1
|
Yazbeck M, Msheik A, Berjaoui C, Dabboucy B, Comair Y. Severe hyponatremia and bilateral sequential facial palsy: A case report. Radiol Case Rep 2023; 18:4062-4065. [PMID: 37701361 PMCID: PMC10493881 DOI: 10.1016/j.radcr.2023.08.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 08/09/2023] [Indexed: 09/14/2023] Open
Abstract
Facial palsy (FP) is a known consequence of head trauma, manifesting either immediately at the time of injury or with delayed onset, typically occurring 2 days or more post-trauma. Unilateral FP is the more common presentation and is often attributed to partial or complete transection of facial nerves or delayed onset edema. Conversely, bilateral facial palsy is a rare occurrence, reported in only a small number of cases, accounting for approximately 3% of patients presenting with bilateral weakness. In this report, we present the case of a previously healthy 28-year-old female who suffered a closed head injury during the Beirut Port Blast. Four days following the incident, the patient exhibited right-sided peripheral FP, which was consistent with a right temporal bone fracture. Subsequently, on the fifth day, the right-sided FP worsened, accompanied by the development of new FP on the left side, characterized by sparing of the frontal region, indicating a central origin for the left-sided FP. Laboratory investigations revealed severe hypovolemic hyponatremia with a sodium level of 105 mmol/L. As isotonic saline fluid replacement was initiated, there was progressive improvement in the left-sided FP. The right-sided palsy also resolved gradually with the implementation of facial rehabilitation therapy. It is important to note that severe head trauma, particularly with a concussive injury, can lead to facial paralysis through various mechanisms. Furthermore, severe hyponatremia should be considered a potential cause of central facial palsy, particularly in the presence of bilateral facial involvement. A thorough evaluation is encompassing assessment of palsy patterns, comprehensive imaging studies, and metabolic investigations is crucial for accurate diagnosis and timely intervention, resulting in successful treatment.
Collapse
Affiliation(s)
- Mohamad Yazbeck
- Department of Neurosurgery, Clemenceau Medical Center, Beirut, Lebanon
| | - Ali Msheik
- Department of Neurosurgery, Lebanese University Faculty of Medical Sciences, Beirut, Lebanon
| | | | - Baraa Dabboucy
- Department of Neurosurgery, Lebanese University Faculty of Medical Sciences, Beirut, Lebanon
| | - Youssef Comair
- Department of Neurosurgery, Clemenceau Medical Center, Beirut, Lebanon
| |
Collapse
|
2
|
Yazbeck M, Comair Y, Berjaoui C, Dabboucy B. Craniocervical Rosai-Dorfman Disease presentation: Case report and review of literature. Neurocirugia (Astur : Engl Ed) 2023:S2529-8496(22)00093-4. [PMID: 36774252 DOI: 10.1016/j.neucie.2022.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 03/21/2022] [Indexed: 02/11/2023]
Abstract
Rosai Dorfman Disease (RDD) is a benign histiocytic lymphoproliferative disease that has variable presentations. The concurrent presentation of RDD in the spinal cord and brain parenchyma is an extremely rare entity. Here, we report another case of a 24-year-old gentleman who presented with a tuberculum sellae and bilateral cavernous extra-axial tumors extending to the subtemporal lobe and was found to have craniocervical lesions. Axillary lymph node biopsy was done showing markedly dilated sinuses filled with large histiocytes and emperipolesis of numerous lymphocytes and plasma cells confirming the diagnosis of RDD. Because the definitive diagnosis of RDD is always pathological, the clinical presentation plays a major role in widening the margin of differential diagnosis. Finally, surgical intervention is the first option to treat RDD with relatively satisfactory follow-up outcomes, and other adjuvant therapies optimize the prognosis.
Collapse
Affiliation(s)
- Mohamad Yazbeck
- Department of Neurosurgery, Faculty of Medicine, Lebanese University, Beirut, Lebanon
| | - Youssef Comair
- Youssef Comair: Department of Neurosurgery, Clemenceau Medical Center, Beirut, Lebanon
| | - Christin Berjaoui
- Christin Berjaoui: Department of Medicine and Surgery, Faculty of Medicine, Beirut Arab University, Beirut, Lebanon
| | - Baraa Dabboucy
- Baraa Dabboucy: Department of Neurosurgery, Faculty of Medicine, Lebanese University, Beirut, Lebanon.
