ABSTRACT
Central pontine myelinolysis (CPM) and extrapontine myelinolysis (EPM) are well recognized syndromes related to the rapid correction of hyponatremia. Cognitive dysfunction and neuropsychological findings, however, have seldom been reported. We present a case of EPM without CPM and report the neuropsychological findings. Neuropsychological testing showed severe impairment of attention, verbal and visual memory, visuospatial functioning, and frontal/executive functioning. Language and language-related functions were normal except for naming. Follow-up neuropsychological testing at 4 months later showed slightly less impairment than the first assessment.
Subject(s)
Follow-Up Studies , Hyponatremia , Memory , Myelinolysis, Central Pontine , Neuropsychological TestsABSTRACT
Paroxysmal kinesigenic dyskinesia (PKD), previously referred to as movement-provoked seizures, is a rare neurological condition that is characterized by short duration dystonic or choreoathetotic movements precipitated by sudden movement, a change in position or hyperventilation. It can be difficult to distinguish this syndrome from seizures. We reported on three brothers in one family all of whom developed abnormal involuntary dystonic or choreoathetotic movement with a tingling or stiffness sensory aura. Evaluations of the patients included general physical examinations, endoclinologic, metabolic studies, chromosomal analysis, video electroencephalograms and brain MRI imaging. All of these studies were normal except for an arachnoid cyst found in one patient. All symptoms showed excellent response to oxcarbamazepine (Trileptal(R)) or carbamazepine. Use of the video electroencephalogram can help differentiate familial PKD from seizures.
Subject(s)
Humans , Arachnoid , Brain , Carbamazepine , Dyskinesias , Electroencephalography , Epilepsy , Hyperventilation , Magnetic Resonance Imaging , Physical Examination , Seizures , SiblingsABSTRACT
Intracranial dermoid cysts are rare benign lesions and account for approximately 0.3% of all brain tumors. Rupture of a dermoid cyst with spillage of its contents into a subarachnoid space or ventricles is a potentially serious complication that can lead to meningitis, seizures, cerebral vasospasm and hydrocephalus. Here, we present a case of intracranial dermoid cyst rupture with cerebral infarction in the right midbrain and thalamus.
Subject(s)
Brain Neoplasms , Cerebral Infarction , Dermoid Cyst , Hydrocephalus , Meningitis , Mesencephalon , Rupture , Seizures , Subarachnoid Space , Thalamus , Vasospasm, IntracranialABSTRACT
A 29-year-old man with schizophrenia was admitted to the emergency department in a stupor following the first generalized tonicclonic seizure. He had drunk about 1.5 L of Coke and 2 L of water each day for 1 week without eating any other food. A laboratory evaluation revealed severe hyponatremia (110 mEq/L), and we diagnosed a hyponatremia-induced seizure. As polydipsia and hyponatremia are not uncommon in schizophrenics, hyponatremia-induced seizure should be included in the causes of seizure in schizophrenics.