upala malog mozga

[vukso]

Molim Vas, da mi poblize objasnite koji su simptomi upale malog mozga, kako se manifestuje i kako se lijeci. Dijete je staro tri godine, ne moze na noge. Kakve su procjene i koliko traje oporavak?

[vukso]

molim vas ljudi, zar je moguce da niko nema nikakvih tekstova o upali malog mozga...vasa misljenja, znanja, bilo sta...pisite...

[macadamia]

Ako se ne varam, u pitanju je cerebelitis.

http://www.uwo.ca/cns/resident/pocketbo ... llitis.htm

Ukratko, sa sajta:

CEREBELLITIS aka acute cerebellar ataxia,

Inflammatory process characterized by an acute or subacute onset of cerebellar ataxia following an infection (usually viral; usually GI or respiratory)

- Most frequently seen in children 1-6 y.o. and young adults, but may occur in elderly
- 0.05-0.1% of children with varicella infection develop cerebellar ataxia
- In young adults, male:female 2:1 to 4:1

Symptoms / Signs

- Ataxia may develop over several hours, days or slowly over a period of 1-4 weeks after infection
- May present as a pure cerebellar syndrome or as part of a more diffuse inflammatory process (brain stem, cerebrum)

Cerebellar symptoms/signs

- Dysarthria (45%)
- Ataxia (limb (55%), truncal / gait (42%))
- Oculomotor disturbances (75%)

Impaired smooth pursuit (60%), dysmetria of saccades (55%), impaired suppression of VOR (55%), nystagmus (40%), macro square wave jerks, ocular flutter, opsoclonus (12%)

Extracerebellar symptoms/signs

- Cranial nerve palsies
- Uni-/bilateral sensory disturbance
- Hyperreflexia, upgoing plantar responses, increased tone
- Nausea / Vertigo
- Seizures, drowsiness (diffuse inflammation)


Etiology of Cerebellitis
***Causative agent not identified in 35% of cases


Children

- VZV, Measles, Mumps, EBV, Hepatitis A, Parvovirus B19
- Rubella
- Pertussis
- Q fever (C. burnetti)
- Vaccinations (DTP, MMR, Varicella, Influenza, HepB)

Adults

- EBV, influenza, parainfluenza, enterovirus (polio, coxsackie, echo), HSV, VZV, CMV, adenovirus, HIV, mumps
- Lyme (B. burgdorferi)
- Mycoplasma
- Legionella
- Salmonella typhi
- P. falciparum (malaria)
- Rickettsia


Differential diagnosis

Infectious:
Listeria
TB

Demyelinating:
MS, ADEM

Neoplastic:
Cerebellar / Posterior fossa tumor (primary or secondary)
Neuroblastoma
Paraneoplastic cerebellar degeneration (PCD)
Lymphoma

Inflammatory:
Sarcoid
GBS / Miller Fisher variant (ataxia, ophthalmoplegia, areflexia)

Drugs:
Thallium, lead, barbiturates, dilantin, piperazine, alcohol, solvents, antineoplastic drugs

Hydrocephalus
Foramen magnum compression


Investigations

- Serology, acute and convalescent
- Blood films (malaria)
- CSF
Pleocytosis (WBC up to 250/mcl), 60-99% lymphocytes
Elevated protein; Glucose normal or slightly reduced
IgG/albumin ratio: normal in 40%
Oligoclonal banding: usually absent
Viral culture / PCR
- EEG / Evoked potentials (Degree of CNS involvement)
- CT / MRI
Inflammation (bright on T2, gadolinium enhancement)
Edema / swelling (10-15%)
Obstructive hydrocephalus


Treatment
- IV acyclovir 10mg/kg q8h x 10-14 days
Reduces duration and severity if given early for VZV or HSV infection
- Lyme disease
IV ceftriaxone 2g BID x 2 weeks
- Q fever (C. burnetti)
Minocycline 4mg/kg OD
- Corticosteroids
Controversial, disease self-limiting
Depends on severity
IV methylprednisolone 1g/day x 5 days followed by oral taper


Prognosis

- Complete recovery in majority in 1-30 weeks
- Mild to moderate cerebellar deficits in 10% to 40%
- Bad prognostic signs during acute phase: Yawning, hiccoughs, >40 y.o.
- Patients with long term sequelae usually demonstrate moderate to severe cerebellar atrophy

Bilo bi super da neko stručan potvrdi ili demantuje.

[vukso]

hvala sto se bar neko potrudio...ali ja ne razumijem engleski najbolje te stoga molim nekoga da mi ukratko preprica ovo...hvala unapred

[macadamia]

Ono najbitnije iz gore citiranog teksta... (uz bitnu napomenu da nisam medicinar, tako da je neophodno da se neki medicinar izjasni oko tačnosti ovog prevoda)...


Cerebelitis - tj akutna cerebelarna ataksija

Zapaljenski proces koji karakteriše akutno ili subakutno javljanje cerebelarne ataksije, koja prati infekciju (obično virusnu; najčešće gastrointestinalna ili respiratorna).

Najčešće se javlja kod dece starosti od 1 do 6 godina i tinejdžera, ali se može javiti i kod starijih. Kod 0.05-0.1% dece sa varičelama, može doći do cerebelarne ataksije.

Simptomi:

Ataksija se može razviti tokom nekoliko časova, dana ili lagano tokom perioda od 1 do 4 nedelje nakon infekcije. Može se manifestovati kao tipičan cerebelarni sindrom ili kao deo raširenijeg zapaljenskog procesa (kičmena moždina, veliki mozak).

Etiologija:
Kod 35%, nije moguće ustanoviti uzročnik. Kod dece to mogu biti varičele, morbile, Epštajn-Bar virus, Hepatitis A, Parvovirus B19, rubela, veliki kašalj, Q-groznica, kao i vakcine.

Tretman zavisi od uzročnika cerebelitisa, te stoga se može sastojati od aciklovira, ceftriaksona, minkociklina, kortikosteriodima ili metilprednizolonom.

Prognoza:
Kod većine, nakon 1-30 nedelja dolazi do potpunog oporavka. Blagi cerebelarni deficiti se javljaju u 10-40% slučajeva. Nepovoljni znaci tokom akutne faze su zevanje, štucanje i starost preko 40 godina. Pacijenti sa dugoročnim posledicama obično pokazuju umerenu i tešku cerebelarnu atrofiju.

Pozdrav!