"Ping pong gaze" suite à une encéphalopathie hépatique sur cirrhose alcoolique . скачать в хорошем качестве

"Ping pong gaze" suite à une encéphalopathie hépatique sur cirrhose alcoolique .

🔴 "Ping pong gaze" suite à une encéphalopathie hépatique sur cirrhose alcoolique . 🔴 #Réanimation #Sémiologie "Ping - pong gaze" chez un patient de 55 ans, dans un état comateux suite à une encéphalopathie hépatique (sur cirrhose alcoolique). 🔴🔴🔴🔴🔴🔴 A 55-year-old man with alcoholic cirrhosis was found to be unresponsive at home. He was hemodynamically stable but obtunded and minimally responsive to noxious stimuli. Examination revealed spontaneous, slow, horizontal, conjugate eye deviation, alternating every 2 to 4 seconds from one extreme to the other (see video). Eye movements were smooth and continuous without interruption. Pupillary reactivity was maintained. The patient also had rigidity of all four limbs, clonus in the lower extremities, and Babinski signs bilaterally. Magnetic resonance imaging of the brain revealed chronic microangiopathic changes, with no electroencephalographic correlate. The plasma ammonia level was elevated at 359 µmol per liter (611 µg per deciliter; normal range, 12 to 48 µmol per liter [20 to 82 µg per deciliter]). “Ping-pong gaze” has been reported in irreversible comatose states associated with diffuse structural brain lesions, such as bilateral hemispheric infarcts and midline cerebellar hemorrhage. In this case, the neuro-ophthalmologic motility pattern was seen as a transient, reversible phenomenon in a patient with advanced hepatic encephalopathy. After 48 hours of lactulose treatment, the patient’s plasma ammonia level was 28 µmol per liter (48 µg per deciliter), with resolution of hepatic encephalopathy and ping-pong gaze. The patient was discharged home with normal mental status 1 week after presentation. 🔴🔴🔴🔴🔴🔴🔴🔴🔴🔴🔴 CREDIT: Muthiah Vaduganathan, M.D., M.P.H. Jacob H. Johnson, M.D. Massachusetts General Hospital, Boston, MA [email protected] 🔴🔴🔴🔴🔴🔴🔴🔴🔴🔴🔴 Suivez nous sur : 👉 Instagram 👇   / gonozodoc   👉 Facebook 👇   / gonozodoc   👉YouTube 👇    / gonozodoc   🔴🔴🔴🔴🔴🔴🔴🔴🔴🔴🔴 ♥♥ Abonnez vous et invitez vos amis à découvrir notre chaine GONOZO DOC et recevoir nos nouvelles vidéos ♥♥ 🔴🔴🔴🔴🔴🔴🔴🔴🔴🔴🔴 🔴 Notre deuxième Chaine Médicale : NEW MEDICAL WORLD :    / @newmedicalworld2035   🔴🔴🔴🔴🔴🔴🔴🔴🔴🔴🔴 🔴 Nos applications médicales Gratuites sur Google Play : https://play.google.com/store/apps/de... 🔴🔴🔴🔴🔴🔴🔴🔴🔴🔴🔴 Les informations médicales données sur cette chaine YouTube ne remplacent pas une consultation chez votre médecin 🔴🔴🔴🔴🔴🔴🔴🔴🔴🔴🔴 MERCI.