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 high-...
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 (Sour...
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. Time o...
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
