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Teaching NeuroImages: Bilateral hypertrophic olivary degeneration following posterior circulation stroke
A 40-year-old comatose man was brought to the hospital with a history of posterior circulation stroke 4 months earlier due to hypertension. On examination, he had spastic quadriplegia, bilateral extensor plantar reflex, and palatal myoclonus. MRI revealed enlarged olives (figure 1) and chronic infarcts involving midbrain and pons (figure 2) suggestive of hypertrophic olivary degeneration seen after 4 months of insult. Hypertrophic olivary degeneration is a transsynaptic degeneration involving interconnecting fibers of inferior olivary nucleus, red nucleus, and contralateral dentate nucleus forming the 3 corners of the Guil...
Source: Neurology - October 30, 2017 Category: Neurology Authors: Venkatesh, M., Prasad, V. R. S., Basha, S. U., Priya, G. H. J. Tags: MRI, Coma, All Cerebrovascular disease/Stroke, All Education, Infarction RESIDENT AND FELLOW SECTION Source Type: research

Zika associated Guillain-Barre syndrome in the United States (P2.327)
Conclusions:Zika can induce GBS after a brief viral illness. Neuropathy can be a mixture of demyelinating and axonal. Dysautonomia may also be present including severe dysphagia, orthostatics and retention.Zika RNA has a short detection window in serum and CSF making a diagnosis time sensitive. Serological assays using IgM and IgG cross-react with other flaviviruses making them unable to differentiate between recent Zika exposure and cross reactivity with Dengue and Chikungunya. Our pt likely had prior exposure to Dengue, being from an endemic area. Prior Dengue exposure may possibly modulate the response to Zika via antib...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Tantillo, G., Sclar, G., Vasa, C., Shin, S., Sivak, M. Tags: Zika, Chikungunya, West Nile Virus, and Other Viral Infections I Source Type: research

A Rare Neurological Complication of Waldenstroms Macroglobulinemia (P5.183)
Conclusions:Diagnostic approach to bilateral FNP should evaluate for: traumatic (skull fractures), infectious (classically Lyme disease), metabolic (diabetes), autoimmune (sarcoidosis, Guillain-Barré syndrome), congenital (Moebius syndrome) and neoplastic (brainstem tumors) entities. WM is a rare cause, a condition due to low-grade B cell lymphoma where lymphoplasmacytoid cells infiltrate different tissues and secrete monoclonal IgM. Peripheral neuropathy develops in 15–30% of the cases, usually a chronic, progressive, symmetric, predominantly distal polyneuropathy. Facial nerve impairment is unusual, caused b...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Acosta, G. T., Gadhia, R., Leslie-Mazwi, T. Tags: Neuro-oncology: Brain and CNS Metastases Source Type: research

Isolated Tongue Hemi-Atrophy from Hypoglossal-Vertebral Entrapment Syndrome (P3.377)
Conclusion: Hypoglossal vertebral entrapment syndrome from a structural vascular anomaly or anomalous vascular course is an extremely rare cause of isolated hypoglossal nerve palsy. Only a few cases have been reported in the literature. Imaging studies and careful exclusion of other potential etiologies is essential to establish the diagnosis.Disclosure: Dr. Roy has nothing to disclose. Dr. Bakradze has nothing to disclose. Dr. Ollenschleger has nothing to disclose. Dr. Felice has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Roy, B., Bakradze, E., Ollenschleger, M., Felice, K. Tags: General Neurology Source Type: research

Mycoplasma pneumoniae infection presenting as stroke and meningoencephalitis with aortic and subclavian aneurysms without pulmonary involvement- a rare case report (P5.122)
Conclusion Mycoplasma infection should be considered in patients presenting with fever, aseptic meningitis and stoke even in absence of respiratory symptoms. Early detection and treatment with appropriate antibiotics offers excellent outcome.Disclosure: Dr. Inshasi has nothing to disclose. Dr. Sarathchandran has nothing to disclose. Dr. Almadani has nothing to disclose. Dr. Alrukn has nothing to disclose. Dr. Alboudi has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Inshasi, J., Sarathchandran, P., Almadani, A., Alrukn, S., Alboudi, A. Tags: Ischemia, Myelitis, and Vascular Malformations Source Type: research