Neuromielitis óptica y lupus eritematoso sistémico en un hombre: caso clínico / Neuromyelitis optica presenting concomitantly with systemic lupus erythematosus: report of one case

Neuromyelitis optica (NMO) is a severe demyelinating disease of the central nervous system, which preferentially attacks the optic nerve and spinal cord. It is associated with antibodies against aquaporin 4. Morbidity and mortality are higher than in multiple sclerosis and its treatment focuses on immunosuppressive drugs. Immunomodulators are contraindicated. We report a previously healthy 35-year-old man, presenting with NMO concomitantly with systemic lupus erythematosus. His evolution was torpid with three outbreaks in the 10 months after the diagnosis, requiring a first-line therapy with methylprednisolone and cyclophosphamide and then a second-line therapy with rituximab.

Ataxia hemiparética en un infarto lacunar lentículo-capsular con evolución favorable: Algunas consideraciones fisiopatológicas / Hemiparetic ataxia secondary to a lenticulo-capsular infarction with favorable outcome: Report of one case

Hemi paretic ataxia (HA) is a lacunars syndrome that presents with motor deficit and pyramidalism associated to ipsilateral ataxia out of proportion to such deficit. Topography of lesions is wide and acute infarcts have been recognized at the infernal capsule, pons, thalamus, corona radiate and cortex. Symptoms are associated to involvement of pyramidal and corticopontocerebellar tracts. We report a 44-year-old mole presenting with right hemi paresis and severe ataxia. The magnetic resonance imaging showed a sub acute infarction of the left lenticular nucleus and infernal capsule. The patient was treated with physiotherapy, anti platelet agents and statins and was discharged with an evident recovery.

Neurobrucellosis: report of a case with CVA manifestation

Although neurological symptoms in brucellosis are frequent, central nervous system [CNS] involvement is uncommon. A 42-year-old man was admitted with an episode of faint without loss of consciousness, right hemi paresis, diplopia and headache lasting for four days. The neurological examination revealed left hemi paresis. Limitation of gazing in left eye in lateral view was seen [partial paresis of 6[th] cranial nerve]. The results of laboratory examinations show positive Wright and Coombs Wright in blood and C.S.F. In the brain CT scan hydrocephaly and in magnetic resonance imaging [MRI] some brain atrophy, few high signal foci in the deep with mater had been detected. Treatment included concurrent administration of three drugs: doxycycline, rifampicin and co-trimoxazole. This patient fully recovered. We suggest that Neurobrucellosis [NB] should always be sought in young patients with ischemic stroke, especially if they do not have any additional risk factors for stroke and live in an endemic area for brucellosis, even if they do not have other systemic signs of brucellosis

Primary neurological manifestations of lung cancer--a retrospective analysis of 8 patients.

Neurological manifestations are reported in 5 to 10% of cases of lung cancer. We present a series of 216 consecutive patients of lung cancer of which 8 patients presented first with neurological manifestations without overt respiratory symptoms. The present study aimed to identify the number of patients of lung cancer presenting with primary neurological symptoms, the nature of the presentations, and the outcome of these patients among 216 patients who presented over a 2 year period in the Institute of Postgraduate Medical Education and Research, Kolkata. Out of 8 patients, 3 patients presented with seizures, 3 patients with hemiparesis and 2 patients with paraparesis. Thus, 3.7% (8/216) of patients in our series presented with a neurological manifestation. We concluded that primary neurological manifestations are rare in lung cancer. The lungs should be the first site of evaluation in a case of a cerebral metastasis with an unknown primary.

Tetraparesia fláccida / Flaccid tetraparesis

In this paper we review a clinical case of a man of 66 years old admitted to the medicine service of the Clinical Hospital of the University of Chile, with a clinical setting of flaccid tetraparesis associated with myalgias, dysphagia, dysphonia, reddish-violaceous eruption on the upper eyelids, periungual erythema and erythema distributed over the anterior neck and chest. We take this case to review the cases of flaccid tetraparesis that can be due to systemic, neuromuscular or psychiatric diseases. The clinical approach begins with the anamnesis: drugs consumption, or systemic diseases; continues with the physical examination orientated to stablish compromise of first or second motoneuron. Finally laboratory test as muscle enzymes, endocronologic test, and others like electromyography and muscle biopsy. We also review the actual tratments and the outcome and prognosis with each of them

Lissauer form of paretic neurosyphilis with a cerebral mass lesion

Registro de caso de paciente do sexo masculino com 40 anos de idade em que a tomografia computadorizada revelou a presença de processo expansivo no hemisfério cerebral direito. Os exames do líqüido cefalorraqueano e biópsia cerebral evidenciaram as características de neurossífilis. Após penicilinoterapia foi constatada atrofia focal no hemisfério cerebral direito. Este caso sugere que a forma de Lissauer da paralisia geral progressiva pode manifestar-se como processo expansivo cerebral