Atypical Association of Autoimmune Limbic Encephalitis with Anti-NMDA Receptor Antibodies in a Young Male Patient: Clinical, Imaging, and Neuropsychological Characteristics
The spectrum of autoimmune encephalitis (AE) encompasses several entities characterized by a variable frequency of psychiatric symptoms, cognitive dysfunction, focal deficits, and seizures. Although patients with AE can be categorized in specific syndromes, overlapping manifestations are also common. Furthermore, atypical correlations between clinical phenotypes and autoantibody profiles could occur in rare cases. Here, we report the rare case of a young adult man attending due to new-onset seizures and a history of memory loss, autonomic disturbances, headache, behavioral changes, and visual and olfactory hallucinations. ...
Source: Case Reports in Neurology - August 19, 2021 Category: Neurology Source Type: research
Idiopathic Arachnoiditis of the Cauda Equina: A Case Report from Tanzania
We present a 26-year-old male with progressive lower back pain with radiation to the lower extremities, aggravated by movement and touch. We diagnosed idiopathic arachnoiditis based on cerebrospinal fluid analysis and magnetic resonance imaging. He was managed with a 5-day course of methylprednisolone and analgesics with a good outcome. Severe back pain without a specific cause in a young patient should be investigated with proper imaging modalities and lumbar puncture if warranted to evaluate the cause.Case Rep Neurol 2021;13:535 –540 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - August 19, 2021 Category: Neurology Source Type: research
A Middle-Aged Man Presented with Quadriparesis during COVID-19 Pandemic
The clinical presentation of COVID-19 is varied: from asymptomatic to severe neurological syndrome like stroke can happen. Guillain-Barr é syndrome (GBS) as a manifestation of COVID-19 is not very common. GBS is an acute immune-mediated polyradiculoneuropathy that usually occurs following previous exposure to infection. Here, we are reporting a case of GBS related to COVID-19 infection. The reported case presented with quadriparesis and was diagnosed with GBS after evaluation. At the same time, his RT-PCR for COVID-19 was also positive. Interestingly, this patient suffered from COVID-19 2 months before this presentation. ...
Source: Case Reports in Neurology - August 18, 2021 Category: Neurology Source Type: research
Test Battery Approach to Assess an Individual with Cerebral Venous Sinus Thrombosis: A Speech Language Pathologist ’s Perspective
Cerebral venous sinus thrombosis (CVST) is an uncommon stroke that has a varied clinical profile. Quite often, speech language pathologists limit the assessment of these patients to a language assessment alone. Subsequently, it is possible that they may miss out certain relevant information which can aid them in their intervention. The aim of the current study was to highlight the relevance of adopting a test battery approach to assess a patient diagnosed with CVST. Here, we present a test battery approach to assess a 43-year-old patient who reported to us after CVST. The test battery included various formal and informal m...
Source: Case Reports in Neurology - August 4, 2021 Category: Neurology Source Type: research
Mind the Gap: Acetazolamide Prolonged Periods without Paralysis in a Girl with Andersen-Tawil Syndrome
We present a case report of a 13-year-old girl with Andersen-Tawil Syndrome (ATS), a rare genetic disorder which is characterized by dysmorphic features, ventricular arrhythmias, and frequent episodes of muscle paralysis that interfere with daily activities and social engagement. After the introduction of off-label treatment with acetazolamide periods without paralysis lengthened, our patient became more independent of the help of her parents and required a wheelchair less frequently, thus improving her social life. Based on our experience, we recommend a trial of acetazolamide in patients with ATS.Case Rep Neurol 2021;13:...
Source: Case Reports in Neurology - August 2, 2021 Category: Neurology Source Type: research
Repeated Intravenous Thrombolysis in Patients with Recurrent Ischemic Stroke in the Vertebrobasilar Territory
Acute ischemic vertebrobasilar stroke (AIVBS) is usually associated with poor outcome and prognosis and in case of basilar artery occlusion (BAO) with high mortality. Intravenous thrombolysis (IVT), as a standard recanalization therapy of acute ischemic stroke (IS) within first 4.5 h, can be administrated beyond this therapeutic time window in case of symptomatic BAO. Repeated IVT is generally contraindicated in case of early recurrent IS, despite a risk of poor outcome or death after recurrent IS. The aim was to present 2 cases of repeated IVT for recurrent AIVBS and discuss specific situations where repeated IVT may be c...
Source: Case Reports in Neurology - July 29, 2021 Category: Neurology Source Type: research
Case Report: Ulcerative Colitis with Multiple Dural Venous Thrombosis
In conclusion, the sudden onset and/or acute worsening of neurological status such as headache and mental confusion in a patient with UC should alert the treating physician about the possibility of CVT so that timely intervention could be employed to prevent disabling and potentially lethal se quelae of this disease.Case Rep Neurol 2021;13:504 –509 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - July 29, 2021 Category: Neurology Source Type: research
Nemaline Myopathy: A Case Report
Generalized weakness in the pediatric and adolescent population is caused by many disorders that affect the neuromuscular axis. As next-generation sequencing (NGS) is becoming of high yield in replacing more invasive procedures, that is, muscle and nerve biopsy, more previously undiagnosed diseases of the muscles are now labeled with specific pathogenicity. A 16-year-old-girl diagnosed with nemaline myopathy but previously was misdiagnosed with congenital myasthenia and put-on unnecessary medications. Clinicians should be aware of congenital diseases that affect the muscles and know the importance of the NGS in reaching th...
