Intracerebral Hemorrhage in Patients with Neuromyelitis Optica: Case Report with Literature Review for Possible Pathological Association
Neuromyelitis optica (NMO) is an autoimmune demyelinating disorder of the central nervous system which is characterized by attacks of optic neuritis and transverse myelitis. An association between NMO and intracerebral hemorrhage (ICH) has been rarely recognized, having been reported only 3 times before. Here we report on a patient with NMO who eventually developed subarachnoid hemorrhage, in order to emphasize that the association between NMO and ICH is mostly not incidental and that the pathological basis for this association should be investigated thoroughly.Case Rep Neurol 2021;13:157 –165 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - March 4, 2021 Category: Neurology Source Type: research

ALS Mimics due to Affection of the Cervical Spine: From Common Compressive Myelopathy to Rare CSF Epidural Collection
Amyotrophic lateral sclerosis (ALS) is a clinically heterogeneous disease, with chameleon presentations and several mimics. Considering the poor prognosis of ALS, their precise and timely identification is pivotal. Affection of the cervical spine represents one potential source of ALS mimics that should never be missed, since it is potentially treatable. We hereby present 5 cases initially diagnosed as ALS but eventually found to have different kinds of cervical spine affection, from a common compressive myelopathy to a rare space-occupying cystic fluid collection.Case Rep Neurol 2021;13:145 –156 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - March 4, 2021 Category: Neurology Source Type: research

Horizontal Gaze Defect as a Result of Subcortical Stroke: Case Report and Review of the Literature
We report a patient with subcortical white matter ischemic stroke who suffered horizontal gaze defects.Case Rep Neurol 2021;13:140 –144 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - February 26, 2021 Category: Neurology Source Type: research

Intrafamilial Phenotypic Variability Associated with the I1739V Mutation in the SCN9A Gene
We report the genotype phenotype analysis in a family carrying a specific mutation, I1739V, in theSCN9A gene. Neurophysiological studies have documented the gain of function impact of this mutation on this sodium channel. Interestingly, there is significant interfamilial phenotypic variability in individuals carrying this mutation. In our family, a father daughter combination had identical genotypes analyzing the SCN9A gene and multiple other genes known to cause neuropathy. Both of them carry the I1739V mutation but exhibit significant phenotypic variability with complaints of decreased sensitivity to discomfort in the fa...
Source: Case Reports in Neurology - February 25, 2021 Category: Neurology Source Type: research

A Case of Alpha-Pyrrolidinopentiophenone (Flakka)-Induced Ischemic Stroke
We present a case report of an acute ischemic stroke following the recreational use of α-PVP. The ischemic lesions were located in the midd le cerebral artery and deep watershed areas of the left cerebral hemisphere. Occupational therapy and physiotherapy were initiated, and the patient was discharged with only a mild right hemiparesis.Case Rep Neurol 2021;13:131 –134 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - February 16, 2021 Category: Neurology Source Type: research

R1352Q < b > < i > CACNA1A < /i > < /b > Variant in a Patient with Sporadic Hemiplegic Migraine, Ataxia, Seizures and Cerebral Oedema: A Case Report
Mutations in theCACNA1A gene show a wide range of neurological phenotypes including hemiplegic migraine, ataxia, mental retardation and epilepsy. In some cases, hemiplegic migraine attacks can be triggered by minor head trauma and culminate in encephalopathy and cerebral oedema. A 37-year-old male without a family history of complex migraine experienced hemiplegic migraine attacks from childhood. The attacks were usually triggered by minor head trauma, and on several occasions complicated with encephalopathy and cerebral oedema. Genetic testing of the proband and unaffected parents revealed a de novo heterozygous nucleotid...
Source: Case Reports in Neurology - February 16, 2021 Category: Neurology Source Type: research

