Intracranial Major Artery and Venous Sinus Thrombosis in a Young Male with MTHFR Mutation and Protein S Deficiency
This case represents a unique example of stroke in a young patient involving major venous sinuses as well as major artery in a span of 6 months. After evaluation, he was found to have an abnormal thrombophilia profile. In young patients with recurrent stroke, investigating for an abnormal thrombophilia profile is crucial.Case Rep Neurol 2021;13:744 –748 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - November 18, 2021 Category: Neurology Source Type: research
EEG Contribution to the Diagnosis of Antibody-Negative Autoimmune Encephalitis: A Case Report
Autoimmune encephalitis (AE) is a group of inflammatory brain diseases that are characterized by prominent neuropsychiatric symptoms. Early therapeutic intervention is important for AE. Therefore, without waiting for autoantibody test results, clinicians must consider the possibility of AE based solely on clinical symptoms and conventional test results. The case described herein is of antibody-negative encephalitis with abnormalities shown only by EEG, which contributed to the diagnosis and treatment. The patient, a 20-year-old woman, showed autonomic seizures in addition to movement disorders, psychiatric symptoms, and co...
Source: Case Reports in Neurology - November 18, 2021 Category: Neurology Source Type: research
Erratum
Case Rep Neurol 2021;13:738 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - November 17, 2021 Category: Neurology Source Type: research
Bilateral Orbitofrontal Repetitive Transcranial Magnetic Stimulation in Frontal Lobe Epilepsy: A Case Report
This article reports a patient with frontal lobe epilepsy. We aimed to investigate whether bilateral orbitofrontal (OFC) low-frequency rTMS (LF-rTMS) is feasible and tolerable, safe, and potentially clinically effective in treating epileptic seizures. The patient ’s satisfaction with rTMS therapy was self-reported to be high, as rTMS helped in reducing the frequency of the focal attacks and completely abolished the preceding feeling of fear and panic. Therefore, bilateral OFC rTMS treatment can be well tolerated in patients with frontal epilepsy although t he findings of the present case report with regard to clinical ef...
Source: Case Reports in Neurology - November 16, 2021 Category: Neurology Source Type: research
Anti-Ma2-Associated Limbic Encephalitis after Termination of Immune Checkpoint Inhibitor Therapy for Malignant Pleural Mesothelioma
Neurological adverse events of immune checkpoint inhibitor (ICI) therapy mostly develop within 3 months after initiation of ICI treatment. An 82-year-old male with malignant pleural mesothelioma developed anti-Ma2-associated limbic encephalitis at a delay of 18 months after the start of nivolumab therapy (3 months after termination of a 15-month course of ICI treatment). Immunotherapy with steroids and immunoglobulins resulted in moderate neurological improvement. Over the next year, malignant pleural mesothelioma gradually worsened, while the anti-Ma2 antibody test remained positive. Anti-Ma2 paraneoplastic encephalitis m...
Source: Case Reports in Neurology - November 8, 2021 Category: Neurology Source Type: research
Alice in Wonderland Syndrome-Like Seizure and Refractory Supraventricular Tachycardia
We report an unusual case of an elderly man who presented with AIWS, focal impaired awareness seizures, ictal tachyarrhythmia, multiple episodes of transient visual disturbances of macropsia and transient loss of consciousness. During those symptoms, telemetry showed self-limited supraventricular tachycardia several times which could not be regulated with heart rate-controlled medication. The electroencephalography was later tested and showed rhythmic theta activity over the right cerebral hemisphere. He was treated with levetiracetam, and all his symptoms and tachyarrhythmias were gradually resolved thereafter. Refractory...
Source: Case Reports in Neurology - November 2, 2021 Category: Neurology Source Type: research
Intrathecal Administration of Nusinersen Using the Ommaya Reservoir in an Adult with 5q-Related Spinal Muscular Atrophy Type 1 and Severe Spinal Deformity
We present a 28-year-old patient with SMA type 1 and severe spinal deformity, who received nusinersen via a subcutaneously implanted Ommaya reservoir connected with an intrathecal catheter at the thoracic level. The repetitive administrations were completed uneventfully, obviating the need for repeated laborious lumbar punctures and eliminating radiation exposure. In adult SMA patients, performing recurrent lumbar punctures can be technically challenging raising the need for an alternative route of administration. The use of Ommaya reservoirs is a viable, practical for repeated infusions, and safe option for the intratheca...