| |
Collapse
|
3
|
Dabboucy B, Yazbeck M, Fares Y, Papatsoris A, Chakra MA, Moussa M. Rare Spinal Epidural Hibernoma: A Case Report. Spine Surg Relat Res 2022; 7:113-115. [PMID: 36819623 PMCID: PMC9931406 DOI: 10.22603/ssrr.2022-0135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/12/2022] [Indexed: 11/07/2022] Open
Affiliation(s)
- Baraa Dabboucy
- Department of Neurosurgery, Faculty of Medicine, Lebanese University, Beirut, Lebanon
| | - Mohamad Yazbeck
- Department of Neurosurgery, Faculty of Medicine, Lebanese University, Beirut, Lebanon
| | - Youssef Fares
- Department of Neurosurgery, Faculty of Medicine, Lebanese University, Beirut, Lebanon
| | - Athanasios Papatsoris
- 2nd Department of Urology, School of Medicine, Sismanoglio Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Mohamad Moussa
- Head of Urology Department, Zahraa Hospital, University Medical Center, Lebanese University, Beirut, Lebanon
| |
Collapse
|
4
|
Dabboucy B, Lahiani W, Bresson D, Aldahak N. The endoscopic transnasal approach to the lesions of the craniocervical junction: two case reports. J Yeungnam Med Sci 2022; 40:96-101. [PMID: 35855592 PMCID: PMC9946913 DOI: 10.12701/jyms.2022.00234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/22/2022] [Indexed: 11/04/2022]
Abstract
The endoscopic endonasal approach (EEA) to the craniovertebral junction (CVJ) has recently been considered a safer alternative and less invasive approach than the traditional transoral approach because the complications associated with the latter are avoided or minimized. Here, we present two challenging cases of CVJ pathologies. The first case involved os odontoideum associated with anterior displacement of the occipitocervical junction where the EEA was used, followed by C0-C1-C2 fusion using a posterior approach to decompress the CVJ, and was complicated by rhinorrhea and Candida albicans meningitis. The second case involved basilar invagination with syringomyelia previously treated using a posterior approach, where aggravation of neuropathic symptoms required combined treatment with EEA and occipitocervical fusion of C0-C2-C3-C4, with the postoperative course challenged by operative site infection requiring drainage with debridement and antibiotic therapy. The EEA is an alternative approach for accessing the CVJ in well-selected patients. Knowledge of EEA complications is crucial for the optimal care of patients.
Collapse
Affiliation(s)
- Baraa Dabboucy
- Department of Neurosurgery, Faculty of Medicine, Lebanese University, Beirut, Lebanon,Corresponding author: Baraa Dabboucy, MD Department of Neurosurgery, Faculty of Medicine, Lebanese University, Rafic Hariri University Campus, Hadath, Lebanon Tel: +961-71661019 • E-mail:
| | - Wissem Lahiani
- Department of Neurosurgery, AP-HP, Henri Mondor Hospital, Créteil, France
| | - Damien Bresson
- Department of Neurosurgery, AP-HP, Henri Mondor Hospital, Créteil, France
| | - Nouman Aldahak
- Department of Neurosurgery, AP-HP, Henri Mondor Hospital, Créteil, France
| |
Collapse
|
5
|
Yazbeck M, Comair Y, Berjaoui C, Dabboucy B. Craniocervical Rosai-Dorfman Disease presentation: Case report and review of literature. Neurocirugia (Astur) 2022. [DOI: 10.1016/j.neucir.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
6
|
Moussa M, Abou Chakra M, Papatsoris AG, Dellis A, Dabboucy B, Peyromaure M, Barry Delongchamps N, Bailly H, Duquesne I. Perspectives on the urological care in Parkinson's disease patients. Arch Ital Urol Androl 2022; 94:107-117. [PMID: 35352535 DOI: 10.4081/aiua.2022.1.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 01/06/2022] [Indexed: 11/23/2022] Open
Abstract
Parkinson's disease (PD) is recognized as the most common neurodegenerative disorder after Alzheimer's disease. Lower urinary tract symptoms are common in patients with PD, either storage symptoms (overactive bladder symptoms or OAB) or voiding symptoms. The most important diagnostic clues for urinary disturbances are provided by the patient's medical history. Urodynamic evaluation allows the determination of the underlying bladder disorder and may help in the treatment selection. Pharmacologic interventions especially anticholinergic medications are the first-line option for treating OAB in patients with PD. However, it is important to balance the therapeutic benefits of these drugs with their potential adverse effects. Intra-detrusor Botulinum toxin injections, electrical stimulation were also used to treat OAB in those patients with variable efficacy. Mirabegron is a β3-agonist that can also be used for OAB with superior tolerability to anticholinergics. Desmopressin is effective for the management of nocturnal polyuria which has been reported to be common in PD. Deep brain stimulation (DBS) surgery is effective in improving urinary functions in PD patients. Sexual dysfunction is also common in PD. Phosphodiesterase type 5 inhibitors are first-line therapies for PD-associated erectile dysfunction (ED). Treatment with apomorphine sublingually is another therapeutic option for PD patients with ED. Pathologic hypersexuality has occasionally been reported in patients with PD, linked to dopaminergic agonists. The first step of treatment of hypersexuality consists of reducing the dose of dopaminergic medication. This review summarizes the epidemiology, pathogenesis, risk factors, genetic, clinical manifestations, diagnostic test, and management of PD. Lastly, the urologic outcomes and therapies are reviewed.
