Progressive Multifocal Leukoencephalopathy Presenting as Viral Encephalitis in a Healthy Adult

Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system caused by the human polyomavirus JC virus. PML mainly occurs in immunocompromised patients. A 36-year-old man with no evidence of immunosuppresion presented seizures. MRI scans of brain showed multifocal lesions in the cerebral white matters. JC virus DNA was positive in the cerebrospinal fluid examined by JC virus PCR. We report a rare case of PML presenting as viral encephalitis that occurred in a healthy adult person.

High Sensitivity CRP, Fibrinogen and Homocysteine in Relation to Carotid Intima-media Thickness in Acute Ischemic Stroke / 고신대학교의과대학학술지

OBJECTIVE: To evaluate the relationship of high sensitivity C-reactive protein (hs-CRP), fibrinogen and homocysteine to carotid intima-media thickness (IMT) in acute ischemic stroke. METHODS: Subjects were 347 patients with acute cerebral infarction. The carotid arterial wall thickness was measured using high resolution B-mode ultrasound. The serum levels of hs-CRP, fibrinogen and homocysteine were measured by latex-enhanced turbidimetric immunoassay, clot scattering method, and chemiluminescence immunoassay respectively. Univariate regression analysis was performed to evaluate the relationship between these levels and carotid IMT. RESULTS: In patients with acute ischemic stroke, carotid IMT was significantly correlated with increased serum levels of hs-CRP and fibrinogen (P < 0.05, P < 0.01, respectively). However association between serum homocysteine and carotid IMT was not statistically significant. CONCLUSIONS: Increased serum levels of hs-CRP and fibrinogen may be correlated with carotid IMT. Measurement of serum hs-CRP and fibrinogen may be helpful for predicting degrees of atherosclerosis in acute ischemic stroke.

Fahr's Syndrome Presenting with Recurrent Epileptic Seizures / 대한간질학회지

Calcium deposits in the basal ganglia and in the other areas of the brain may occur as idiopathic disease or secondary to metabolic disturbances including hypoparathyroidism. Fahr's syndrome is characterized by secondary cerebral calcification and variable clinical manifestations of movement disorder, cognitive impairment, and behavioral changes. We report a 48 year-old man with Fahr's syndrome due to idiopathic hypoparathyroidism who presented with recurrent epileptic seizures. Brain CT showed multiple calcifications of the Fahr type in the basal ganglia, thalami, cerebellar white matter and dentate nuclei, and centrum seiovale. Brain MRI diffusion-weighted image showed high signal intensity in the right anterior temporal region.