Source: Case Reports in Neurology - July 21, 2021 Category: Neurology Source Type: research
Lower Urinary Tract Symptoms in Myasthenia Gravis
In conclusion, our study results showed that MG patients had significantly more LUTSs (overactive bladder) than healthy control subjects and had worse LUTS-related QOL; therefore, amelioration of LUTS in MG is important.Case Rep Neurol 2021;13:490 –498 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - July 20, 2021 Category: Neurology Source Type: research
Coming to Terms with a Conundrum: A Case of Primary Progressive Apraxia of Speech due to Corticobasal Degeneration?
Primary progressive apraxia of speech (PPAOS) is a progressive disorder impairing the motor speech act leaving linguistic function unattained. Although apraxia of speech frequently co-occurs with other neurodegenerative conditions, PPAOS defines a clinical syndrome where apraxia of speech is the sole or prominent symptom for much of the disease ’s natural history. Mounting evidence is beginning to fully define this disease as the epiphenomenon of 4-repeat (4R) tau pathology although other pathologic signatures have been reported. Indeed, PPAOS patients generally present a parkinsonian syndrome late into their natural his...
Source: Case Reports in Neurology - July 20, 2021 Category: Neurology Source Type: research
Sellar Gangliocytoma: Case Report and Review of an Extremely Rare Tumour
In conclusion, this patient presented with a silent SG with likely pituitary hyperplasia. SGs are a challenging diagnosis, have a benign course, and may provide insights into PA tumourigenesis.Case Rep Neurol 2021;13:475 –482 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - July 19, 2021 Category: Neurology Source Type: research
Myocardial Injury and Stroke after Attempted Suicide
Self-stabbing is an uncommon method of suicide and attempt of suicide, mostly chosen by young men and people with a psychiatric history. A curious case of suicide attempt by self-stabbing with a huge pointed knife in a 56-year-old man is presented which resulted in a myocardial injury and was evaluated with a stroke after cardiorrhaphy.Case Rep Neurol 2021;13:470 –474 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - July 19, 2021 Category: Neurology Source Type: research
Therapy-Resistant Atypical Downbeat Nystagmus with Vertigo Confined to Specific Head-Hanging Positions: Mapping to the Gravity Vector on a Multi-Axis Turntable
Downbeat nystagmus (DBN) observed in head-hanging positions, may be of central or peripheral origin. Central DBN in head-hanging positions is mostly due to a disorder of the vestibulo-cerebellum, whereas peripheral DBN is usually attributed to canalolithiasis of an anterior semicircular canal. Here, we describe an atypical case of a patient who, after head trauma, experienced severe and stereotypic vertigo attacks after being placed in various head-hanging positions. Vertigo lasted 10 –15 s and was always associated with a robust DBN. The provocation of transient vertigo and DBN, which both showed no decrease upon repeti...
Source: Case Reports in Neurology - July 19, 2021 Category: Neurology Source Type: research
Neuropsychiatric Aspects in a Patient Diagnosed with Frontotemporal Dementia: Clinical Case of Low Incidence and Prevalence Disease in Colombia
Frontotemporal dementia (FTD) is a neuropsychiatric pathology characterized by dysfunctions in the frontal lobe of the brain, especially in planning, execution, and inhibition tasks, with an inability to make decisions and handle different sequences, also affecting the temporal lobe. The patient presents alterations to store, consolidate, and recall information. These neurocognitive deficits are accompanied by neurobehavioral disorders such as depression, anxiety, and apathy that contribute to the worsening of the quality of life, with a high impact on the individual, social, and family level. To identify the neurobehavior...
Source: Case Reports in Neurology - July 8, 2021 Category: Neurology Source Type: research
Aneurysm Arising at the Origin of a Duplicated Middle Cerebral Artery
A duplicated middle cerebral artery (DMCA) is a common anomaly. However, aneurysms arising from the origin of a DMCA are extremely rare. A 22-year-old female was admitted to our hospital with a World Federation of Neurosurgical Societies grade 2 subarachnoid haemorrhage. Four-vessel angiography revealed a DMCA and an aneurysm arising from the origin of this artery. The aneurysm was successfully treated by embolization, and the patient was discharged 2 weeks later. Ruptured aneurysms arising from the origin of a DMCA can be successfully treated by embolization. These aneurysms are small and 3D-computed tomography reconstruc...
Source: Case Reports in Neurology - July 8, 2021 Category: Neurology Source Type: research
