Basilar Artery Embolism Mimicking Transient Global Amnesia in a 61-Year-Old Female: A Case Report
We present the case of a 61-year-old female with clinical appearance of TGA. MRI and duplex scan revealed punctiform and patchy ischemic lesions in both temporal lobes and right vertebral artery dissection, suggesting basilar artery embolism as the underlying cause. Our case report shows that TGA can be a symptom of ischemic lesions in the hippocampus and patients with presentation of additional focal neurologic symptoms or atypical distribution or appearance of t he diffusion-weighted image (multiple/patchy) lesions should get ischemic stroke diagnosis and treatment.Case Rep Neurol 2022;14:19 –24 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - February 1, 2022 Category: Neurology Source Type: research
Late-Onset Guillain-Barr é Syndrome and Right Facial Nerve Palsy after COVID-19 Infection
Here, we present a case of late-onset Guillain-Barr é syndrome (GBS) associated with COVID-19. A 70-year-old woman presented with ascending paralysis and right lower motor neuron facial weakness 2 months after COVID-19 infection. Test results for SARS-CoV-2 immunoglobulin were positive at the time of presentation. Lumbar puncture showed albuminocyto logical dissociation, and electrophysiology showed features of demyelination with secondary axon loss. In the published literature on GBS associated with COVID-19, almost all patients presented with neurological symptoms 1–4 weeks after the infection. GBS can be an early or ...
Source: Case Reports in Neurology - January 18, 2022 Category: Neurology Source Type: research
An Evidence-Based Approach to Diagnosis and Prognosis in a Young Woman with New-Onset Super-Refractory Status Epilepticus: A Case Report
We describe a case of a 24-year-old female who presented with confusion and myoclonus. Electroencephalogram revealed NORSE that evolved into super-refractory status epilepticus. Her CSF showed a mild lymphocytic pleocytosis, and her MRI demonstrated changes in the bilateral temporal lobes. She was ultimately diagnosed with GAD65 autoimmune encephalitis and treated with immune-modulating therapy. This case highlights the complex diagnostic workup of patients with NORSE and the utility of validated prediction models for diagnosis and prognosis. While maintaining a broad differential, the patient ’s Antibody Prevalence in E...
Source: Case Reports in Neurology - January 17, 2022 Category: Neurology Source Type: research
Pathological Laughter Prodromal to a Stroke of the Head of the Left Caudate Nucleus
A 38-year-old right-handed female with a past history of intermittent painful rash, dizzy spells, and chronic daily headaches as well as episodic migraines experienced an episode of transient involuntary pathological laughter, right arm weakness, and expressive dysphasia. She was found on MRI to have multiple strokes in multiple vascular distributions, including one in the head of the left caudate. A cardiac ECHO found an atrial myxoma, with extensive evaluation for other causes of stroke unrevealing. The differential diagnosis for pathological laughter in this patient is discussed. The most plausible cause in this patient...
Source: Case Reports in Neurology - January 13, 2022 Category: Neurology Source Type: research
Autonomic Status Epilepticus in a Patient with Parasellar Meningioma: A Case Report
Autonomic status epilepticus (Aut SE) is a condition characterized by ongoing focal autonomic seizure lasting for #x3e;30 min. Aut SE can show a variety of clinical manifestations including vomiting, nausea, changes in heart rate, piloerection, pupillary abnormalities, and visual abnormalities. Although Aut SE is a common finding in childhood in the context of Panayiotopoulos syndrome, few reports have described this condition during adulthood. In the present report, we describe a case of Aut SE in an adult patient with parasellar meningioma and bilateral frontotemporal epileptiform activity on EEG record.Case Rep Neurol 2...
Source: Case Reports in Neurology - December 27, 2021 Category: Neurology Source Type: research
Mimicking Amyotrophic Lateral Sclerosis: A Case of a Spinal Dural Arteriovenous Fistula
We present a novel mimicking disorder. A 58-year-old male, without relevant past medical history, presented with a 7-year history of progressive paraparesis. On examination, he had bilateral thigh atrophy, fasciculations, and asymmetric paraparesis (severe on the left side). Upper motor neuron signs were present in the lower limbs, with normal sensory examination. Needle EMG disclosed mild chronic neurogenic changes in the lower limbs. Brain and spinal cord neuroimaging was normal, namely, in the dorso-lumbar segment. Lumbar puncture showed mild hyperproteinorachia. Diagnosis of slowly progressive (possible) ALS was establ...
Source: Case Reports in Neurology - December 27, 2021 Category: Neurology Source Type: research
Treatment of Dysphagia with Biofeedback and Functional Electrical Stimulation in a Patient with Wallenberg Syndrome: A Prospective Case Report
Biofeedback games and automated functional electrical stimulation (FES) can be used in the treatment of dysphagia. This case study aims to evaluate the effect of the treatment on a 77-year-old man with chronic Wallenberg syndrome and his and the therapist ’s experiences when using this therapy form. The participant received intensive treatment for nine days with Facial Oral Tract Therapy, biofeedback games and FES. The Penetration Aspiration Scale was scored using Functional Endoscopic Evaluation of Swallowing at baseline and the end of the interve ntion period. Swallowing-specific parameters were measured daily, and int...