Collapse
Affiliation(s)
- Mohamad Moussa
- Urology Department, Zahraa Hospital, University Medical Center, Beirut.
| | - Mohamad Abou Chakra
- Department of Urology, Faculty of Medical Sciences, Lebanese University, Beirut.
| | - Athanasios G Papatsoris
- 2nd Department of Urology, School of Medicine, Sismanoglio Hospital, National and Kapodistrian University of Athens, Athens.
| | | | - Baraa Dabboucy
- Department of Neurosurgery, Faculty of Medical Sciences, Lebanese University, Beirut.
| | - Michael Peyromaure
- Department of Urology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris.
| | - Nicolas Barry Delongchamps
- Department of Urology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris.
| | - Hugo Bailly
- Department of Urology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris.
| | - Igor Duquesne
- Department of Urology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris.
| |
Collapse
|
7
|
Moussa M, Chakra MA, Dabboucy B, Fares Y, Dellis A, Papatsoris A. The safety and effectiveness of mirabegron in Parkinson's disease patients with overactive bladder: a randomized controlled trial. Scand J Urol 2021; 56:66-72. [PMID: 34672847 DOI: 10.1080/21681805.2021.1990994] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To assess the safety and effectiveness of mirabegron in patients with PD complaining of overactive bladder (OAB). PATIENTS AND METHODS From January 2017 to November 2020, we performed a prospective randomized, double-blind, placebo-controlled trial that enrolled PD patients with symptoms of OAB. The total duration of the study was 13 weeks, comprising a 1-week screening period and a 12-week treatment period. A total of 110 patients were randomized in one of two groups: treatment group (mirabegron 50 mg) or placebo group. The primary outcomes of our study were the change from baseline in OAB symptom score (OABSS) and the overactive bladder questionnaire short form (OAB-q SF) score. The secondary outcomes were the change from baseline in the mean number of micturitions/24 hours, the mean number of urgency episodes/24 hours, the mean number of urgency incontinence episodes/24 hours and the mean number of nocturia episodes/night, volume voided/micturition (ml) as recorded on a 3-day bladder diary. Safety assessments included adverse events, electrocardiogram, QT corrected for heart rate using Fridericia's correction (QTcF) interval and blood pressure and pulse rate measurements. RESULTS There was a significant improvement in the primary outcome and secondary outcome measures in the treatment group compared to the placebo group. Adverse events were mild and the same in the two groups. The cardiovascular safety profile was high. This study is limited by its sample size and its short follow-up period. CONCLUSIONS Mirabegron is a promising drug to control OAB symptoms in patients with PD with an excellent safety profile.
Collapse
Affiliation(s)
- Mohamad Moussa
- Urology Department, Zahraa Hospital, University Medical Center, Lebanese University, Beirut, Lebanon
| | - Mohamad Abou Chakra
- Faculty of Medicine, Urology Department, Lebanese University, Beirut, Lebanon
| | - Baraa Dabboucy
- Department of Neurosurgery, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Youssef Fares
- Department of Neurosurgery, Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Athanasios Dellis
- Department of Urology/General Surgery, Areteion Hospital, Athens, Greece
| | - Athanasios Papatsoris
- 2nd Department of Urology, School of Medicine, Sismanoglio Hospital, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
8
|
Abstract
Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system. Lower urinary tract dysfunction due to MS includes a dysfunction of the storage phase or dysfunction of the voiding phase or a detrusor-sphincter dyssynergia. Baseline evaluation includes a voiding chart, an ultrasound scan of the urinary tract, urine culture, and an urodynamic study. For storage symptoms, antimuscarinics are the first-line treatment, and clean intermittent catheterization (CIC) is indicated if there is concomitant incomplete bladder emptying. Intradetrusor injections with botulinum toxin A (BTX-A), are recommended for refractory cases. Urinary diversion is rarely indicated. For patients with voiding symptoms, CIC and alpha-blockers are usually offered. Sexual dysfunction in patients with MS is multifactorial. Phosphodiesterase type 5 inhibitors are first-line therapies for MS-associated erectile dysfunction in both male and female patients. This review summarizes the epidemiology, pathogenesis, risk factors, genetic, clinical manifestations, diagnostic tests, and management of MS. Lastly, the urologic outcomes and therapies are reviewed.
