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Teaching NeuroImages: Posterior reversible encephalopathy syndrome resulting in hydrocephalus
A woman with prior lung transplantation presented with headaches, seizure, and obtundation. Head MRI (figure) revealed obstructive hydrocephalus and hyperintensity on T2-weighted imaging in the bilateral thalami and brainstem. Management included antiepileptic medications, ventriculostomy placement, and cessation of tacrolimus for concern of atypical posterior reversible encephalopathy syndrome (PRES). Infectious and paraneoplastic etiologies were ruled out. An autoimmune process was unlikely due to immunosuppression. There was rapid clinical improvement with repeat MRI revealing resolution of hydrocephalus and T2 changes....
Source: Neurology - June 5, 2016 Category: Neurology Authors: Paolini, S., Jadhav, A. P. Tags: Hydrocephalus, Secondary headache disorders, Other cerebrovascular disease/ Stroke RESIDENT AND FELLOW SECTION Source Type: research

Oculomotor Nerve Palsy after Herpes Zoster Opthalmicus: A Case Report and Review of Literature (P1.297)
Conclusions: HZO is manifestation of re-activation of herpes zoster with involvement of ophthalmic division of trigeminal nerve. CNIII palsy after HZO is rare, especially with associated pupillary defect. The long term prognosis is felt to be excellent with use of antiviral agents and steroids.Disclosure: Dr. Shaker has nothing to disclose. Dr. Rai has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Shaker, H., Rai, V. Tags: Herpes Virus Infections Source Type: research

Susceptibility to MELAS Exacerbations in a POLG1 Mutation Carrier (P5.264)
We describe a case of a 46-year-old woman who presented with expressive aphasia, disorientation, and inappropriate laughter. She notably had a history of bilateral sensorineural hearing loss and two stroke-like episodes in her 30s characterized by left hemiparesis. Over the preceding six months, she experienced rapidly progressive vision loss, headaches, and an episode of non-convulsive status epilepticus. Incidentally, she had undergone renal transplantation nine months earlier for autosomal dominant polycystic kidney disease, and was on immunosuppressive therapy with two calcineurin inhibitors—cyclosporine and tacr...
Source: Neurology - April 3, 2016 Category: Neurology Authors: Nadkarni, D., Restrepo, L. Tags: General Neurology: Genetics Source Type: research