Delayed encephalopathy with movement disorder and catatonia: A rare combination after wasp stings

In our study, the ratios of NAA/Cr and Ch/Cr showed a progressive increase within the normal range except the excess ratios in the right lesion in the follow-up study. Because N-acetyl aspartate (NAA) is a marker of neuronal and axonal integrity [5], its increase in our case suggested improvement of...

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Bibliographic Details
Published in:Clinical neurology and neurosurgery 2013-08, Vol.115 (8), p.1506-1509
Main Authors: Sun, Zhanfang, Yang, Xiaosu, Ye, Hui, Zhou, Gaofeng, Jiang, Hong
Format: Article
Language:English
Subjects:
Adult
Animals
Brain - diagnostic imaging
Brain - pathology
Catatonia
Catatonia - etiology
Creatine - blood
Delayed encephalopathy
Electrocardiography
Electroencephalography
Globus pallidus
Globus Pallidus - pathology
Headaches
Humans
Hypersensitivity, Delayed - complications
Insect Bites and Stings - complications
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy
Male
Medical treatment
Metabolites
Movement Disorders - etiology
Muscle Rigidity - etiology
Neurologic Examination
Neurology
Neurosurgery
Proton MR spectroscopy
Spectrum analysis
Tomography, X-Ray Computed
Venom
Wasp stings
Wasp Venoms
Wasps
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Summary:In our study, the ratios of NAA/Cr and Ch/Cr showed a progressive increase within the normal range except the excess ratios in the right lesion in the follow-up study. Because N-acetyl aspartate (NAA) is a marker of neuronal and axonal integrity [5], its increase in our case suggested improvement of neuronal and axonal function. Increased membrane synthesis and/or glial activation in response to tissue injury could be responsible for the elevated Ch level in our patient during the recovery period. 4 Conclusion This case reports a rare delayed encephalopathy caused by wasp stings.
ISSN:0303-8467
1872-6968
DOI:10.1016/j.clineuro.2012.11.030