Primary Diffuse Leptomeningeal Gliomatosis: Report of a Case Presenting with Chronic Meningitis

Neoplastic meningitis occurs in approximately 5% of patients with cancer. Primary diffuse leptomeningeal gliomatosis is a rare condition whereby a glioma arises from heterotopic cell nests in the leptomeninges. We report here a case presenting with clinical features similar to those of chronic infectious meningitis without positive cerebrospinal fluid cytology. Neurological signs in our patient deteriorated progressively without responding to antitubercular, antiviral, or antibiotic therapy. Leptomeningeal biopsy sampling revealed the condition to be primary diffuse leptomeningeal gliomatosis.

A Case of Ophthalmoplegia Caused by Herpes Zoster Ophthalmicus

Ophthalmoplegia may accompany herpes zoster ophthalmicus(HZO). A 60-year-old woman with rheumatoid arthritis suffered from HZO in the right side consecutively developed a mydriasis and abduction deficit in the right eye. CSF examination revealed pleocytosis and increased protein, while magnetic resonance imaging of the brain was normal. She was treated with intravenous acyclovir for 7 days. Ophthalmoplegia was completely resolved over the following 8 weeks, but mydriasis persisted.

A Case of Myasthenia Gravis Associated with Aplastic Anemia

Myasthenia gravis is occasionally associated with other autoimmune diseases. Aplastic anemia of autoimmune type has been reported to coincide with myasthenia gravis, particularly with thymoma. A 63-year-old woman with diplopia and ptosis was diagnosed as myasthenia gravis and aplastic anemia was found incidentally through appropriate studies. She was treated with prednisolone and mestinon, and ptosis and anemia were well controlled. We report this patient as the first case of myasthenia gravis associated with aplastic anemia without thymoma in Korea.

Post-stroke Epilepsy Presenting as Focal Paroxysmal Pain / 대한간질학회지

Post-stroke epilepsy presenting as paroxysmal pain is rare. In most cases, the characteristic pain nature responsible for this kind of post-stroke epilepsy is associated with lesion of somatosensory areas. In this case, however, the precental motor cortex was responsible lesion site. A 60-year-old male with right frontal cortical and subcortical infarction complained paroxysmal shock like painful sensation on left lower extremity. This sensory symptom began after 2 weeks of stroke, and all analgesics failed to relieve the pain. EEG revealed sharp and slow wave at right frontotemporal region. Antiepileptic drug medication dramatically reduced the pain. In addition, epileptiform discharge disappeared after antiepileptic medication. In this paper, we report a post-stroke epilepsy presenting as focal paroxysmal pain associated with involvement of precental motor cortices.