Sudden Bilateral Deafness in a Patient with Transient Ischemic Attack: A Case Report
We report a 53-year-old man with an acute onset of complete bilateral hearing loss that gradually improved spontaneously over 4 h. The hearing loss was explained by an infarction visualized on magnetic resonance imaging, which showed a subacute temporoparietal ischemic lesion in the left cerebral hemisphere involving the insular cortex and an older infarction in the right temporoparietal region. The location of these kinds of lesions may typically not cause motor deficits, but sensory and cognitive (e.g., aphasia) symptoms, which can be challenging to recognize in a suddenly deaf patient. Taking the possible differential d...
Source: Case Reports in Neurology - February 16, 2021 Category: Neurology Source Type: research

A Patient with Noonan Syndrome with a < b > < i > KRAS < /i > < /b > Mutation Who Presented Severe Nerve Root Hypertrophy
We report a 45-year-old female with clinical features resembling Noonan syndrome (NS) who presented with significant nerve root hypertrophy. She was initially diagnosed with Charcot-Marie-Tooth disease because her gait disturbance gradually deteriorated and nerve conduction velocity was reduced. However, she did not carry aPMP22 gene mutation. RASopathies are a group of phenotypically overlapping developmental syndromes caused by germline mutations that encode components of the Ras/MAPK signaling pathway. These disorders include NS, cardiofaciocutaneous (CFC) syndrome, and Costello syndrome and are associated with molecula...
Source: Case Reports in Neurology - February 16, 2021 Category: Neurology Source Type: research

A 56-Year-Old Woman with Recurrent Strokes: A Clear Case with a Therapeutic Dilemma
A 56-year-old woman with a history of cerebral amyloid angiopathy (CAA) complicated by prior intracranial hemorrhage (ICH) was evaluated for an asymptomatic ischemic stroke discovered on screening brain MRI. On echocardiogram, she was found to have a mass on her mitral valve and strongly positive antiphospholipid antibodies. She was diagnosed with nonbacterial thrombotic (Libman-Sacks) endocarditis associated with the primary antiphospholipid syndrome (APS). The treatment decision was complicated by the history of CAA with ICH within the last year with very high risk for bleeding complications if on anticoagulation. A mult...
Source: Case Reports in Neurology - February 15, 2021 Category: Neurology Source Type: research

Transcranial Direct Current Stimulation Combined with Botulinum Neurotoxin Type A Injections for Treatment of Upper Limb Intention Tremor in Multiple Sclerosis: A Case Report
Upper limb intention tremor is a common cause of disability in multiple sclerosis (MS). Transcranial direct current stimulation (tDCS) is an emerging form of brain stimulation used to improve sensorimotor impairments in many neurological disorders. Here, we describe a combined therapeutic approach with botulinum neurotoxin type A (BoNT-A) and tDCS for the treatment of upper limb tremor in a patient with MS. We administered a cathodal tDCS 15 days after the injections of BoNT-A. Both post-injection and post-stimulation evaluation revealed a considerable improvement of the tremor. This approach positively affected the patien...
Source: Case Reports in Neurology - February 15, 2021 Category: Neurology Source Type: research

Coexistence of Hereditary Spastic Paraplegia Type 4 and Narcolepsy: A Case Report
In this report, we describe the clinical symptoms and genetic background of the patient.Case Rep Neurol 2021;13:84 –91 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - February 15, 2021 Category: Neurology Source Type: research

Two Cases of Probable Neuro-Beh çet’s Disease with Longitudinally Extensive Transverse Myelitis
We report 2 cases of probable neuro-Beh çet’s disease (NBD) with longitudinally extensive transverse myelitis (LETM). In both cases, the patients presented paraplegia, as well as sensory, bladder, and rectal disturbances. Magnetic resonance imaging (MRI) of patient 1 showed continuous high signal intensity extending from the midbrain t o the entire spinal cord in the central part of the cord on T2-weighted imaging (T2WI). Spinal MRI of patient 2 revealed high signal intensity extending from Th2 to Th10 in the central part of the cord on T2WI. Both patients received high-dose methylprednisolone. A continuous le...
Source: Case Reports in Neurology - February 8, 2021 Category: Neurology Source Type: research

