Evidence map›Paper›PMID 37491326›Full record

ArticleNeurology2023

Clinical Reasoning: A 17-Year-Old Girl With Progressive Cognitive Impairment.

Bo Zhao, Zonghong Zhu, Jinjing Zhao, Miao Yang, Yimo Zhang, Hang Li, Shuyi Pan, Xiaokun Qi, Yingxin Yu

Open access · bronzeAbstract readCase Reports

In one paragraph

Article in Neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it

0cells of the map it votes in

0citing papers in PubMed

–field-weighted citation impact, top 73% of its field

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Bo ZhaoFrom the Department of Neurology (B.Z., Y.Z., X.Q., Y.Y.), The First Medical Center, Chinese PLA General Hospital, Beijing; The Second School of Clinical Medicine (B.Z., M.Y., S.P.), Southern Medical University, Guangzhou; Department of Hyperbaric Oxygen (B.Z., H.L., S.P.), and Department of Emergency (Z.Z.), Sixth Medical Center of Chinese PLA General Hospital; and Department of Neurology (J.Z.), The 305th Hospital of the People's Liberation Army, Beijing, China.

Zonghong ZhuFrom the Department of Neurology (B.Z., Y.Z., X.Q., Y.Y.), The First Medical Center, Chinese PLA General Hospital, Beijing; The Second School of Clinical Medicine (B.Z., M.Y., S.P.), Southern Medical University, Guangzhou; Department of Hyperbaric Oxygen (B.Z., H.L., S.P.), and Department of Emergency (Z.Z.), Sixth Medical Center of Chinese PLA General Hospital; and Department of Neurology (J.Z.), The 305th Hospital of the People's Liberation Army, Beijing, China.

Jinjing ZhaoFrom the Department of Neurology (B.Z., Y.Z., X.Q., Y.Y.), The First Medical Center, Chinese PLA General Hospital, Beijing; The Second School of Clinical Medicine (B.Z., M.Y., S.P.), Southern Medical University, Guangzhou; Department of Hyperbaric Oxygen (B.Z., H.L., S.P.), and Department of Emergency (Z.Z.), Sixth Medical Center of Chinese PLA General Hospital; and Department of Neurology (J.Z.), The 305th Hospital of the People's Liberation Army, Beijing, China.

Miao YangFrom the Department of Neurology (B.Z., Y.Z., X.Q., Y.Y.), The First Medical Center, Chinese PLA General Hospital, Beijing; The Second School of Clinical Medicine (B.Z., M.Y., S.P.), Southern Medical University, Guangzhou; Department of Hyperbaric Oxygen (B.Z., H.L., S.P.), and Department of Emergency (Z.Z.), Sixth Medical Center of Chinese PLA General Hospital; and Department of Neurology (J.Z.), The 305th Hospital of the People's Liberation Army, Beijing, China.

Yimo ZhangFrom the Department of Neurology (B.Z., Y.Z., X.Q., Y.Y.), The First Medical Center, Chinese PLA General Hospital, Beijing; The Second School of Clinical Medicine (B.Z., M.Y., S.P.), Southern Medical University, Guangzhou; Department of Hyperbaric Oxygen (B.Z., H.L., S.P.), and Department of Emergency (Z.Z.), Sixth Medical Center of Chinese PLA General Hospital; and Department of Neurology (J.Z.), The 305th Hospital of the People's Liberation Army, Beijing, China.

Hang LiFrom the Department of Neurology (B.Z., Y.Z., X.Q., Y.Y.), The First Medical Center, Chinese PLA General Hospital, Beijing; The Second School of Clinical Medicine (B.Z., M.Y., S.P.), Southern Medical University, Guangzhou; Department of Hyperbaric Oxygen (B.Z., H.L., S.P.), and Department of Emergency (Z.Z.), Sixth Medical Center of Chinese PLA General Hospital; and Department of Neurology (J.Z.), The 305th Hospital of the People's Liberation Army, Beijing, China.

Shuyi PanFrom the Department of Neurology (B.Z., Y.Z., X.Q., Y.Y.), The First Medical Center, Chinese PLA General Hospital, Beijing; The Second School of Clinical Medicine (B.Z., M.Y., S.P.), Southern Medical University, Guangzhou; Department of Hyperbaric Oxygen (B.Z., H.L., S.P.), and Department of Emergency (Z.Z.), Sixth Medical Center of Chinese PLA General Hospital; and Department of Neurology (J.Z.), The 305th Hospital of the People's Liberation Army, Beijing, China.

Xiaokun QiFrom the Department of Neurology (B.Z., Y.Z., X.Q., Y.Y.), The First Medical Center, Chinese PLA General Hospital, Beijing; The Second School of Clinical Medicine (B.Z., M.Y., S.P.), Southern Medical University, Guangzhou; Department of Hyperbaric Oxygen (B.Z., H.L., S.P.), and Department of Emergency (Z.Z.), Sixth Medical Center of Chinese PLA General Hospital; and Department of Neurology (J.Z.), The 305th Hospital of the People's Liberation Army, Beijing, China.

Yingxin YuFrom the Department of Neurology (B.Z., Y.Z., X.Q., Y.Y.), The First Medical Center, Chinese PLA General Hospital, Beijing; The Second School of Clinical Medicine (B.Z., M.Y., S.P.), Southern Medical University, Guangzhou; Department of Hyperbaric Oxygen (B.Z., H.L., S.P.), and Department of Emergency (Z.Z.), Sixth Medical Center of Chinese PLA General Hospital; and Department of Neurology (J.Z.), The 305th Hospital of the People's Liberation Army, Beijing, China. fmmuyingxin@hotmail.com.

Chinese PLA General Hospital · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

A 17-year-old girl presented with a long history of cognitive impairment, personality and behavioral changes, dysarthria, and paroxysmal lower-extremity weakness. She was initially suspected of having mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes because of stroke-like symptoms, such as episodic lower-extremity weakness, as well as abnormal brain MRI findings of generalized cerebral atrophy, extensive high-intensity lesions in the cortex and subcortical white matter on fluid-attenuated inversion recovery images, decreased N-acetyl aspartate/creatine ratio, and a lactate peak in the focal area on spectrum images. However, there were no relatives with similar presentations in the family of the patient. The whole mitochondrial genome and whole-exome sequencing did not suggest pathogenic mutations, and no abnormalities were found in the blood or CSF lactate levels. In this case, we detail the clinical manifestations, diagnostic workup, and imaging findings. This case highlights the importance of assessing cognitive function and the relevant differential diagnoses in an adolescent with cognitive impairment.

Indexed as

Acidosis, LacticMELAS SyndromeStrokeAdolescentBrainClinical ReasoningFemaleHumansMagnetic Resonance Imaging

Identifiers

PMID37491326

DOI10.1212/WNL.0000000000207597

PMCPMC10573138

OpenAlexW4385232045

What OpenQuestion holds

Textmetadata

Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.