Source: Case Reports in Neurology - December 22, 2021 Category: Neurology Source Type: research
Bilateral Paragangliomas in the Setting of Autonomic Dysfunction: A Case Report
In 2018, a 59-year-old female patient presented with hoarseness in her voice, headache, intermittent pain in her right side, difficulty of right arm movement, left side neck pain, difficulty controlling hypertension of unknown etiology, and a large mass on the upper left side of her neck with a smaller mass on the right side. MRI of the neck revealed masses at each carotid bifurcation. These were determined to be bilateral paragangliomas. Paragangliomas are rare tumors, and bilateral ones tremendously so. The patient underwent radiation over 2 years, resulting in the successful shrinking and stabilization of both masses. S...
Source: Case Reports in Neurology - December 16, 2021 Category: Neurology Source Type: research
Does Madopar Have a Role in the Treatment of Prolonged Disorders of Consciousness? A Call for Randomized Controlled Trials
It is suggested that dopaminergic treatment may contribute to accelerated improvement in patients with a disorder of consciousness (DoC). Dopamine is an important stimulatory neurotransmitter, which plays a key role in alertness, arousal, behavior, emotion, cognition, and motor function. We discuss our experience with Madopar in 2 patients with DoC and review the literature on dopaminergic medication in patients with DoC.Case Rep Neurol 2021;13:782 –789 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - December 16, 2021 Category: Neurology Source Type: research
Three Generations of FLNA-Associated Periventricular Nodular Heterotopia
We present a family with 3 generations of FLNA gene-associated periventricular nodular heterotopia (PVNH), with a unique presentation in a fetus with multiple neurologic malformations. Neurologic abnormalities were noted on routine fetal imaging for a 33-year-old G1P0 woman; absence of the corpus callosum and PVNH was confirmed on follow-up MRI. This prompted genetic evaluation, revealing a nonsense mutation in the FLNA gene. Familial genetic analysis and neuroimaging revealed the same variant and MRI evidence of PVNH in the fetus ’s asymptomatic mother, and maternal grandmother, who had a long history of seizure disorde...
Source: Case Reports in Neurology - December 9, 2021 Category: Neurology Source Type: research
Distressing Belching with Chorea Induced by Caudate Infarction
Although belching is mostly associated with gastrointestinal disorders, it occasionally accompanies movement disorders such as Parkinsonism or dystonia. A woman in her 80s presented distressing belching and chorea of the right arm and leg from 3 years earlier. A brain MRI showed a left caudate infarction and atrophic change. Haloperidol significantly improved belching and chorea. Caudate infarction can cause distressing belching with chorea. It might be important to select the appropriate drug by referring to the accompanying involuntary movement to treat belching with movement disorders.Case Rep Neurol 2021;13:772 –775 ...
Source: Case Reports in Neurology - December 7, 2021 Category: Neurology Source Type: research
A Complex Phenotype of a Patient with Spastic Paraplegia Type 4 Caused by a Novel Pathogenic Variant in the < b > < i > SPAST < /i > < /b > Gene
In conclusion, the missense variant inSPAST may cause a complex SPG4 phenotype accompanied by epilepsy and cognitive impairment, suggesting that the clinical manifestations of this condition do not confine to the motor system.Case Rep Neurol 2021;13:763 –771 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - December 7, 2021 Category: Neurology Source Type: research
Oculomotor Nerve Palsy as a Presenting Symptom of Epstein-Barr Virus-Associated Infectious Mononucleosis: Case Report and Review of the Literature
We report on a 23-year-old man with subacute oculomotor nerve palsy followed by symptoms of IM 6 days later. Primary EBV infection was confirmed by PCR detection of EBV DNA in blood as well as by subsequent serology. High-resolution magnetic resonance imaging revealed an edematous change at the root exit zone and gadolinium enhancement of the right oculomotor nerve as well as pial enhancement adjacent to the right ventral mesencephalon. A review of the literature identified 5 further patients with isolated oculomotor nerve palsy as the presenting symptom of unfolding primary EBV infection. MRIs performed in 3 of those 5 pa...
Source: Case Reports in Neurology - November 29, 2021 Category: Neurology Source Type: research
Notice of Duplicate Publication
Case Rep Neurol (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - November 24, 2021 Category: Neurology Source Type: research
PARK2 Patient Presenting with Dopa-Responsive Dystonia
We report a 34-year-old female PARK2 patient presenting with dopa-responsive dystonia (DRD). She noticed difficulty in raising her foot while walking at the age of 24. Her lower limb symptoms were identified as dystonia later, and she was started on Menesit, which resulted in improvement of her symptoms. She was diagnosed as DRD and has been on continuous treatment since then. The specific binding ratio (SBR) of123I FP-CIT SPECT was significantly lower than those of controls of the same age, but123I-meta-iodobenzylguanidine myocardial scintigraphy showed a normal heart to mediastinum ratio. The Montreal Cognitive Assessmen...
Source: Case Reports in Neurology - November 23, 2021 Category: Neurology Source Type: research