A Severe Course of Relapsing-Remitting Acute-Onset Chronic Inflammatory Demyelinating Polyneuropathy in a Young Man
Acute-onset chronic inflammatory demyelinating polyneuropathy (A-CIDP) is an immune mediated neuropathy characterized by progressive weakness and sensory impairment lasting over 2 months. Guillain-Barr é-Strohl syndrome (GBS) is an immune mediated polyneuropathy with a similar presentation often over less than 4 weeks. While some have argued for the existence of recurrent GBS, most classify the syndrome as a form of relapsing-remitting CIDP. However, there are cases of GBS with treatment-related fluctuations that must be distinguished from A-CIDP as patients with A-CIDP require long-term immunotherapy. In this case ...
Source: Case Reports in Neurology - February 4, 2021 Category: Neurology Source Type: research

Eculizumab during Pregnancy in a Patient with Treatment-Refractory Myasthenia Gravis: A Case Report
The recombinant humanized monoclonal antibody eculizumab has been shown to be effective and well tolerated in patients with anti-acetylcholine receptor antibody-positive, treatment-refractory generalized myasthenia gravis (gMG). Myasthenia gravis (MG) often affects women of child-bearing potential. However, management can be challenging during pregnancy, and current treatment options are limited due to potential teratogenicity. Data are currently lacking on the use of eculizumab in pregnant women with gMG. This case report describes a successful pregnancy in a young woman with treatment-refractory gMG treated with eculizum...
Source: Case Reports in Neurology - February 1, 2021 Category: Neurology Source Type: research

ALS-Like Disorder in Three HIV-Positive Patients: Case Series
We report three cases of HIV-positive individuals, all male, who were subsequently diagnosed with ALS. Each presented with symptoms of limb onset ALS with involvement of upper and lower motor neurons and whose disease originated at the cervical level. All three had been diagnosed with HIV prior to presentation and were presumably compliant with antiretroviral therapy throughout. Our patients demonstrated effective control of their HIV infection. Each experienced relatively slow progression of motor impairment compared to ge neral ALS characteristics. Our study offers a distinct profile of HIV-positive patients compliant wi...
Source: Case Reports in Neurology - January 28, 2021 Category: Neurology Source Type: research

Very-Late-Onset Neuromyelitis Optica Spectrum Disorder in a Patient with Breast Cancer and Parkinson Disease
We report herein a case of very-late-onset NMOSD (76 years of age) and try to promote its awareness as a type of neurological deterioration in elder patients. A 76-year-old woman suffering from Parkinson disease was admitted to our hospital because of consciousness disturbance. Cranial magnetic resonance imaging revealed the presence of fluid-attenuated inversion recovery high-signal-intensity lesions in the right peri- and intralateral ventricle. Part of this lesion and the meninges showed gadolinium enhancement. Physical examination revealed the presence of a tumor in the right breast, which was later diagnosed as invasi...
Source: Case Reports in Neurology - January 28, 2021 Category: Neurology Source Type: research

Hemichorea Neglect after Stroke
We report a case of a 74-year-old Japanese woman who, after left thalamic infarction, developed right hemichorea and its neglect. This rare finding was associated with ipsi- and contralateral brain perfusion changes, presumably reflecting de-afferentiation within the brain.Case Rep Neurol 2021;13:50 –52 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - January 28, 2021 Category: Neurology Source Type: research

Luxury Perfusion Producing Sensory Aphasia
We describe the case of an 86-year-old Japanese man who, by luxury perfusion after spontaneous recanalization of the left middle cerebral artery/internal carotid artery, produced acute transient sensory aphasia. This rare phenomenon is thought to be caused by reperfusion brain injury.Case Rep Neurol 2021;13:46 –49 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - January 27, 2021 Category: Neurology Source Type: research

