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Lim GZ, Chan VEY, Yu WY, Tan NCK, Yeo T. FLAIR hyperintense lesions with U-fiber and subcortical enhancement (FUSE) in MOG antibody-associated cerebral cortical encephalitis. Neurol Sci 2024; 45:809-812. [PMID: 37792111 DOI: 10.1007/s10072-023-07092-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 09/20/2023] [Indexed: 10/05/2023]
Affiliation(s)
- Gareth Zigui Lim
- Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Level 3, Clinical Staff Office, Singapore, 308433, Singapore
| | - Vincent Ern Yao Chan
- Department of Neuroradiology, National Neuroscience Institute, Singapore, Singapore
| | - Wai-Yung Yu
- Department of Neuroradiology, National Neuroscience Institute, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Nigel Choon Kiat Tan
- Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Level 3, Clinical Staff Office, Singapore, 308433, Singapore
| | - Tianrong Yeo
- Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Level 3, Clinical Staff Office, Singapore, 308433, Singapore.
- Duke-NUS Medical School, Singapore, Singapore.
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
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Lim GZ, Lai JY, Seet CYH, Tham CH, Venketasubramanian N, Tan BYQ, Jing M, Yeo JYP, Myint MZ, Sia CH, Teoh HL, Sharma VK, Chan BPL, Yang C, Makmur A, Ong SJ, Yeo LLL. Revolutionizing the Management of Large-Core Ischaemic Strokes: Decoding the Success of Endovascular Therapy in the Recent Stroke Trials. J Cardiovasc Dev Dis 2023; 10:499. [PMID: 38132666 PMCID: PMC10743836 DOI: 10.3390/jcdd10120499] [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: 11/10/2023] [Revised: 12/02/2023] [Accepted: 12/15/2023] [Indexed: 12/23/2023] Open
Abstract
Endovascular therapy (EVT) has revolutionized the management of acute ischaemic strokes with large vessel occlusion, with emerging evidence suggesting its benefit also in large infarct core volume strokes. In the last two years, four randomised controlled trials have been published on this topic-RESCUE-Japan LIMIT, ANGEL-ASPECT, SELECT2 and TENSION, with overall results showing that EVT improves functional and neurological outcomes compared to medical management alone. This review aims to summarise the recent evidence presented by these four trials and highlight some of the limitations in our current understanding of this topic.
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Affiliation(s)
- Gareth Zigui Lim
- Department of Neurology, National Neuroscience Institute, Tan Tock Seng Hospital, Singapore 308433, Singapore
| | - Jonathan Yexian Lai
- Department of Neurology, National Neuroscience Institute, Tan Tock Seng Hospital, Singapore 308433, Singapore
| | - Christopher Ying Hao Seet
- Department of Neurology, National Neuroscience Institute, Tan Tock Seng Hospital, Singapore 308433, Singapore
| | - Carol Huilian Tham
- Department of Neurology, National Neuroscience Institute, Tan Tock Seng Hospital, Singapore 308433, Singapore
| | | | - Benjamin Yong Qiang Tan
- Division of Neurology, Department of Medicine, National University Health System, Singapore 119228, Singapore (V.K.S.); (B.P.L.C.)
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
| | - Mingxue Jing
- Division of Neurology, Department of Medicine, National University Health System, Singapore 119228, Singapore (V.K.S.); (B.P.L.C.)
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
| | - Joshua Yee Peng Yeo
- Division of Neurology, Department of Medicine, National University Health System, Singapore 119228, Singapore (V.K.S.); (B.P.L.C.)
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
| | - May Zin Myint
- Division of Neurology, Department of Medicine, National University Health System, Singapore 119228, Singapore (V.K.S.); (B.P.L.C.)
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
| | - Ching-Hui Sia
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
- Department of Cardiology, National University Heart Center, Singapore 119228, Singapore
| | - Hock Luen Teoh
- Division of Neurology, Department of Medicine, National University Health System, Singapore 119228, Singapore (V.K.S.); (B.P.L.C.)
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
| | - Vijay Kumar Sharma
- Division of Neurology, Department of Medicine, National University Health System, Singapore 119228, Singapore (V.K.S.); (B.P.L.C.)
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
| | - Bernard Poon Lap Chan
- Division of Neurology, Department of Medicine, National University Health System, Singapore 119228, Singapore (V.K.S.); (B.P.L.C.)
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
| | - Cunli Yang
- Division of Neurology, Department of Medicine, National University Health System, Singapore 119228, Singapore (V.K.S.); (B.P.L.C.)
- Department of Diagnostic Imaging, National University Health System, Singapore 119228, Singapore
| | - Andrew Makmur
- Division of Neurology, Department of Medicine, National University Health System, Singapore 119228, Singapore (V.K.S.); (B.P.L.C.)
- Department of Diagnostic Imaging, National University Health System, Singapore 119228, Singapore
| | - Shao Jin Ong
- Division of Neurology, Department of Medicine, National University Health System, Singapore 119228, Singapore (V.K.S.); (B.P.L.C.)
