Status Epilepticus Secondary to Hypocalcemia Due to Vitamin D Deficiency
We present such a case in a 6-month-old infant who presented with status epilepticus secondary to hypocalcemia due to vitamin D deficiency, which was first misdiagnosed as epilepsy. Thereby, we want to emphasize that hypocalcemia secondary to vitamin D deficiency can lead to convulsion and the importance of vitamin D supplementation.Case Rep Neurol 2022;14:124 –129 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - March 15, 2022 Category: Neurology Source Type: research
Yellow-Coloured Left Homonymous Visual Hemi-Field after Ischaemic Stroke
We report a patient ’s challenging case who suffered two acute ischaemic strokes, first in the right occipital lobe and later in the right dorsolateral thalamus (with affection of the lateral geniculate nucleus) who developed a yellow-tinted left homonymous visual hemi-field. No previously described case matched our peculiar symptom presentation in combination with the described brain lesions. Especially, the visual phenomena of patients with these brain lesions that were up until now described in literature were complex and vivid visual hallucinations. Here, we discuss possible explanations and mechanisms of t his visua...
Source: Case Reports in Neurology - March 14, 2022 Category: Neurology Source Type: research
Nerve Ultrasound Findings before and after Surgery in a Patient with Charcot-Marie-Tooth Disease Type 1A and Comorbid Carpal Tunnel Syndrome
The diagnosis of comorbid carpal tunnel syndrome (CTS) in patients with Charcot-Marie-Tooth (CMT) disease is challenging due to the overlapping symptoms and inconclusive electrodiagnostic studies (EDX). This case report is aimed at illustrating the value of ultrasonography (US) in a patient with CMT1 disease and comorbid CTS. A 28-year-old woman presented with symptoms of painful paresthesia and weakness of both hands. EDX demonstrated a demyelinating sensory-motor polyneuropathy in the upper and lower extremities, consistent with CMT1 disease. US showed an increased cross-sectional area (CSA) of the median nerve at the ca...
Source: Case Reports in Neurology - March 10, 2022 Category: Neurology Source Type: research
Dysarthria-Facial Paresis and Rostral Pontine Ischemic Stroke
We describe an acute, postoperative dysarthria-facial paresis. While the rare stroke syndrome has been described previously, we present an under-described clinical nuance to its presentation with a particularly clear imaging correlation. A 78-year-old, right-handed man with a past medical history of aortic stenosis presented after a transcatheter aortic valve replacement. Immediately postoperatively, no neurological deficits were noted. That evening, he described his speech as “drunken.” He was later noted to have a right lower facial droop in addition to the speech change. His speech exhibited labial, lingual, and (to...
Source: Case Reports in Neurology - March 10, 2022 Category: Neurology Source Type: research
Late-Onset Pompe Disease Presenting with Isolated Tongue Involvement
Late-onset Pompe disease (LOPD) is a rare autosomal recessive metabolic disorder that is caused by deficiency of the lysosomal enzyme acid alpha-glucosidase (GAA), which is responsible for glycogen breakdown. It has a wide clinical spectrum but usually presents with limb girdle and respiratory muscles weakness. Tongue involvement has been rarely reported as the sole initial symptom of LOPD. A 65-year-old male presented with difficulty in speech and eating for a 4-year duration. He started to notice speech difficulty with production of particular speech sounds such as /l/, /d/, and /t/. Within 1 year, he developed difficult...
Source: Case Reports in Neurology - March 10, 2022 Category: Neurology Source Type: research
Cardiac Structure and Function in Epilepsy Patients with Drug-Resistant Convulsive Seizures
High frequency of convulsive seizures and long-lasting epilepsy are associated with an increased risk of sudden unexpected death in epilepsy (SUDEP). Structural changes in the myocardium have been described in SUDEP victims. It is speculated that these changes are secondary to frequent convulsive seizures and may predispose to SUDEP. The aim of this cross-sectional study was to investigate the impact of chronic drug-resistant epilepsy on cardiac function and structure in patients with a high frequency of convulsive seizures. We consecutively included 21 patients (17 women, 4 men) aged 18 –40 years, with at least 10 years...
Source: Case Reports in Neurology - March 10, 2022 Category: Neurology Source Type: research
Frontotemporal Brain Sagging Syndrome as a Treatable Cause Mimicking Frontotemporal Dementia: A Case Report
Frontotemporal brain sagging syndrome (FBSS) is a progressive disorder characterized by symptoms similar to the behavioral variant of frontotemporal dementia (FTD), with a sagging appearance of the brain on imaging similar to that observed in spontaneous intracranial hypotension (SIH). The onset of behavioral and cognitive symptoms of FBSS is insidious and progressive, similar to those of FTD. Here, we report a case involving a 53-year-old man with progressive hypersomnolence, apathy, forgetfulness, and personality changes but without headache or auditory symptoms. The combination of frontotemporal dysfunction, hypersomnol...
