A is a highly specific and sensitive biomarker, sufficient to diagnose NT1. Read More

J Clin Med 2023 Aug 15;12(16). Epub 2023 Aug 15.

Department of General and Visceral Surgery, University Hospital OWL, Campus Bielefeld-Bethel, 33617 Bielefeld, Germany.

Diaphragm eventration (DE) represents a frequent problem with consecutive major impacts on respiratory function and the quality of life of the patients. The role of diaphragmatic plication (DP) is still underestimated. The aim of the present study is to evaluate the efficacy of minimally-invasive surgical diaphragmatic plication for the management of unilateral diaphragmatic eventration, to the best of our knowledge, this is the largest series reported in the literature using a non-resectional technique. Read More

Aorta (Stamford) 2023 Jun 24;11(3):116-124. Epub 2023 Aug 24.

Department of Thoracic and Cardiovascular Surgery, Aorta Center, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.

Background:  As risks of repairing the descending thoracic and thoracoabdominal aorta diminish, common complications that may prolong hospital stay, or actually increase risk, require attention. One such complication is postoperative atrial fibrillation (AF). Therefore, we characterized prevalence of, risk factors for, and effects of postoperative atrial fibrillation (PoAF) after descending and thoracoabdominal aorta repair. Read More

Cureus 2023 Jul 23;15(7):e42322. Epub 2023 Jul 23.

Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, USA.

Lyme disease (LD) is the most common vector-borne disease in the United States. The early localized disease presents with erythema migrans and nonspecific constitutional symptoms. A neurological manifestation of LD (neuroborreliosis) is only seen in 10-15% of LD cases, and it typically presents as cranial neuritis or painful radiculitis. Read More

J Neurotrauma 2023 Aug 22. Epub 2023 Aug 22.

Case Western Reserve University School of Medicine, 12304, Department of Neurosciences, Cleveland, Ohio, United States;

Spinal cord injuries, for which there are limited effective treatments, result in enduring paralysis and hypoesthesia due, in part, to the inhibitory microenvironment that develops and limits regeneration/sprouting, especially during chronic stages. Recently, we discovered that targeted enzymatic modulation of the inhibitory chondroitin sulfate proteoglycan (CSPG) component of the extracellular and perineuronal net (PNN) matrix via Chondroitinase ABC (ChABC) rapidly restores robust respiratory function to the previously paralyzed hemi-diaphragm after remarkably long times post-injury (up to 1.5 years) following a cervical level 2 lateral hemi-transection. Read More

Neurol Sci 2023 Aug 22. Epub 2023 Aug 22.

University Clinic for Infectious and Tropical Diseases of the University Clinical Centre of Serbia, Belgrade, Serbia.

Introduction: We aimed to describe neurological manifestations and functional outcome at discharge in patients with West Nile neuroinvasive disease.

Methods: This retrospective study enrolled inpatients treated in the University Clinic for Infectious and Tropical Diseases in Belgrade, Serbia, from 1 June until 31 October 2022. Functional outcome at discharge was assessed using modified Rankin scale. Read More

Cureus 2023 Jul 21;15(7):e42277. Epub 2023 Jul 21.

Department of Clinical Sciences, California Northstate University College of Medicine, Elk Grove, USA.

This case report aims to highlight a rare and severe presentation of Legionnaires' disease complicated by thrombotic thrombocytopenic purpura (TPP). The patient, a 75-year-old male with a history of COVID-19 infection, presented with bilateral pneumonia positive for . He developed signs of TTP, cerebral hemorrhage, and renal failure. Read More

J Infect Chemother 2023 Aug 18. Epub 2023 Aug 18.

Department of Neurology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.

We report a case of an 80-year-old woman with botulism from 2020 in Osaka, Japan. The patient complained of dysarthria and dizziness. On the same day, the patient developed respiratory failure, and was intubated and placed on mechanical ventilation. Read More

Front Genet 2023 12;14:1190222. Epub 2023 Jul 12.

Expertise Centre of Genetics, Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands.

Hereditary necrotizing myelopathy (HNM) in young Kooiker dogs is characterized by progressive ataxia and paralysis with autosomal recessive inheritance. The basic genetic defect is unknown. We investigated the possible cause by a genome-wide analysis using six affected and 17 unrelated unaffected Kooiker dogs and by functional follow-up studies. Read More

BMC Nephrol 2023 Aug 15;24(1):237. Epub 2023 Aug 15.

Division of Gastroenterology and Nephrology, Tottori University Faculty of Medicine, Yonago, Tottori, 683-8504, Japan.

Background: Renal tubular acidosis is the principal clinical feature associated with tubulointerstitial nephritis in patients with primary Sjögren's syndrome. Renal tubular dysfunction due to interstitial nephritis has been considered the underlying pathophysiology connecting renal tubular acidosis and primary Sjögren's syndrome. However, the detailed mechanisms underlying the pathophysiology of renal tubular acidosis in primary Sjögren's syndrome is not fully understood. Read More