Leucine-rich glioma-inactivated 1 (LGI-1) antibody encephalitis is a type of limbic encephalitis characterized by faciobrachial dystonic seizure and short-term memory loss as initial clinical symptoms. We present a case initially misdiagnosed as schizophrenia and finally diagnosed as LGI-1 antibody encephalitis. A 41-year-old female presented to the neurology clinic with a 4-month history of anxiety and disoriented speech and a new onset headache. Her explanation of symptoms was unclear, and she was unable to answer questions properly. Her brain magnetic resonance imaging (MRI) showed no specific lesions. After 6 months, depersonalization, place disorientation and memory impairment were noted. Her symptoms continue to progress, experiencing visual/auditory hallucinations. She was diagnosed with schizophrenia and admitted to a closed psychiatric ward. In the hospital, she showed mild fever, and her memory loss worsened faster than her psychiatric symptoms, unlike in schizophrenia. Follow-up MRI scans showed a diffusely enlarged right hippocampus with a 2.5 × 1.3-cm mass lesion. Electroencephalogram showed rhythmic theta activities/interictal spikes in the right frontal lobe, for which she was treated with an antiepileptic drug. Cerebrospinal fluid analysis results showed pleocytosis. Based on this, autoimmune encephalitis was diagnosed, and steroid pulse treatment and immunoglobulin treatment were performed. Positivity for LGI-1 antibody was reported and finally led to diagnosis of LGI-1 antibody encephalitis. Clinical symptoms gradually improved, and the lesion had shrunk considerably on MRI performed 6 months after immunoglobulin treatment. She reports persistent amnesia for 6 months but has returned to her daily life under follow-up observation.
Background: The volume of cosmetic procedures and expenditures has increased over the past 15 years. Recent studies have shown that the market for cosmetic procedures follows the standard laws of economics. However, no studies published in the literature have found a direct correlation between US stock market indices and expenditures on cosmetic surgery and minimally invasive procedures. Methods: The authors analyzed annual cosmetic procedure statistics from the American Society of Plastic Surgeons for 2005–2020 against economic indices, including major US stock market indices [NASDAQ 100, S&P 500, Dow Jones Industrial Average (DJIA), Russell 2000 indices from the New York Stock Exchange, gross domestic product (GDP)], median income of US citizens, and the US population from the Federal Reserve Bank of St. Louis. Pearson correlation coefficient and multiple regression analysis were used for the statistical analysis. Results: Total expenditure on cosmetic surgery and minimally invasive procedures (TECP) has more than doubled since 2005 to 2020. TECP revealed statistically significant correlations with all other indicators. TECP had the greatest correlation with DJIA (r = 0.952, P < 0.001). In the multiple regression analysis, the increase in TECP led to the rise of the NASDAQ 100 index (adjusted R2 was 0.790, P < 0.001). Conclusions: There was a statistically significant correlation between the TECP in USA and the major indices of the US stock market. In particular, the increase in TECP led to the rise of the NASDAQ 100 index.
Somnambulism or sleepwalking is a disorder classified as non-rapid eye movement sleep parasomnia and is common in adolescents. Sleep fragmentation occurs frequently in somnambulism, and waking up and wandering are the main symptoms of the disorder. Our patient was a 14-year-old male with a 3-year history of sleepwalking at night when he visited our sleep clinic. A polysomnography was performed for the evaluation of parasomnia. Our patient was diagnosed as having parasomnia overlap syndrome with moderate obstructive sleep apnea (OSA). Continuous positive airway pressure (CPAP) therapy was prescribed for the OSA. After 12 weeks of CPAP, not only did the patient’s OSA symptoms resolve but somnambulism disappeared. Previous reports of overlap syndrome with OSA and somnambulism also supported the use of CPAP treatment for patients with both OSA and somnambulism.
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