Other symptoms of PME include generalized, tonic clonic, tonic, and atypical absence seizures. In Laforas disease the seizures are occipital and the person experiences transient blindness as well as visual hallucinations. The person may also have atypical absences and atonic and complex partial seizures. In Myoclonus epilepsy with ragged-red fibers (MERRF) the person experiences generalized epilepsy along with myoclonus, weakness, and dementia.As PME progresses neurological ability decreases and can lead to myopathy, neuropathy, cognitive decline, cerebellar ataxia, and dementia. The different symptoms in each of the PME and between individuals makes diagnosis difficult. Therefore, diagnosis of PME is dependent on failure to respond to antiepileptic drugs and therapy but diagnosis of specific PME depends on genetic testing, EEG (electroencephalography), enzyme measurements and more. Diagnosis
Diagnosis of PME is based on the individuals signs and symptoms as well as failure to respond to antiepileptic drugs and therapy. Further diagnosis support includes EEG results, genetic testing, enzyme testing, and skin and muscle biopsies. Gauchers disease can be diagnosed through enzyme testing as it is a metabolic disease. Laforas disease can be diagnosed using skin biopsies. While Action myoclonus renal failure (AMRF) syndrome can only be diagnosed using genetic test. Using EEGs as a form of diagnosis can prove difficult as patients differ in their neurophysiology. In Laforas disease EEGs can show slowing background activity or focal discharges as well as epileptiform discharges. In ULD EEGs show generalized epileptiform discharges and in MERRF patients show background slowing.
Retained antrum syndrome or retained gastric antrum syndrome is one of the rare postgastrectomy syndromes. It happens after Billroth II surgery and the mechanism involved is the inadequate removal of the distal antrum and pylorus during resection of the antrum and gastrojejunostomy.Lack of the usual acid-secreting gastric glands makes the antral segment continually exposed to the alkaline environment of the duodenum, which causes it to secrete excessive acid and be prone to form ulcers. == References ==