ABSTRACT
BACKGROUND: Posterior fossa syndrome (PFS) is a rare manifestation of ponto-mesencephalic lesions frequently reported in post-surgical pediatric tumors, rarely described as a consequence of vascular, infective or inflammatory lesions. OBJECTIVE: The aim of this article is to report the clinical and neuroradiological characteristics of a patient with an acute PFS presentation as a relapse in relapsing-remitting MS, significantly responsive to Alemtuzumab treatment. CASE REPORT: 24-year-old patient affected by multiple sclerosis developed motor-cognitive and behavioral syndrome related to an extensive ponto-mesencephalic lesion under Fingolimod treatment. CONCLUSION: Our case highlights the significant and rapid effect of Alemtuzumab therapy on both cognitive and motor symptoms occurring during a MS relapse with atypical neuroradiological localization.
Subject(s)
Alemtuzumab/pharmacology , Behavioral Symptoms/etiology , Brain Diseases/etiology , Cognitive Dysfunction/etiology , Immunologic Factors/pharmacology , Multiple Sclerosis, Relapsing-Remitting/complications , Multiple Sclerosis, Relapsing-Remitting/drug therapy , Mutism/etiology , Adult , Alemtuzumab/administration & dosage , Behavioral Symptoms/drug therapy , Behavioral Symptoms/physiopathology , Brain Diseases/drug therapy , Brain Diseases/pathology , Brain Diseases/physiopathology , Brain Stem/pathology , Cognitive Dysfunction/drug therapy , Cognitive Dysfunction/physiopathology , Fingolimod Hydrochloride/administration & dosage , Humans , Immunologic Factors/administration & dosage , Magnetic Resonance Imaging , Mutism/drug therapy , Mutism/physiopathology , Recurrence , White Matter/pathology , Young AdultABSTRACT
We report a patient with a right cortical and subcortical temporo-occipital lesion who showed spatial neglect mainly involving the left and the near peripersonal space. In drawing tasks the patient omitted the elements closer to him within each figure. A copying task with pairs of radially aligned line drawings demonstrated that the patient's radial neglect was based on within-object coordinates. This novel observation extends the egocentric-allocentric distinction to the radial dimension.