Source: Case Reports in Neurology - October 26, 2021 Category: Neurology Source Type: research
Intravenous Thrombolysis for a Stroke Mimic Patient
The authors present the case of a young woman on phentermine and herbal supplements who presented as an acute stroke alert with right-sided facial droop and numbness. She was treated acutely with intravenous tissue plasminogen activator (tPA). However, the workup did not reveal any evidence of cerebrovascular disease or cerebral infarct. The authors discuss plausible stroke mimics and the safety of administering tPA to such patients.Case Rep Neurol 2021;13:704 –709 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - October 25, 2021 Category: Neurology Source Type: research
Organized Chronic Subdural Hematoma: A Condition Presenting Mixed-Density Hematoma without Gradation Density on Brain CT
Organized chronic subdural hematoma is a neurological condition characterized by organized clot formation inside the hematoma. Unlike nonorganized chronic subdural hematoma with persistent bleeding inside, organized subdural hematoma is often a nonurgent condition that does not require emergency drainage, unless progressive cerebral compression with neurological disturbances is present. However, as the CT values in organized clot formation and active bleeding fall in similar ranges, distinguishing these 2 conditions with different emergency levels based on brain CT alone is sometimes difficult. Here, we describe the case o...
Source: Case Reports in Neurology - October 25, 2021 Category: Neurology Source Type: research
Posterior Reversible Encephalopathy Syndrome Induced by Hypomagnesemia due to < b > < i > Clostridium Difficile < /i > < /b > in a Patient with Kidney Transplant
Hypomagnesemia is found in 12% of hospitalized patients and up to 60% of intensive care unit patients and is associated with a variety of organ dysfunction. Posterior reversible encephalopathy syndrome is a neurologic hyperperfusion disorder that mostly affects posterior portions of the brain. Various theories were proposed to explain whether hypomagnesemia is etiology or associated with posterior reversible encephalopathy syndrome (PRES). A patient with kidney transplantation suffered from fatigue and reduced urine output due to chronic diarrhea induced byClostridium difficile. Hypoparathyroidism in addition to persistent...
Source: Case Reports in Neurology - October 22, 2021 Category: Neurology Source Type: research
Neurosarcoidosis Presenting as Young-Onset Chronic Headache: A Case Report
We present an interesting case of a 30-year-old nonalcoholic, nonsmoker man who presented with a chronic headache of 6 years. He had a recent swaying of the body for 6 months and mild forgetfulness for 4 months. The patient had 2 episodes of facial nerve palsy in the past – which had responded to the treatment of Bell’s palsy; however, the patient had some residual findings on presentation. While CSF findings suggested meningeal tube rculosis, the radiological evidence and biopsy confirmed the diagnosis of neurosarcoidosis. On follow-up after 6 weeks of steroid therapy, the patient displayed a marked improvement in hea...
Source: Case Reports in Neurology - October 21, 2021 Category: Neurology Source Type: research
Cortical Hyper-Connectivity in a Stroke Patient with Rotated Drawing
In the present case report, we investigated the cortical networks of a patient (DDA) affected by right parietal stroke who showed a constructional phenomenon, in which when coping and recalling from memory a complex figure, the model was reproduced rotated of 90 ° along the vertical axis. Previous studies suggested that rotation on copy is associated with visuospatial impairments and abnormalities in parietal cortex, whereas rotation on recall might be related to executive deficits and dysfunction of frontal regions. Here, we computed the DDA’s resting-s tate functional connectivity (FC) derived from cortical regions of...
Source: Case Reports in Neurology - October 19, 2021 Category: Neurology Source Type: research
Atypical Perfusion Manifestation in Migraine with Aura
Migraine with aura may be confused with a stroke. Magnetic resonance imaging is an important tool for the differential diagnosis. Cerebral hypoperfusion has been described in classic migraine, mainly during the aura. A 47-year-old male had an unremarkable past medical history. After sneezing, he developed a left hemi hypoesthesia, bitemporal vision loss, photopsia, and some distortion in the position of letters and words. This lasted #x3c;1 h, and it was followed by a severe headache. A magnetic resonance angiography was performed during the headache. It showed a left hemispheric hypoperfusion that did not correlate with t...
Source: Case Reports in Neurology - October 12, 2021 Category: Neurology Source Type: research
Hypoxic-Ischemic Injury of Basal Ganglia Associated with the COVID-19 Infection: Case Report
We report a case of a patient diagnosed with COVID-19 who presented bilateral lesions of the basal ganglia related to a severe acute respiratory distress syndrome. This observation allows expanding the neurological spectrum of COVID-19 particularly in patients with a more severe clinical course.Case Rep Neurol 2021;13:668 –671 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - October 4, 2021 Category: Neurology Source Type: research
Anti-NMDA Receptor Encephalitis in a Patient with Tuberous Sclerosis-Related Brain Tumor: A Case Report
We present a case of a 35-year-old woman with recurrent episodes of schizophrenia-like symptoms. Accidentally, MRI revealed TSC-related brain tumors. NMDAR antibody titers were strongly positive in serum and cerebrospinal fluid. This is the first case describing an overlap of NMDARE and TSC-related brain tumors. A review of brain tumors and NMDARE is given in the supplementary material. Although a causal link seems interesting from a pathophysiological point of view, we are in favor of a coincidence.Case Rep Neurol 2021;13:634 –641 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - September 30, 2021 Category: Neurology Source Type: research