Collapse
Affiliation(s)
- Mohamad Moussa
- Chairman of Urology Department, Lebanese University & Al Zahraa Hospital, University Medical Center, Beirut, Lebanon
| | - Mohamad Abou Chakra
- Urology Department, Lebanese University, Beirut, Lebanon
- Address correspondence to:Mohamad Abou Chakra, Faculty of Medicine, Department of Urology, Lebanese University. Beirut, Lebanon. E-mail:
| | - Athanasios G. Papatsoris
- 2nd Department of Urology, School of Medicine, Sismanoglio Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Baraa Dabboucy
- Department of Neurosurgery, Lebanese University, Beirut, Lebanon
| | - Michael Hsieh
- Division of Urology, Children's National Hospital, Washington, USA
- Department of Urology, The George Washington University, Washington, USA
| | - Athanasios Dellis
- Department of Urology/General Surgery, Areteion Hospital, Athens, Greece
| | - Youssef Fares
- Department of Neurosurgery, Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| |
Collapse
|
9
|
Moussa M, Papatsoris AG, Chakra MA, Fares Y, Dabboucy B, Dellis A. Perspectives on urological care in spina bifida patients. Intractable Rare Dis Res 2021; 10:1-10. [PMID: 33614369 PMCID: PMC7882087 DOI: 10.5582/irdr.2020.03077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/04/2020] [Accepted: 12/12/2020] [Indexed: 02/05/2023] Open
Abstract
Spina bifida (SB) is a neurogenetic disorder with a complex etiology that involves genetic and environmental factors. SB can occur in two major forms of open SB or SB aperta and closed SB or SB occulta. Myelomeningocele (MMC), the most common neural tube defects (NTDs), occurs in approximately 1 in 1,000 births. Considering non-genetic factors, diminished folate status is the best-known factor influencing NTD risk. The methylenetetrahydrofolate reductase (MTHFR) gene has been implicated as a risk factor for NTDs. The primary disorder in the pathogenesis of MMC is failed neural tube closure in the embryonic spinal region. The clinical manifestation of SB depends on clinical type and severity. SB can be detected in the second trimester using ultrasound which will reveal specific cranial signs. The management of MMC traditionally involves surgery within 48 h of birth. Prenatal repair of MMC is recommended for fetuses who meet maternal and fetal Management of Myelomeningocele Study (MOMS) specified criteria. Urological manifestations of SB include urinary incontinence, urolithiasis, sexual dysfunction, renal dysfunction, and urinary tract infection. Renal failure is among the most severe complications of SB. The most important role of the urologist is the management of neurogenic bladder. Medical management with clean intermittent catheterization and anticholinergic treatment is generally considered the gold standard of therapy. However, when this therapy fails surgical reconstruction become the only remaining option. This review will summarize the pathogenesis, risk factors, genetic contribution, diagnostic test, and management of SB. Lastly, the urologic outcomes and therapies are reviewed.