SMART Syndrome Identification and Successful Treatment
We report a 41-year-old male patient admitted to our emergency room with a reduced level of consciousness and global aphasia. One month prior to admission, he started with frequent headache attacks of moderate intensity and paroxysmal behavioral alterations, advancing to confusion, gait instability, language impairment, and somnolence. He had a history of medulloblastoma treated with surgical resection followed by craniospinal irradiation 21 years before symptom onset. After excluding more frequent causes for the patient ’s symptoms along with a suggestive image pattern, we started treatment for SMART syndrome with h...
Source: Case Reports in Neurology - January 25, 2021 Category: Neurology Source Type: research

Complete Oculomotor Palsy after Influenza Vaccination in a Young Healthy Adult: A Case Report
We present a case report of a 25-year-old woman without any medical history who developed complete oculomotor palsy 2 weeks after influenza vaccination. Other possible causes of oculomotor nerve palsy, such as stroke, compressive lesions, infections, and autoimmune disorders, were eliminated by blood tests, cerebrospinal fluid examination, and imaging studies. Hence, influenza vaccine was considered as the likely cause.Case Rep Neurol 2021;13:35 –39 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - January 25, 2021 Category: Neurology Source Type: research

Inner-Ear Symptom May Herald Basilar Artery Occlusion
A 75-year-old Japanese man suddenly experienced right cochlear and vestibular dysfunction. Basilar artery occlusion and silent right cerebellar infarction were identified 3 days later. These were treated with intravenous ozagrel (an antiplatelet agent) and edaravone, a free-radical scavenger. The patient did not develop cerebello-brainstem signs. His first sign most probably reflected a right labyrinthine artery occlusion that heralded, or occurred together with, the basilar artery occlusion. This case highlights the possibility that a sudden inner ear dysfunction may herald a basilar stroke. Clinicians should therefore in...
Source: Case Reports in Neurology - January 21, 2021 Category: Neurology Source Type: research

Common Peroneal Nerve Injury Related to Small Saphenous Vein Surgery: Report of 2 Cases and Review of the Literature
This report chronicles 2 instances of CPN injury after SSV surgery, addressing treatment strategies and therapeutic gains. The pertinent literature is also reviewed.Case Rep Neurol 2021;13:24 –30 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - January 21, 2021 Category: Neurology Source Type: research

Anti-N-Methyl-D-Aspartate Receptor Encephalitis with Decrease in Blood Flow in Cerebellum
In anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis, progressive cerebellar atrophy potentially leads to severe sequelae. We encountered a patient with anti-NMDAR antibody encephalitis who showed a decrease of blood flow in the cerebellum. A 15-year-old girl presented with consciousness disturbance. Influenza encephalopathy was suspected, and she was treated with glucocorticoid pulse therapy, high-dose intravenous immunoglobulins, and plasma exchange sequentially. She subsequently underwent left oophorectomy due to the presence of anti-NMDAR antibodies and a left ovarian teratoma. In spite of the surgery, her neurop...
Source: Case Reports in Neurology - January 21, 2021 Category: Neurology Source Type: research

Unusual Presentation in Infratentorial Superficial Siderosis: Acute Intracranial Hypertension
Superficial siderosis (SS) of the nervous system is a rare acquired condition related to hemosiderin deposits in subpial layers of the brain, brainstem, cerebellum, cranial nerves, and spinal cord, leading to brain iron-mediated neurodegeneration. The cardinal neurological features are slowly progressive hearing loss, ataxia, and pyramidal signs. Here we describe an atypical case of infratentorial SS evolving with acute intracranial hypertension in the absence of typical chronic signs.Case Rep Neurol 2021;13:9 –16 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - January 8, 2021 Category: Neurology Source Type: research

Case Series: Clinical Impact of Plasmapheresis and Thymectomy on Early-Onset Myasthenia Gravis
We describe clinical features and postoperative data and evaluate the clinical outcome after thymectomy. Muscle strength was assessed by the Medical Research Council scale. Evaluation of clinical stage before and after thymectomy were carri ed out with the modified Osserman classification. All patients showed improvement (100%) in the clinical grade of the modified Osserman classification: 3 patients were in the complete remission category and 2 patients were in the improved category. All patients with general weakness experienced impr ovement in muscle strength at the 1-year evaluation.Case Rep Neurol 2021;13:1 –8 (...
Source: Case Reports in Neurology - January 7, 2021 Category: Neurology Source Type: research

