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Atypical presentation of giant cell arteritis in a patient with vertebrobasilar stroke: A case report
Rationale: Giant cell arteritis (GCA) is known to present with typical manifestations like temporal headache and visual abnormalities. However, several cases with atypical manifestations were reported. Stroke occurs in 3% to 7% of patients with GCA. Patient concerns: A 67-year-old male patient with known hypertension presented with somnolence, disorientation and mild bilateral limb ataxia. The magnetic resonance imaging showed multiple acute infarctions in the territory of the vertebrobasilar system with occlusion of the left vertebral artery. Diagnosis: Ten months later, during a routine neurovascular follow-up, r...
Source: Medicine - August 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

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

Parvovirus B19 infection associated with hemolytic anemia and cranial polyneuropathy
AbstractParvovirus B19 (PB19) is a common, widespread, small, single-stranded DNA virus which has been linked with a broad spectrum of clinical illnesses, including a variety of neurological complications such as encephalitis, meningitis, myelitis, stroke, cerebellar ataxia, and neuropathy. The authors describe a case of PB19 infection associated with hemolytic anemia and cranial polyneuropathy involving the second and third cranial nerves in a 23-year-old immunocompetent woman. The diagnosis of acute PB19 infection was established with detection of positive DNA and anti-PB19 IgM antibodies in blood samples. Antigangliosid...
Source: Journal of NeuroVirology - August 22, 2017 Category: Neurology Source Type: research

Acute ischemic stroke in a young female: a novel presentation of anti-GAD autoimmunity (P3.272)
Conclusions:Restricted diffusion, seen typically in ischemia, indicates cytotoxic oedema and irreversible cell damage. In this patient, we postulate a mechanism of severe CNS inflammation with cellular toxicity and small vessel vasculitis. Anti-GAD autoimmunity should be considered in young patients presenting with stroke-like episodes, particularly when accompanied by positive phenomenon.Disclosure: Dr. Neo has nothing to disclose. Dr. Lee has nothing to disclose. Dr. Lee has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Neo, X. S., Lee, K. E., Lee, R. Tags: Cerebrovascular Disease Case Reports II Source Type: research

A Rare Presentation of Chronic Lymphocytic Inflammation with Pontine Perivascular Enhancement Responsive to Steroids (CLIPPERS) as Acute Ischemic Stroke (P6.112)
CONCLUSIONS: This case illustrates not only a classic clinical and radiographic case of CLIPPERS, but also that this recently recognized disorder can be easily misdiagnosed as a neuromuscular disease in the early stages, and stroke in the more severe stages. Rarely, the inflammatory infiltrate can result in stroke in these patients, and is likely the cause of the acute exacerbation of our patient’s symptoms. This case also demonstrates the need for contrast imaging whenever possible, as the non-contrast imaging failed to identify the characteristic diffuse enhancing punctate lesions.Disclosure: Dr. Gadhia has nothing...
Source: Neurology - April 3, 2016 Category: Neurology Authors: Gadhia, R., Smith, S., Lai, E., Lee, A. Tags: MS and CNS Inflammatory Disease: CNS Inflammatory Diseases and Differential Diagnosis Source Type: research

Anti glutamic acid decarboxylase antibody mediated encephalopathy while on etanercept in a patient with multiple autoimmune diseases
A 39 year old lady presented with an altered mental state and unsteadiness of gait. She had a history of juvenile idiopathic arthritis, autoimmune thyroiditis and alopecia, protein S deficiency with vena cava thrombosis, previous excision of ovarian mass and vasculitic rash. There was a previous history of ovarian mass and her immunomodulatory therapy for arthritis over the previous year was Etanercept. She used recreational cannabis but denied any other illicit drug usage. Her affect was variable and at times inappropriate with frequent laughter. She would spit regularly. There was anxiety and a prevailing sensation of do...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: MacDougall, N., Waddell, B., O'Riordan, J. I. Tags: Immunology (including allergy), Brain stem / cerebellum, Drugs: CNS (not psychiatric), Epilepsy and seizures, Infection (neurology), Stroke, Drugs misuse (including addiction), Connective tissue disease, Musculoskeletal syndromes Association of British Source Type: research