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A severe, relapsing case of myelin oligodendrocyte glycoprotein IgG-associated CNS inflammation
A 55-year-old man presented in October 2004 with general unease, vomiting, and gait disturbance. Initially diagnosed with an inner ear infection, the patient's symptoms did not improve and he was evaluated further. MRI revealed a cerebellar lesion, which led to the suspicion of a posterior circulation stroke, and he was started on antiplatelet drugs. However, an angiogram suggested no vascular pathology. In March 2011, he had another episode of ataxia and MRI showed a right brainstem lesion. Cryptogenic stroke was reconsidered. In March 2013, the patient developed paraparesis with urinary and bowel symptoms. MRI revealed m...
Source: Neurology Clinical Practice - February 12, 2018 Category: Neurology Authors: Saviour, M., Hamid, S., Moore, P., Mutch, K., Bhojak, M., Duddy, M., Jacob, A. Tags: All Demyelinating disease (CNS), Devic's syndrome, Optic neuritis; see Neuro-ophthalmology/Optic Nerve, Transverse myelitis Case Source Type: research

Hickam's dictum versus ockham's razor
A 56-year-old man presented with evolving symptoms of left-sided weakness and fatigue over six months. Examination revealed spastic hemiparesis. MR brain imaging revealed confluent, oedematous white matter lesions in the right hemisphere without restricted diffusion or enhancement. Initial CSF analysis was unremarkable, including negative JC virus. Blood screen revealed a mild lymphopaenia. CT scanning of the viscera showed pulmonary changes which revealed, via transbronchial biopsy, non-caseating granulomata suggesting pulmonary sarcoidosis. High dose prednisolone was commenced following which the weakness improved. Metho...
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: Marchant, R., Bunting, E., Barritt, A., Good, C., Adams, N., Merve, A., Wickremaratchi, M. Tags: Immunology (including allergy), Neuroimaging, Stroke, Radiology, Surgical diagnostic tests, Radiology (diagnostics) ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research

Recurrent headaches: a case of neurological Behçet's disease.
Abstract A 48-year-old black male, of Nigerian heritage, presented with a 24-hour history of frontal headache of gradual onset. The headache characteristic was migranous, being described as throbbing in nature and located to the right frontal area with associated blurring of vision. Although similar to prior frequent headaches, there was now increasing unsteadiness on walking. Diagnosed 10 years earlier with Behçet's disease, the initial presentation was with oral and genital ulceration. Recurrent episodes of headache caused by neurological flare-ups resulted in a stroke at the age of 46 years. This previous stro...
Source: British Journal of Hospital Medicine - October 9, 2013 Category: Internal Medicine Authors: M Ismail A, W Dubrey S, C Patel M Tags: Br J Hosp Med (Lond) Source Type: research