Mixed Upper and Lower Motor Neuron Damage in Japanese Encephalitis Virus Infection
Cerebral manifestations in Japanese B encephalitis are well known. However, there are very few studies focusing on extra-cerebral manifestations, among which focal anterior horn cell involvement is exceedingly rare. We herein report a case of Japanese B encephalitis with focal anterior horn cell involvement and unfurl how stepwise clinical approach and targeted investigations helped to solve the diagnostic conundrum. A 27-year-old female was admitted with fever, headache, altered sensorium, and convulsions. She tested positive for Japanese B encephalitis-IgM. Following conservative management, she regained consciousness af...
Source: Case Reports in Neurology - December 18, 2020 Category: Neurology Source Type: research

NeuroAid II (MLC901) in Haemorrhagic Stroke
Stroke is a leading cause of death and disability. NeuroAid (MLC601), which originates from Traditional Chinese Medicine, comprises herbal and animal components, and has been shown to improve the functional status of patients after ischaemic stroke. The use of NeuroAid II (MLC901), which comprises only the herbal components of MLC601, in haemorrhagic stroke has not been previously reported. Our patient is a 63-year-old male with a significant stroke risk factor of hypertension. He developed visual field defect, aphasia, unilateral weakness, and hemisensory loss. CT scan showed a left thalamic haemorrhage. In addition to an...
Source: Case Reports in Neurology - December 14, 2020 Category: Neurology Source Type: research

“Cortical” Wrist Drop due to a Cerebral Peduncle Infarct
We report a unique case of “cortical” wrist drop due to an acute infarction of the contralateral cerebral peduncle. The patient is a 70-year-old gentleman with the vascular factors of hypertension, hyperlipidaemia, and prior cerebellar strokes, who developed sudden onset of right wrist weakness without numbness. Neurologi cal examination showed a right wrist and finger drop. Nerve conduction study of the radial nerve was normal. MRI brain revealed an acute infarct in the medial part of the left cerebral peduncle, extending slightly to the medial thalamus; there were also old medial posterior cerebellar infarcts...
Source: Case Reports in Neurology - December 14, 2020 Category: Neurology Source Type: research

10-Year Follow-Up of a Patient with Cerebral Amyloid Angiopathy
We report the case of long-term follow-up of brain magnetic imaging of cerebral amyloid angiopathy. Cerebral amyloid angiopathy is often considered a major cause of spontaneous intracerebral hemorrhage in the elderly. This case illustrates the markedly progressive clinical and radiological features of the vasculopathic process in 10 years.Case Rep Neurol 2020;12:202 –206 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - December 14, 2020 Category: Neurology Source Type: research

Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) – Still to be Considered in the Presence of Vascular Risk Factors
We report a 46-year-old male with a 9 and 3-month history of progressive unilateral lower limb weakness and dysarthria, respectively. He had a history of diabetes mellitus but no hypertension, hyperlipidemia, or smoking history. Both parents had a stroke at the age of 65 years. Neurological examination was significant for moderate dysarthria and reduced right upper limb dexterity. Magnetic resonance imaging (MRI) of the brain revealed extensive white matter disease, lacunar infarcts, and a few microhemorrhages. Electron microscopy of his skin biopsy showed electron-dense deposits of extracellular osmiophilic granular mater...
Source: Case Reports in Neurology - December 14, 2020 Category: Neurology Source Type: research

Late Diagnosis of Multiple Cerebral Aneurysms A Decade after Resection of Cardiac Myxoma
We report a case of delayed presentation of neurological manifestations in form of multiple intracranial aneurysms many years after treatment of a cardiac myxoma. Our patient, a 55-year-old right-handed female with a background history of hypertension, first presented at the age of 45 years with a sudden onset of right hemiplegia. A CT brain scan detected multiple infarcts in the territory of the left middle cerebral artery. Echocardiography revealed a cardiac myxoma for which she underwent immediate total surgical resection. Nearly 10 years after this diagnosis, she presented again with right-sided weakness and left ptosi...
Source: Case Reports in Neurology - December 14, 2020 Category: Neurology Source Type: research