Collapse
Affiliation(s)
- Mohamad Moussa
- Urology Department, Zahraa Hospital, University Medical Center, Lebanese University, Beirut, Lebanon
| | - Athanasios G. Papatsoris
- 2nd Department of Urology, School of Medicine, Sismanoglio Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Mohamad Abou Chakra
- Department of Urology, Faculty of Medicine, Lebanese University, Beirut, Lebanon
| | - Youssef Fares
- Department of Neurosurgery, Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Baraa Dabboucy
- Department of Neurosurgery, Faculty of Medicine, Lebanese University, Beirut, Lebanon
| | - Athanasios Dellis
- Department of Urology/General Surgery, Areteion Hospital, Athens, Greece
| |
Collapse
|
10
|
Moussa M, Chakra MA, Papatsoris AG, Dellis A, Dabboucy B, Fares Y. Bladder irrigation with povidone-iodine prevent recurrent urinary tract infections in neurogenic bladder patients on clean intermittent catheterization. Neurourol Urodyn 2021; 40:672-679. [PMID: 33476092 DOI: 10.1002/nau.24607] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 12/24/2020] [Accepted: 01/04/2021] [Indexed: 11/09/2022]
Abstract
AIMS To determine if daily povidone-iodine (PI) bladder irrigation in neurogenic lower urinary tract dysfunction (NLUTD) patients doing clean intermittent catheterization (CIC) can reduce the rate of symptomatic urinary tract infections (UTIs), emergency department (ED) visit for UTIs, and hospitalization for UTIs. METHODS We prospectively reviewed the records of patients with NLUTD on CIC who had recurrent symptomatic UTIs and who were placed on daily intravesical instillations of PI. This trial was conducted from January 2014 to January 2020 on 119 patients. RESULTS After using daily PI bladder irrigation, the rate of symptomatic UTIs was reduced by 99.2% (incidence rate ratio [IRR]: 0.008, 95% confidence interval [CI]: 0.001-0.059; p < .001), the rate of ED visits was reduced by 99.2%% (IRR: 0.008, 95% CI: 0.001-0.059; p < .001), and the rate of inpatient hospitalizations for UTI was reduced by 99.9% (IRR: 0.0008, 95% CI: 0.0002-0.0035; p < .001). There was also a significant decrease in multidrug resistance in UTI organisms with the use of PI bladder instillation. CONCLUSIONS Daily intravesical PI instillation is a well-tolerated approach to prevent UTIs and related ED visits and hospitalizations in NLUTD patients doing CIC.
Collapse
Affiliation(s)
- Mohamad Moussa
- Department of Urology, Lebanese Univeristy, Beirut, Lebanon
| | - Mohamed Abou Chakra
- Department of Urology, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Athanasios G Papatsoris
- Second Department of Urology, School of Medicine, Sismanoglio Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasios Dellis
- Department of Urology and General Surgery, Areteion Hospital, Athens, Greece
| | - Baraa Dabboucy
- Department of Neurosurgery, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Youssef Fares
- Department of Neurosurgery, Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| |
Collapse
|
11
|
Yazbeck M, Dabboucy B, Comair Y. Orofacial dyskinesia post resection of pineal gland tumor. J Surg Case Rep 2021; 2020:rjaa465. [PMID: 33391638 PMCID: PMC7769191 DOI: 10.1093/jscr/rjaa465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 10/13/2020] [Indexed: 11/14/2022] Open
Abstract
We reported a case of a 33-year-old lady who was diagnosed with a Pineal tumor and underwent craniotomy and gross total surgical resection of the mass through a right occipital transtentorial approach. Immediately upon extubation, the patient started to have persistent chewing-like movements typical of orofacial dyskinesia that resulted later in buccal mucosal injury and swelling of the lips. The movements spontaneously resolved after 3 days. The patient was not taking any medications that were known to induce such movements. Literature review showed that one of the possible mechanisms could be that the suddenly reduced melatonin level in the acute postoperative period leads to dysregulation of dopamine secretion in the nigrostriatal and limbic system causing these abnormal movements. To the best of our knowledge, this is the first such reported complication of orofacial dyskinesia post craniotomy for resection of the pineal tumor in humans.
Collapse
Affiliation(s)
- Mohamad Yazbeck
- Department of Neurosurgery, Faculty of Medicine, Lebanese University, Beirut, Lebanon
| | - Baraa Dabboucy
- Department of Neurosurgery, Faculty of Medicine, Lebanese University, Beirut, Lebanon
| | - Youssef Comair
- Department of Neurosurgery, Lebanese Hospital Geitawi, Beirut, Lebanon
| |
Collapse
|
12
|
Moussa M, Papatsoris AG, Abou Chakra M, Dabboucy B, Fares Y. Erectile dysfunction in common neurological conditions: A narrative review. ACTA ACUST UNITED AC 2020; 92. [PMID: 33348971 DOI: 10.4081/aiua.2020.4.371] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 06/08/2020] [Indexed: 11/23/2022]
Abstract
Neurogenic erectile dysfunction (NED) can be defined as the inability to achieve or maintain an erection due to central or peripheral neurologic disease. Neurologic diseases can also affect the physical ability and psychological status of the patient. All these factors may lead to a primary or secondary NED. Medication history plays an important role since there are many drugs commonly used in neurologic patients that can lead to ED. The assessment of NED in these patients is generally evolving with the application of evoked potentials technology in the test of somatic and autonomic nerves, and functional magnetic resonance imaging. With the electrophysiological examinations, neurogenic causes can be determined. These tools allow to categorize neurologic lesion and assess the patient prognosis. The first-line treatment for NED is phosphodiesterase inhibitors. Second-line treatments include intracavernous and intraurethral vasoactive injections. Third-line treatments are penile prostheses. The efficacy and safety of each treatment modality depend on the specific neurologic condition. This review discusses the physiology, pathophysiology, diagnosis, and treatment of ED in multiple peripheral and central neurologic conditions, as well as for future research.
