Adult Abdominal Migraine Improved by OnabotulinumtoxinA Injections
Abdominal migraine is often regarded as a childhood disorder and less commonly described in adults. However, gastrointestinal symptoms are known to occur to adult migraine patients, and recognition of adult abdominal migraine may facilitate treatment of the recurrent abdominal symptoms and avoidance of unproductive and sometimes invasive therapies. Here, I describe a patient with chronic migraine headaches and recurrent abdominal pain both of which showed sustained improvement after treatment with onabotulinumtoxinA injections.Case Rep Neurol 2021;13:656 –659 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - September 30, 2021 Category: Neurology Source Type: research
Spinal Cord Ischemia Secondary to Aortic Dissection: Case Report with Literature Review for Different Clinical Presentations, Risk Factors, Radiological Findings, Therapeutic Modalities, and Outcome
We report a 64-year-old male, presented with severe back pain, asymmetrical paresthesia, and weakness of both limbs, more in the left lower limb with loss of pinprick, temperature, and fine touch sensation on the lower left lower limb below the level of T5 with preserved proprioception and vibration and urine hesitancy. Computed tomography showed AD, Stanford type A, and spinal magnetic resonance imaging (MRI) showed hyperintense owl ’s eye sign at T5. The patient was diagnosed as anterior spinal artery syndrome secondary to an AD and referred for aortic surgical repair with good functional outcome. In our review to case...
Source: Case Reports in Neurology - September 28, 2021 Category: Neurology Source Type: research
Characteristic Magnetic Resonance Image Features of Acute Network Injury in Young Patients
Cerebral infarction is known to cause secondary degeneration of the areas connected to the primarily damaged regions. This has been named as acute network injury and is usually recognized in newborns or babies by high signal intensity on diffusion-weighted imaging (DWI). In this article, we present 2 cases demonstrating several characteristics of network injury. Some features are comparable to previous studies and others are distinctive to our cases. The patients not only showed secondary injury in the thorough pyramidal tract along the longitudinal extensions of neural tracts as expected but also followed transverse conne...
Source: Case Reports in Neurology - September 21, 2021 Category: Neurology Source Type: research
A Case of Reversible Cerebral Vasoconstriction Syndrome: Postpartum Cerebral Angiopathy in a 32-Year-Old Primigravid Treated with Intravenous Immunoglobulin
This is a case of a 32-year-old primigravid who developed sudden severe headache on the 7th day postpartum associated with focal neurologic deficits and altered sensorium. She had a GCS score of 6, anisocoric pupils and an NIHSS score of 31. Cranial MRI with MRA showed multifocal hyperacute to acute infarcts on the left occipital lobe, left thalamus, and midbrain which was more prominent on the right. Due to clinical deterioration, a repeat Cranial MRI with MRA was done and showed progression of infarcts involving both thalami and right pons with interval appearance of contour irregularities in the proximal anterior cerebr...
Source: Case Reports in Neurology - September 14, 2021 Category: Neurology Source Type: research
Elderly-Onset Multiple System Atrophy with Lewy Body Pathology: A Case Report
An 81-year-old woman presented with a 2-year history of progressive dysarthria and gait disturbance. Subsequently, she developed orthostatic hypotension, obstructive sleep apnea, right-sided resting tremor, and rigidity. Together with characteristic findings of imaging studies, she was diagnosed with multiple system atrophy (MSA). Despite progressive dysphagia and repeated choking episodes, the patient elected not to use artificial feeding or tracheostomy. She died suddenly at age 91 after 12 years of illness. The autopsy revealed neuropathological features of both MSA and of Parkinson ’s disease. The peripheral autonomi...
Source: Case Reports in Neurology - September 14, 2021 Category: Neurology Source Type: research
Neurosarcoidosis Mimicking the Recurrence of Malignant Lymphoma
A 67-year-old woman with a recurrent history of malignant lymphoma (ML) presented with muscle weakness and paresthesia of the fingertips and feet. Due to the elevated level of serum soluble interleukin-2 receptor and increased18F-fluorodeoxyglucose uptake in a mediastinal lymph node, neurolymphomatosis was initially suspected. Neurological and electrophysiological examinations were consistent with mononeuropathy multiplex. A diagnosis of neurosarcoidosis was made based on the presence of noncaseating epithelioid granulomas in the mediastinal lymph node, along with the presence of the uveitis, cardiac inflammation, and mono...
Source: Case Reports in Neurology - September 14, 2021 Category: Neurology Source Type: research
Successful Treatment of a Paroxysmal Kinesigenic Dyskinesia Patient with Carbamazepine-Induced Stevens-Johnson Syndrome Using Oxcarbazepine Monotherapy: A Case Report
We report a 21-year-old male patient with PKD referred to our movement disorders clinic after being misdiagnosed with conversion syndrome. PRRT2 gene testing using next-generation sequencing revealed a mutation in c.649dupC p. (Arg217fs). The patient responded well to carbamazepine but had to withdraw the treatment due to carbamazepine-induced Stevens-Johnson syndrome after 3 weeks of medication. Our patient did not respond to trials of levetiracetam and phenytoin but finally responded well to oxcarbazepine. The patient was followed up for 4 years, during which he had no attacks and no side effects. Here, we present a PKD ...
