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
Multiple Microbleeds: A Serious Neurological Manifestation in a Critically Ill COVID-19 Patient
We describe here the clinical, radiological, and laboratory findings as well as the 90-day outcome of a 72-year-old gentleman who presented with severe SARS-CoV-2 infection, leading to diffuse cerebral microhemorrhages and ischemic infarct causing severe morbidity. He was tested positive for COVID-19 confirmed by reverse transcriptase polymerase chain reaction.Case Rep Neurol 2020;12:373 –377 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - November 2, 2020 Category: Neurology Source Type: research
Guillain-Barr é Syndrome Heralding the Diagnosis of Hodgkin Lymphoma: A Case Report
Lymphoma is a prevalent type of lymphoid tissue malignancy that is seldom associated with Guillain-Barr é syndrome (GBS). In the majority of instances, both Hodgkin’s and non-Hodgkin’s lymphoma are not proceeded by GBS. Here, we report on a case of a young patient with a manifestation and investigation suggestive of GBS, signaling an unconfirmed diagnosis of Hodgkin’s lymphoma. A cerebrospinal fluid test revealed an albuminocytological dissociation with a noteworthy rise in protein (2.32 g/L). The patient was initiated on intravenous immunoglobulin (IVIG) treatment and then showed dramatic improvement after the thir...
Source: Case Reports in Neurology - October 30, 2020 Category: Neurology Source Type: research
Avoiding Anchoring Bias in the Times of the Pandemic!
We present a patient of COVID-19 pneumonia who presented with dyspnea and acute confusional state. His initial workup was suggestive of tuberculous meningoencephalitis with lymphocytic pleocytosis, high protein in CSF analysis, and suspicious MRI findings, which was later confirmed with a positive CSF culture. To the best of our knowledge, it is the first such case. Anchoring to the diagnosis of COVID-19 may deter clinicians from considering other concurrent diagnoses and a poor outcome consequently.Case Rep Neurol 2020;12:359 –364 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - October 9, 2020 Category: Neurology Source Type: research
Exploding Head Syndrome: A Case Series of Underdiagnosed Hypnic Parasomnia
Exploding head syndrome (EHS) is an under-recognized parasomnia characterized by a complaint of sudden loud noise or a sense of explosion in the head that usually occurs at sleep onset. This paper is a report of 6 patients diagnosed with EHS through a structured clinical interview and video-polysomnography (vPSG) recordings. We also reviewed the available literature that addressed the presentation and clinical and PSG characteristics of EHS. The case series included 4 men and 2 women of a mean age of 44.2 years (between 13 and 77 years). Their episodes were variable in expression, between a sudden firecracker-like explosio...
Source: Case Reports in Neurology - October 8, 2020 Category: Neurology Source Type: research
Paraneoplastic Stiff Person Syndrome in Early-Stage Breast Cancer with Positive Anti-Amphiphysin Antibodies
We present the case of a patient with paraneoplastic SPS, presenting with muscle cramps of lower extremities that progressed to severe muscle rigidity and spasms, associated with a right breast tumor and positive anti-amphiphysin antibodies. Paraneoplastic SPS is a rare neurological disorder, challenging for the physicians both to diagnose and treat.Case Rep Neurol 2020;12:339 –347 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - October 2, 2020 Category: Neurology Source Type: research
A Case of HaNDL with Low Cerebrospinal Fluid Level of Neurofilament Light Chain
We present a case presenting with characteristic features of HaNDL and an MRI lesion in the splenium of corpus callosum. CSF neurofilament light chain (NFL) levels were assessed in this patient together with 7 additional HaNDL patients, 18 multiple sclerosis (MS) patients, and 15 primary headache patients. Both HaNDL and primary headache patients showed significantly lower NFL levels than MS patients. Our results suggest that increased CSF levels of NFL and neuroaxonal loss are not characteristic features of HaNDL. Neurological disorders mimicking HaNDL often present with increased levels of NFL, and thus CSF measurement o...
Source: Case Reports in Neurology - October 2, 2020 Category: Neurology Source Type: research
A Pyramidal Cause of a Cerebellar Ataxia: HSP-7
A 43-year-old man presented with a slowly progressive fatigue and coordination problems, coupled with a radiological appearance of diffuse atrophy, especially in the cerebellar hemispheres. The diagnostic process was challenging because initially the additional investigations were focused on a cerebellar ataxia. In the following months, his ataxic gait developed in a more spastic pattern and whole exome sequencing revealed mutations in the SPG7 gene, confirming a diagnosis of hereditary spastic paraplegia. Therefore, the authors call for an extension of genetic panels in ataxia patients.Case Rep Neurol 2020;12:329 –333 (...
Source: Case Reports in Neurology - October 2, 2020 Category: Neurology Source Type: research
COVID-19 Related Cerebrovascular Thromboembolic Complications in Three Young Patients
Coronavirus disease 2019 (COVID-19) is a viral illness, caused by the novel severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). It is currently affecting millions of people worldwide and is associated with coagulopathy, both in the venous and arterial systems. The proposed mechanism being excessive inflammation, platelet activation, endothelial dysfunction, and stasis. As an ongoing pandemic declared by WHO in March 2020, health systems worldwide are experiencing significant challenges with COVID-19-related complications. It has been noticed that patients with COVID-19 are at greater risk of thrombosis.Case Rep N...
Source: Case Reports in Neurology - September 28, 2020 Category: Neurology Source Type: research
A Case of Cervical Spondylotic Amyotrophy Mimicking Amyotrophic Lateral Sclerosis
We present the case of a 57-year-old female who presented with a 1-year history of left-hand weakness and wasting with no sensory deficits. She denied any involvement of her other hand or bilateral lower limbs, and she was referred to our clinic with the potential diagnosis of amyotrophic lateral sclerosis (ALS). An elaborate history, physical examination, electrophysiological studies, and imaging assisted us in reaching the diagnosis of CSA, 1 year after the onset of symptoms.Case Rep Neurol 2020;12:314 –320 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - September 18, 2020 Category: Neurology Source Type: research
An Atypical Presentation of CLIPPERS, a Challenging Diagnosis of Reversible Early-Onset Dementia
Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a rare inflammatory disorder featured by pontocerebellar dysfunctions and, in some cases, later cognitive disturbances. Here, we describe an atypical presentation of CLIPPERS, characterized by clinical onset with neuropsychiatric and cognitive symptoms. A 45-year-old man was referred to our Memory Clinic due to difficulties at work for over a month, caused by confusion and asthenia. Furthermore, insomnia and mood changes appeared. These disturbances were unresponsive to antipsychotic and antidepressant drugs. At admi...
Source: Case Reports in Neurology - September 18, 2020 Category: Neurology Source Type: research