Source: Case Reports in Neurology - February 15, 2022 Category: Neurology Source Type: research
Plasmapheresis for Extrapontine Myelinolysis: A Case Series and a Literature Review
We present our findings from a series of successfully treated patients at a high-volume tertiary care center in Sri Lanka, with an appraisal of available literature. A total of 21 patients with established ODS are analyzed here, including 5 cases of EPM managed by the authors over a 2-year period. Thirteen (40.2%) patients were treated with plasmapheresis alone, 6 (28.5%) received dual therapy (TPE + IVIG or steroids) and 2 (9.5%) received triple therapy (TPE + IVIG + steroids). There was complete or near complete response in 18 (85.7%) and complete response in 10 (47.6%) patients. We conclude that although the management ...
Source: Case Reports in Neurology - February 15, 2022 Category: Neurology Source Type: research
Right Tegmental Hemorrhage with Urinary Retention: A Case Report
The upper brainstem tegmentum is dense and complex, making it difficult to localize functions to specific subregions. In particular, the precise location and possible laterality of subregions supporting basic functions like consciousness and urinary continence remain unclear. Here, we describe a patient who presented with a right pontine tegmental syndrome caused by intraparenchymal hemorrhage. Despite hemorrhage extension into the fourth ventricle and expansion of both hemorrhage and edema into a large region of the caudal midbrain and right-sided pontine tegmentum, this patient did not lose consciousness. Instead, he dev...
Source: Case Reports in Neurology - February 15, 2022 Category: Neurology Source Type: research
Parsonage-Turner Syndrome Following COVID-19 Vaccination: Clinical and Electromyographic Findings in 6 Patients
We describe the clinical and electromyographic features of 6 patients presenting with the clinical picture of PTS following COVID-19 vaccination. All patients were referred for electromyographic studies to evaluate the acute onset of pain in the shoulder girdle/upper limb accompanied by muscle weakness in the distribution of one or more branches of the brachial plexus. Each patient had received the COVID-19 vaccine within a few weeks prior to the onset of symptoms. Patients underwent detailed neurological examinations followed by nerve conduction and EMG studies. The patients developed symptoms after a mean duration of 17 ...
Source: Case Reports in Neurology - February 15, 2022 Category: Neurology Source Type: research
Belly Dancer ’s Dyskinesia: 3 Cases of a Rare Entity
We present 3 cases of belly dancer’s dyskinesia, in which differential diagnostic work-up did not uncover known etiologies for this movement disorder. Strikingly, 2 patients manifested vitamin B12 deficiency while 1 case showed values close to the lower limit of normal. Wh ile relevance of vitamin B12 levels remains elusive, all patients improved substantially following a combined therapeutic approach of clonazepam treatment and vitamin B12 supplementation.Case Rep Neurol 2022;14:51 –57 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - February 15, 2022 Category: Neurology Source Type: research
Large Intraneural Ganglion Cyst in the Peroneal Nerve
This report demonstrates the utility of nerve ultrasound in differentiating between different causes of peroneal nerve dysfunction.Case Rep Neurol 2022;14:44 –50 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - February 15, 2022 Category: Neurology Source Type: research
Progressive Multifocal Leukoencephalopathy and Immune Reconstitution Inflammatory Syndrome after Discontinuation of Fingolimod
We present a clinical case of a patient with MS who, after the withdrawal of fingolimod, developed PML-IRIS despite sustained lymphopenia. This is important for pharmacovigilance purposes, not only for NTZ but also for alternative drugs used in MS treatment.Case Rep Neurol 2022;14:38 –43 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - February 7, 2022 Category: Neurology Source Type: research
Cervical Myelopathy Associated with Deep Neck Muscle Rhabdomyolysis after Polysubstance Abuse: A Case Report
When used appropriately, buprenorphine and oxycodone are safe drugs. They are, however, widely abused in combination with other drugs. Here we describe a case series of 8 patients with cervical myelopathy and rhabdomyolysis of the adjacent deep neck muscles after using an opioid in combination with other drugs. All patients were young males who had a previous history of polysubstance abuse. Six of the patients had used buprenorphine in combination with pregabalin and/or benzodiazepines, and one patient had used oxycodone with pregabalin and/or benzodiazepines. One patient used buprenorphine with amphetamine. After taking t...
Source: Case Reports in Neurology - February 7, 2022 Category: Neurology Source Type: research
Opioid-Induced Leukoencephalopathies: A Report of Two Cases
We report a case of ATL along with a case of DPHL happening in young male patients with OI, including their clinical courses as well as imaging characteristics with comparable time intervals. Initially, both leukoencephalopathies typically show magnetic resonance imaging findings with confluent and symmetric white matter (WM) abnormalities in the periventricular regions on T2 and fluid-attenuated inversion recovery images along with restricted diffusion on diffusion-weighted imaging. The DPHL patient however also presented with WM cystic substance loss in the deterioration phase, several weeks after hospital admission, whi...
Source: Case Reports in Neurology - February 1, 2022 Category: Neurology Source Type: research