Source: Case Reports in Neurology - September 13, 2021 Category: Neurology Source Type: research
Brain Tumor Presenting with Parkinsonism
We describe and discuss a 59-year-old female pati ent who presented for several months of increasing tremor in her left hand, which was caused by a large meningioma located in the right frontal area, pressing on the right frontal lobe and nucleus lenticularis.Case Rep Neurol 2021;13:595 –597 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - September 13, 2021 Category: Neurology Source Type: research
Unusual Presentation of Cerebral Lupus: A Case Report of Parkinsonism in Cerebral Lupus
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with multisystem involvement that follows a relapsing and remitting course. It is characterized by an immune-mediated response to own body defense mechanism and mistakenly attacked healthy cells of the skin, joints, kidneys, blood cells, and nervous system. Cerebral lupus refers to a constellation of neurological and/or behavioral clinical syndromes in patients with SLE. The spectrum of presentation can vary widely ranging from mild symptoms such as headaches, slight cognitive dysfunction, and mood disorders to more serious conditions like seizures, stroke,...
Source: Case Reports in Neurology - September 13, 2021 Category: Neurology Source Type: research
TMS-Induced Seizure during FDA-Approved Bilateral DMPFC Protocol for Treating OCD: A Case Report
Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive brain stimulation therapy that has become a method of choice for the treatment of several neuropsychiatric disorders such as depression and OCD. It is considered to be a safe and well-tolerated treatment, with only few side effects. The most serious adverse event during any rTMS treatment is the potential induction of a seizure. rTMS has shown very encouraging results for treatment-resistant OCD, although the optimal target area and the stimulation frequency are still matters of controversy. Here, we present a 19-year-old female patient with OCD who exper...
Source: Case Reports in Neurology - September 9, 2021 Category: Neurology Source Type: research
Medical Case Report on Repeat Treatment of Restless Legs Syndrome with Intravenous Infusion of Iron
Restless legs syndrome (RLS) is a debilitating neurological disorder for which a range of medical interventions with varied efficacy has been employed. Based on evidence of iron deficiency in the substantia nigra of the midbrain, there are reports of substantial benefits from intravenous iron infusion. This case report demonstrates a strong statistically significant negative correlation between serum ferritin and RLS severity of symptoms in a subject with RLS who received 2 intravenous infusions of ferric carboxymaltose over a period of 464 days. The results provide further evidence to support the treatment strategy.Case R...
Source: Case Reports in Neurology - September 2, 2021 Category: Neurology Source Type: research
Bihemispheric Cortical Infarcts in an Adult Secondary to < b > < i > Escherichia coli < /i > < /b > K1 Meningitis
This study demonstrates the necessity of early diagnosis and treatment ofE. coli meningitis to prevent neurological complications, including stroke.Case Rep Neurol 2021;13:572 –577 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - August 24, 2021 Category: Neurology Source Type: research
Early-Onset Vascular Dementia in a 43-Year-Old Man with Accelerated Atherosclerotic Disease, Elevated Lipoprotein (a), and a Missense DNAJC5 Variant with Potential Association to Adult-Onset Ceroid Lipofuscinosis
In conclusion, in patients with early-onset dementia and evidence of accelerated atherosclerosis, it is reasonable to measure Lp(a) and consider testing for variants in genes such as DNAJC5 and others, particularly when disease severity appears unexplained by known risk factors or circumstances.Case Rep Neurol 2021;13:565 –571 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - August 24, 2021 Category: Neurology Source Type: research
Varied Presentation and Importance of MR Neurography of the Common Fibular Nerve in Slimmer ’s Paralysis
We present 5 cases of slimmer’s paralysis in patients who had lost 32–57 kg in approximately 1 year. In 2 cases, MR neurogram of the knee demonstrated abnor malities of the common fibular nerve at the fibular head. Two patients underwent a common fibular nerve decompression at the fibular head and attained improved gait and sensorimotor function. Weight loss, diabetes mellitus, and immobilization may have contributed to slimmer’s paralysis in 1 case. Awareness of slimmer’s paralysis in patients who have lost a significant amount of weight in a short period of time is imperative to detect and treat a fibular nerve n...
Source: Case Reports in Neurology - August 19, 2021 Category: Neurology Source Type: research
Leucine-Rich Glioma-Inactivated Protein 1 Antibody-Positive Polyradiculopathy Associated with Epstein-Barr Virus Infection
Epstein-Barr virus (EBV) has been associated with a plethora of neurological manifestations including polyneuropathy and polyradiculopathy. A 27-year-old man with a recent upper respiratory system infection presented with difficulty in walking. His neurological examination revealed reduced muscle strength in both proximal and distal lower limb muscles without sensory and autonomic signs. Needle electromyography showed abnormal spontaneous activity and reduced recruitment of motor units in muscles innervated by multiple lumbo-sacral roots. Cerebrospinal examination showed increased protein levels with normal cell counts. Wh...
Source: Case Reports in Neurology - August 19, 2021 Category: Neurology Source Type: research
