Encefalitis aguda con síndrome cerebeloso secundario a neuroborreliosis / Cerebellar syndrome associated to Lyme neuroborreliosis: case report

La enfermedad de Lyme es la infección transmitida por garrapatas más común en Norteamérica y Europa. Sin embargo, en América Latina se han reportado pocos datos. Borrelia burgdorferi es capaz de invadir el sistema nervioso central causando la neuroborreliosis de Lyme. Se comunica el caso de una mujer joven con encefalitis y síndrome cerebeloso, una presentación poco frecuente, que se manifestó con cefalea, marcha atáxica, nistagmo y ptosis palpebral. Se realizó el diagnóstico con serología positiva por Western blot para Borrelia burgdorferi en suero. Recibió tratamiento con mejoría clínica. El diagnóstico de neuroborreliosis es difícil, ya que no existen hallazgos neurológicos o de imagen específicos. Se recomienda tener un mayor nivel de vigilancia epidemiológica en Latinoamérica, así como los antecedentes recreativos o viajes, que deben incluirse en la historia clínica para mejorar la aproximación diagnóstica.

Lyme disease is the most common tick-borne disease in North America and Europe. However, in Latin America, few data have been reported. Borrelia burgdorferi is capable of invading the central nervous system causing Lyme neuroborreliosis. This is a case report of a female with encephalitis and cerebellar syndrome, a rare manifestation, presented with generalized headache ataxic gait, nystagmus and palpebral ptosis. Serologic diagnosis was made for Borrelia burgdorferi and treatment was initiated with clinical improvement. Neuroborreliosis is a very difficult diagnosis, since there are no neurologic or imaging findings specific. It is recommended to physicians to have an enhanced level of surveillance in Latin America, as well as recreational/travel history of the patient, which should be included in the clinical record to improve the diagnostic approach.

Remote Cerebellar Hemorrhage after Surgery for Degenerative Lumbar Spine Disease: A Case Report / 대한신경손상학회지

Spine surgery has been increased as the population ages, but the occurrence of unusual complication such as remote cerebellar hemorrhage (RCH) is not well understood. We recently experienced a case of RCH in a 60-year-old woman showed neurologic dysfunction after degenerative lumbar spine surgery. There was no definite dural tearing and cerebrospinal fluid (CSF) loss during operation. Brain magnetic resonance imaging showed cerebellar hemorrhage. The patient received conservative management and rehabilitation program. Most other reports have been suggested that RCH after spinal surgery might be related with excessive CSF drainage perioperatively. Minimizing of CSF loss during operation would be helpful to reduce the risk of RCH. If large volume of CSF has been lost accompanied by neurologic deterioration, brain imaging is necessary simultaneously.

A Case of HIV Infection with Progressive Cerebellar Dysfunction as Initial Manifestation / 감염과화학요법

Human immunodeficiency virus (HIV) is known to affect the nervous system at all levels. Neurological complications of HIV occur at all stage of HIV infection, but cerebellar degeneration associated with HIV infection in the absence of cognitive impairment is exceedingly rare. We report a case of HIV infection, in which cerebellar degeneration was the first clinical manifestation. The brain MRI showed marked isolated cerebellar atrophy with severe cerebellar degeneration, but the patient did not have cognitive dysfunction. She was diagnosed as cerebellar form of progressive multifocal leukoencephalopathy with HIV infection. HIV infection should be considered in the diagnosis of any patient with cerebellar dysfunction of unclear origin.

A Case of HIV Infection with Progressive Cerebellar Dysfunction as Initial Manifestation / 감염과화학요법

Human immunodeficiency virus (HIV) is known to affect the nervous system at all levels. Neurological complications of HIV occur at all stage of HIV infection, but cerebellar degeneration associated with HIV infection in the absence of cognitive impairment is exceedingly rare. We report a case of HIV infection, in which cerebellar degeneration was the first clinical manifestation. The brain MRI showed marked isolated cerebellar atrophy with severe cerebellar degeneration, but the patient did not have cognitive dysfunction. She was diagnosed as cerebellar form of progressive multifocal leukoencephalopathy with HIV infection. HIV infection should be considered in the diagnosis of any patient with cerebellar dysfunction of unclear origin.