Kleine Zecke – Grosse Gefahr

Wir berichten über einen 23-jährigen Patienten, der sich aufgrund persistierender Kopfschmerzen sowie Fieber und Erbrechen in der Hausarztpraxis vorstellte. Im weiteren Verlauf kamen eine rechtsbetonte Tetraparese, eine Dysphagie sowie eine Dysarthrie hinzu und es kam zu einem generalisierten tonisch-klonischen Krampfanfall. Weitere Abklärungen bestätigten eine FSME-Enzephalomyelitis und Polyradikulitis. Auch nach zweimonatiger Rehabilitation blieben beim ungeimpften Patienten sowohl neuropsychologische wie auch fokal-neurologische Residuen bestehen. Schlüsselwörter: FSME, Enzephalomyelitis, Polyradikulitis, Tetraparese. // We report a 23-year-old patient who presented to the general practitioner due to persisting headache, fever, and vomiting. In the further course, a tetraparesis dominated on the right side, dysphagia and dysarthria occurred, and a general tonic-clonic seizure. Further examinations confirmed tick-borne encephalomyelitis as well as polyradiculitis. After two months of rehabilitation, neuropsychological as well as focal-neurological deficits persisted in the unvaccinated patient

School-age structural and functional MRI and lung function in children following lung resection for congenital lung malformation in infancy.

BACKGROUND The management of asymptomatic congenital lung malformations is debated. Particularly, there is a lack of information regarding long-term growth and development of the remaining lung in children following lung resection for congenital lung malformations. In addition to conventional pulmonary function tests, we used novel functional magnetic resonance imaging (MRI) methods to measure perfusion and ventilation. OBJECTIVE To assess functionality of the remaining lung expanded into the thoracic cavity after resection of congenital lung malformations. MATERIALS AND METHODS A prospective, cross-sectional pilot study in five children who had surgery for congenital lung malformations during infancy. Participants had structural and functional MRI as well as spirometry, body plethysmography and multiple breath washout at school age. RESULTS Structural MRI showed an expansion of the remaining lung in all cases. Fractional ventilation and relative perfusion of the expanded lung were locally decreased in functional MRI. In all other parts of the lungs, fractional ventilation and relative perfusion were normal in all children. There was an association between overall impairment of perfusion and elevated lung clearance index. The results of spirometry and body plethysmography varied between patients, including normal lung function, restriction and obstruction. CONCLUSION Fractional ventilation and relative perfusion maps from functional MRI specifically locate impairment of the remaining lung after lung resection. These changes are not captured by conventional measures such as structural MRI and standard pulmonary function tests. Therefore, following lung resection for congenital lung malformation, children should be investigated more systematically with functional lung MRI

Stufen-Becken-Tagung: 24. Augst 2022, Zweisimmen

ISSN:0374-005