Nonbacterial Thrombotic Endocarditis Related to Adenocarcinoma of the Uterine Cervix
We report a 66-year-old female patient who presented with acute onset of visual loss with relative afferent pupillary defect, hemineglect, hemihypesthesia, and apraxia. Magnetic resonance imaging of the brain demonstrated different stages of ischemic stroke in different vascular territories, suggesting cardiogenic embolism. Past history was significant for advanced-stage adenocarcinoma of the uterine cervix under chemoradiation treatment. On echocardiogram, vegetation at the aortic valve was observed. With the absence of evidence of infectious endocarditis, diagnosis of nonbacterial thrombotic endocarditis was made, and th...
Source: Case Reports in Neurology - December 14, 2020 Category: Neurology Source Type: research

Acute Ischemic Stroke in a Young Patient with Left Ventricular Thrombus Attributed to Doxorubicin Cardiomyopathy
We report a case of acute middle cerebral territory ischemic infarction caused by left ventricular thrombus (LVT) in a doxorubicin cardiomyopathy patient. A major adverse effect of doxorubicin is cardiotoxicity. In doxorubicin cardiomyopathy, as the ventricular contractility decreases, LVT can occur and lead to systemic embolic events such as stroke.Case Rep Neurol 2020;12:178 –182 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - December 14, 2020 Category: Neurology Source Type: research

Uncommon Causes of Cardioembolic Stroke and Related Complications
Case Rep Neurol 2020;12:176 –177 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - December 14, 2020 Category: Neurology Source Type: research

Subarachnoid Hemorrhage due to Ruptured Spinal Artery Aneurysm: A Diagnostic Challenge
In conclusion, rupture of a spinal aneurysm should be considered a possible cause of SAH in appropriate clinical settings, and clinicians must be aware of the possibility of cord compression.Case Rep Neurol 2020;12:169 –175 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - December 14, 2020 Category: Neurology Source Type: research

Small Intracranial Aneurysms and Subarachnoid Hemorrhage: Is the Size Criterion for Risk of Rupture Relevant?
The current understanding is that small intracranial aneurysms (#x3c;7 mm) are not at a significant risk for rupture. However, there have been several published series of rupture and subarachnoid hemorrhage from aneurysms #x3c;5 mm. Three cases of intracranial aneurysms rupturing at #x3c;3 mm are presented in this paper. Patient age ranged between 38 and 57 years. The aneurysms were located in different parts of the circulation in the brain. This case series highlights that the size criterion alone is not adequate when evaluating patients with unruptured brain aneurysms for observational follow-up or treatment.Case Rep Neu...
Source: Case Reports in Neurology - December 14, 2020 Category: Neurology Source Type: research

Psychogenic Seizure Imitating Narcolepsy
We describe a 55-year-old man with frequent brief and sudden sleep-like attacks in combination with nocturnal sleep disturbance. During attacks he was unresponsive, snoring but maintained posture. He resisted passive eye opening but with rolling eyes. The patient was confused on waking. In the interictal period, there were FND signs including give-way weakness of the left hand, typical functional “leg-dragging” gait, mistake in the finger-to-nose test. Video-electroencephalogram monitoring did not detect specific epileptic activity or sleep pattern during the attacks. Polysomnography showed multiple waking epis...
Source: Case Reports in Neurology - December 11, 2020 Category: Neurology Source Type: research

Fragile-X-Associated Tremor/Ataxia Syndrome or Alcohol-Induced Cerebellar Degeneration? A Case Report
We present and discuss a male patient whose diagnosis of FXTAS was delayed due to his concomitant alcohol abuse.Case Rep Neurol 2020;12:466 –471 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - December 11, 2020 Category: Neurology Source Type: research