Collapse
Affiliation(s)
- Mohamad Moussa
- Urology Department, Zahraa Hospital, University Medical Center, Beirut.
| | - Athanasios G Papatsoris
- 2nd Department of Urology, School of Medicine, Sismanoglio Hospital, National and Kapodistrian University of Athens, Athens.
| | - Mohamad Abou Chakra
- Department of Urology, Faculty of Medical Sciences, Lebanese University, Beirut.
| | - Baraa Dabboucy
- Department of Neurosurgery, Faculty of Medical Sciences, Lebanese University, Beirut.
| | - Youssef Fares
- Department of Neurosurgery, Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut.
| |
Collapse
|
13
|
Moussa M, Chakra MA, Dabboucy B, Papatsoris AG, Fares Y. Seizure as the first manifestation of transitional cell carcinoma of the renal pelvis. J Surg Case Rep 2020; 2020:rjaa126. [PMID: 32699589 PMCID: PMC7365028 DOI: 10.1093/jscr/rjaa126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 04/13/2020] [Indexed: 11/12/2022] Open
Abstract
Upper tract urothelial carcinoma (UTUC) is a rare genitourinary entity of the renal pelvis and the ureter characterized by an aggressive behavior. Cisplatin-based chemotherapy is the first-line therapy of metastatic UTUC. However, a large number of patients with metastatic UTUC are considered ineligible for cisplatin. Immunotherapy emerged as a promising treatment in this setting. Brain metastasis from UTUC is unusual, occurring most often in the presence of systemic metastases. Local therapies such as stereotactic radiosurgery, neurosurgical resection and whole-brain radiotherapy (WBRT) remain the main therapeutic options for brain metastasis. We report a case of a 65-year-old male patient presenting with generalized tonic–clonic seizure. Imaging studies confirmed the presence of multiple brain metastasis. During an evaluation for the primary, he was found to be having metastatic UTUC of the renal pelvis. The brain metastases were treated by hippocampal sparing WBRT with minimal neurotoxicity. The primary tumor was treated by pembrolizumab.
Collapse
Affiliation(s)
- Mohamad Moussa
- Head of Urology Department, Zahraa Hospital, University Medical Center, Lebanese University, Beirut, Lebanon
| | - Mohamed Abou Chakra
- Department of Urology, Faculty of Medicine, Lebanese University, Beirut, Lebanon
| | - Baraa Dabboucy
- Department of Neurosurgery, Faculty of Medicine, Lebanese University, Beirut, Lebanon
| | - Athanasios G Papatsoris
- 2nd Department of Urology, School of Medicine, Sismanoglio Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Youssef Fares
- Department of Neurosurgery, Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| |
Collapse
|
14
|
Hammoud M, Fares Y, Atoui R, Dabboucy B. Burkholderia cepacia as a cause of pyogenic spondylodiscitis in immunocompetent patients: a single-institution case series and literature review. J Spine Surg 2019; 5:372-377. [PMID: 31663049 DOI: 10.21037/jss.2019.07.02] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Burkholderia cepacia is an important pathogen of humans in both immunocompromised and hospitalized patients. This uncommon pathogen is established to be the cause of pyogenic spondylodiscitis in only seven cases in the medical literature. Here, we report the cases of four patients who were diagnosed over two years period with Burkholderia cepacia spondylodiscitis and were successfully managed by appropriate antimicrobial treatment after open surgical biopsy was done for debridement and microbiological identification.
Collapse
Affiliation(s)
- Maarouf Hammoud
- Department of Neurosurgery, Zahraa University Hospital, Beirut, Lebanon
| | - Youssef Fares
- Department of Neurosurgery, Neuroscience Research Center, Faculty of Medicine, Lebanese University, Beirut, Lebanon
| | - Roula Atoui
- Infectious Disease Department, Zahraa University Hospital, Beirut, Lebanon
| | - Baraa Dabboucy
- Department of Neurosurgery, Faculty of Medicine, Lebanese University, Beirut, Lebanon
| |
Collapse
|