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Cervical Dystonia – additional opinion

47-year-old female with neck problems underwent Blink Reflex tests and EMG of the neck, and was diagnosed with cervical dystonia. Medical treatments available for cervical dystonia include anticholinergic therapy, Baclofen, or deep brain stimulation, but the mainstay of therapy remains botulinum toxin injections, which are considered the superior treatment for symptom control with less side effects in comparison to oral medications.

Chromosome 22 micro-deletion syndrome

26-year-old female diagnosed with Chromosome 22 micro-deletion syndrome (VCFS). Psychiatric exam showed borderline cognitive ability, with attentive-amnesic-executive deficits. The suggested treatment is drug therapy together with psychological intervention.

SOL (Space occupying lesion) of brain

33-year-old female underwent an episode of dizziness followed by speech disturbances and some right hand weakness. Her physical exam showed very mild signs of right cerebelar dysfunction. The MRI found mid-Vermian Cavernoma with clear signs of past bleeding and Bulging into the fourth ventricle. A surgery for resection of the cavernous malformation was recommended.

Cerebral Atrophy

A 52 year old began having difficulties with balance. His problems evolved and he had been seen by neurologists providing clinical evidence for a cerebellar motor syndrome. The most recent examination showed ataxia, dysarthria, nystagmus, dysphagia and hyperreflexia. Although the disease has progressed the patient is not severely disabled at this time. 

 

Cricotracheal resection as treatment for laryngeal stenosis cotton grade IV

The patient is a former premature baby who underwent tracheostomy after 30 days of intubation and laryngotracheoplasty with anterior and posterior costal grafts and implantation of a T-tube. She is now 10 years-old and was diagnosed with Cotton’s grade 4 subglottic stenosis. The restricted airways (laryngeal stenosis) cause severe breathing and communication difficulties.

Mild Alzheimer’s disease – additional opinion

78-year-old male was diagnosed with possible mild Alzheimer’s disease. Medical history suggests a condition running a slow but steadily deteriorating course characterized by apathy as well as by impairment of memory, word finding difficulties and reduced vocabulary, impaired ability to make calculation and handle finances and difficulties in managing house work and going outside unsupervised. An episode with characteristics of delirium in the past is described as well. The neuropsychological evaluation describes moderate dementia.