Unilateral Dorsolateral Medullary Hemorrhage Presenting with Severe Dysphagia
We report an 87-year-old woman with right dorsolateral medullary hemorrhage. She did not show all of the usual symptoms of Wallenberg syndrome and her main symptom was severe dysphagia. Dorsolateral medullary hemorrhage may be overlooked, because it is rare and does not exhibit the typical Wallenberg syndrome presentation usually seen in patients with infarction at the dorsolateral medulla.Case Rep Neurol 2020;12:460 –465 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - November 27, 2020 Category: Neurology Source Type: research

Bell ’s Palsy in Pregnancy: A Case Series
The association between pregnancy-associated Bell ’s palsy (PABP) and gestational hypertension (GHT), preeclampsia (PE), and eclampsia (EC) remains inconclusive. We aimed to study the characteristics of PABP cases and the neonatal outcomes at our institution. All cases diagnosed with PABP from 2006 to 2016 were identified. Demographic and clinica l characteristics including maternal age, previous medical and obstetric illnesses, gestational age at the onset of PABP, the development of PE/EC, GHT, gestational diabetes mellitus (GDM), treatment and outcomes, as well as neonatal health indices and anomalies were describ...
Source: Case Reports in Neurology - November 26, 2020 Category: Neurology Source Type: research

Prominent Prolongation of Cortical Silent Period Induced by Transcranial Magnetic Stimulation in Creutzfeldt-Jakob Disease
The cortical silent period (CSP) induced by transcranial magnetic stimulation (TMS) has been reported to be prolonged in 2 Creutzfeldt-Jakob disease (CJD) patients who presented with periodic myoclonus. Herein, we will show a prominent prolongation of TMS-induced CSP in a patient with CJD who did not have periodic myoclonus. The patient was a 66-year-old woman who developed rapidly progressive dementia. No myoclonic jerks were observed. Brain magnetic resonance imaging showed high-intensity lesions in the cerebral cortex, basal ganglia, and thalamus on diffusion-weighted images. Electroencephalography (EEG) showed diffuse ...
Source: Case Reports in Neurology - November 17, 2020 Category: Neurology Source Type: research

Reversible Cerebral Vasoconstriction Syndrome after Nifedipine Withdrawal
Reversible cerebral vasoconstriction syndrome (RCVS) is an essential but often unrecognized cause of intracranial haemorrhage. While there are no specific causes of the syndrome, associations with many clinical conditions and drugs have been observed, and calcium channel blockers (CCBs) are often used to relieve the symptoms. This is a case of RCVS that was triggered by the sudden withdrawal of nifedipine, a CCB.Case Rep Neurol 2020;12:440 –446 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - November 17, 2020 Category: Neurology Source Type: research

Gasperini Syndrome: A Case Report and Systematic Review and Proposing a New Definition
We report a new case and reviewed the clinical features of this syndrome from all published reports to propose a new definition. A 57-year-old man with acute br ainstem stroke had right CN V–VIII and XII palsies, left body hypoesthesia and ataxia. Brain MRI showed an acute stroke in the right caudal pons and bilateral cerebellum. After a systematic review, we classified the clinical manifestations into core and associate features based on the frequencies of occurring neurological deficits. We propose that a definitive GS requires the presence of ipsilateral CN VI and VII palsies, plus one or more of the other three c...
Source: Case Reports in Neurology - November 13, 2020 Category: Neurology Source Type: research

Rare Case of Late-Onset Narcolepsy Type 1
A 69-year-old male developed symptoms typical of the diagnosis of narcolepsy type 1 without any previous triggering events. First, daytime sleepiness occurred, soon followed by cataplexy. Nocturnal polysomnography revealed rapid eye movement (REM) sleep behavior disorder, a apnea-hypopnea index of 25.8 events/h, and no sleep-onset REM. Multiple Sleep Latency Test showed a mean sleep latency of 2.1 min and REM sleep in 3 tests. HLA DQB1*06:02 was positive and hypocretin-1 in cerebrospinal fluid unmeasurable. A treatment with 50 mg clomipramine controlled the cataplexy; excessive daytime sleepiness was sufficiently managed b...
Source: Case Reports in Neurology - November 12, 2020 Category: Neurology Source Type: research