- Department of Diagnostic Imaging, National University Health System, Singapore 119228, Singapore
| | - Leonard Leong Litt Yeo
- Division of Neurology, Department of Medicine, National University Health System, Singapore 119228, Singapore (V.K.S.); (B.P.L.C.)
- Department of Diagnostic Imaging, National University Health System, Singapore 119228, Singapore
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Chen Z, Saini M, Koh JS, Lim GZ, Dang NJ, Prasad K, Koh SH, Tay KSS, Lee M, Ong HL, Zhao Y, Tandon A, Chai JYH. A novel variant in the tropomyosin 3 gene presenting as an adult-onset distal myopathy - a case report. BMC Neurol 2023; 23:181. [PMID: 37147571 PMCID: PMC10161565 DOI: 10.1186/s12883-023-03225-3] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 04/19/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND We report a patient with a novel c.737 C > T variant (p.Ser246Leu) of the TPM3 gene presenting with adult-onset distal myopathy. CASE PRESENTATION A 35-year-old Chinese male patient presented with a history of progressive finger weakness. Physical examination revealed differential finger extension weakness, together with predominant finger abduction, elbow flexion, ankle dorsiflexion and toe extension weakness. Muscle MRI showed disproportionate fatty infiltration of the glutei, sartorius and extensor digitorum longus muscles without significant wasting. Muscle biopsy and ultrastructural examination showed a non-specific myopathic pattern without nemaline or cap inclusions. Genetic sequencing revealed a novel heterozygous p.Ser246Leu variant (c.737C>T) of the TPM3 gene which is predicted to be pathogenic. This variant is located in the area of the TPM3 gene where the protein product interacts with actin at position Asp25 of actin. Mutations of TPM3 in these loci have been shown to alter the sensitivity of thin filaments to the influx of calcium ions. CONCLUSION This report further expands the phenotypic spectrum of myopathies associated with TPM3 mutations, as mutations in TPM3 had not previously been reported with adult-onset distal myopathy. We also discuss the interpretation of variants of unknown significance in patients with TPM3 mutations and summarise the typical muscle MRI findings of patients with TPM3 mutations.
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Affiliation(s)
- Zhiyong Chen
- Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.
| | - Monica Saini
- Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Jasmine Shimin Koh
- Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Gareth Zigui Lim
- Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Nancy Jiaojiao Dang
- Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Kalpana Prasad
- Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Swee Hoon Koh
- Neuromuscular Laboratory, National Neuroscience Institute, Singapore, Singapore
| | - Karine Su Shan Tay
- Neuromuscular Laboratory, National Neuroscience Institute, Singapore, Singapore
| | - Ming Lee
- Department of Pathology, Singapore General Hospital, Singapore, Singapore
| | - Helen Lisa Ong
- Department of Clinical and Translational Research, Singapore General Hospital, Singapore, Singapore
| | - Yi Zhao
- Department of Clinical and Translational Research, Singapore General Hospital, Singapore, Singapore
| | - Ankit Tandon
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore, Singapore
| | - Josiah Yui Huei Chai
- Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
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Lim GZ, Chua HE, Ei MA, Seet YHCCS, Lin X, Chng SM, Tan LCCS. Recurrent Multi-Territorial Acute Ischemic Stroke Due to Cardiac Angiosarcoma. Neurology 2022; 98:765-766. [PMID: 35277440 DOI: 10.1212/wnl.0000000000200342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 02/21/2022] [Indexed: 11/15/2022] Open
Affiliation(s)
- Gareth Zigui Lim
- Department of Neurology, National Neuroscience Institute, Singapore
| | - Hsieh En Chua
- Department of Internal Medicine, Tan Tock Seng Hospital, Singapore
| | - Mon Aung Ei
- Department of Neurology, National Neuroscience Institute, Singapore
| | | | - Xuling Lin
- Department of Neurology, National Neuroscience Institute, Singapore
| | - Soke Miang Chng
- Department of Neuroradiology, National Neuroscience Institute, Singapore
| | - Louis Cs C S Tan
- Department of Neurology, National Neuroscience Institute, Singapore
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Cheong KW, Lim GZ, Tan KB, Lim JHL. An instructive case of amlodipine-induced reversible granulomatous CD30 + T-cell pseudolymphoma. Australas J Dermatol 2020; 61:e346-e350. [PMID: 31965571 DOI: 10.1111/ajd.13240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 11/29/2019] [Accepted: 12/25/2019] [Indexed: 11/27/2022]
Abstract
We report an unusual case of drug-associated granulomatous CD30+ T-cell pseudolymphoma secondary to amlodipine. A 55-year-old Chinese man presented with a 6-month eruption of disseminated erythematous dermal papulonodules and annular infiltrated plaques over his neck and limbs symmetrically. Histopathology revealed a perivascular and interstitial infiltrate of histiocytes, eosinophils and morphologically normal lymphocytes associated with CD30 expression. The eruption improved rapidly after discontinuation of amlodipine and did not recur.
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Affiliation(s)
| | | | - Kong Bing Tan
- Department of Pathology, National University Health System and National University of Singapore, Singapore, Singapore
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