Wound Botulism Caused by Botulinum Neurotoxin Type A in a Chronic Parenteral Drug Abuser
Botulism is an acute paralytic disease caused by botulinum neurotoxin (BoNT)-mediated inhibition of neurosignaling at the neuromuscular junction. BoNTs are produced by gram positive, anaerobic, spore-forming bacteria from the genusClostridium,most commonly Clostridium botulinum. Over the last decade, a previously uncommon form of botulism, wound botulism, has increased in prevalence possibly due to the rise in parenteral drug abuse. A 53-year-old patient with a history of drug abuse presents to a rural emergency department with rapidly progressing lower extremity weakness over the past few days. He reports a recent heroin ...
Source: Case Reports in Neurology - November 12, 2020 Category: Neurology Source Type: research

A Case of Sporadic Cerebral Small Vessel Disease in an Identical Twin
Sporadic cerebral small vessel disease (cSVD) is primarily attributed to heritability and vascular risk factors. Still, our understanding of the causative factors in cSVD lesion burden in the brain is far from complete. This is exemplified by this case of identical twins with remarkably similar vascular risk profiles, where one twin had developed severe cSVD on neuroimaging with cognitive deficits, while the other twin had no cSVD. This case highlights the need to search for further causes of cSVD, also beyond genetic and conventional vascular risk factors. Identification of other potential risk factors or disease mechanis...
Source: Case Reports in Neurology - November 10, 2020 Category: Neurology Source Type: research

Dysphagia in a Young Man
This case report presents oropharyngeal dysphagia due to oromandibular and cervical dystonia, a rare consequence of aseptic meningitis. A 19-year-old male who was diagnosed with aseptic meningitis visited the rehabilitation outpatient clinic for a sense of foreign body in his throat and odynophagia. Repetitive involuntary movements of his facial, tongue, and laryngeal muscles accompanied by lateroanterior torticollis were observed. Videofluoroscopic swallowing study showed inefficient bolus formation due to repetitive rolling of his tongue and vallecular stasis without penetration or aspiration. Dysphagia and odynophagia h...
Source: Case Reports in Neurology - November 9, 2020 Category: Neurology Source Type: research

Central Nervous System Vasculitis as a Rare Presentation of < b > < i > Mycoplasma pneumoniae < /i > < /b > : A Case Report
This report is presenting a rare case of central nervous system vasculitis secondary to MP, highlighting the diagnosis and management with a succinct literature review.Case Rep Neurol 2020;12:402 –409 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - November 9, 2020 Category: Neurology Source Type: research

Neuropsychiatric Aspects in a Patient Diagnosed with Corticobasal Degeneration: Clinical Case of Low Incidence and Prevalence in Colombia
Corticobasal degeneration (CBD) is a pathology of low incidence and prevalence worldwide; it is accompanied by symptoms such as dystonia, rigid akinetic syndrome (bradykinesia), gait disturbances, neurological deterioration associated with severe cortical subcortical atrophy, and progressive to moderate to severe neurocognitive deficits, especially in immediate verbal memory and dorsolateral or dysexecutive syndrome. We identified neurocognitive impairment and neuropsychiatric symptoms in a patient diagnosed with CBD. Participant was a 70-year-old female patient, single; she presented progressive memory loss of an immediat...
Source: Case Reports in Neurology - November 9, 2020 Category: Neurology Source Type: research

A Patient with Limbic Encephalitis, Ear Perichondritis, and Episcleritis – An Unusual Presentation of Relapsing Polychondritis
We report a patient with limbic encephalitis associated with RPC, where PET/CT was effectively used in the diagnosis, and monitoring of response to treatment. We also demonstrate that it can be a useful modality in certain situations when brain magnetic resonance imaging cannot be done.Case Rep Neurol 2020;12:378 –386 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - November 3, 2020 Category: Neurology Source Type: research