Wernicke-Korsakoff syndrome as a rare phenotype of sporadic Creutzfeldt-Jakob disease.

We reported the case of a patient with Wernicke-Korsakoff syndrome (WKs) as an early clinical manifestation of sporadic Creutzfeld-Jakob disease (sCJD). The 66-year-old female complained of dizziness and imbalance which mostly occurred while walking. A neurological examination revealed a triad of symptoms characteristic for WKs such as gaze paresis, ataxia of limbs and trunk as well as memory disturbances with confabulations. The disturbances increased during the course of the disease, which led to the death of the patient four months after the appearance of the signs. The patient was finally diagnosed with sCJD disease. The most useful ancillary examination results supporting sCJD diagnosis were brain diffusion DWI MRI (diffusion weighted magnetic resonance imaging) and the presence of 14-3-3 protein in CSF (cerebrospinal fluid). Since that manifestation of sCJD is very unique other causes should be taken into consideration while making a final diagnosis.

Acute stroke-elicited epilepsia partialis continua responsive to intravenous sodium valproate.

We present an interesting case of epilepsia partialis continua (EPC) responsive to valproate treatment as an acute manifestation of cortical ischaemia in the course of vasospasm after subarachnoid bleeding A 72-year-old, right-handed woman suffering a subarachnoid haemorrhage complicated with intracerebral left hemispheric haematoma was admitted to our Department of Neurology In the disease course acute vasospasm developed, affecting the contralateral hemisphere Epilepsia partialis continua (EPC) ensued as an acute complication, with clonic jerks of the left side of the face and left upper limb This was related to epileptiform ictal activity which was followed by periodic lateralized epileptiform discharges (PLEDs) from the right frontal lobe When the standard treatment with benzodiazepines and phenytoin failed, the infusion of sodium valproate (VPA) was started This completely abolished seizure activity, bringing an improvement of the patient's neurological condition EPC may be an acute complication of cortical ischaemic damage and valproate intravenous preparation is an interesting alternative for the treatment of this poorly studied condition.

The perception of emotional chimeric faces in schizophrenia: further evidence of right hemisphere dysfunction.

OBJECTIVE: To examine lateral perceptual bias, an index of right hemisphere function, and its relation to performance on a standard facial perception test and to clinical variables in a large sample of first episode and chronic schizophrenia. BACKGROUND: Judgments made on chimeric faces reliably elicit a perceptual bias to the left hemispace, presumed to be a result of right hemisphere dominance for spatial attention. Recent studies have suggested that this bias is reduced or absent in people with schizophrenia. METHODS: Fifty first-episode and 50 patients with chronic schizophrenic and 50 control subjects were given a brief neuropsychologic battery that included a Happy-Sad Chimeric Face test and the Benton Facial Recognition Test. All patients were rated on the Positive and Negative Syndrome Scale of Schizophrenia after 4 weeks of neuroleptic treatment. All were right handed RESULTS: The patients with schizophrenia showed a significantly weaker perceptual left hemispatial bias compared with controls. In fact the mean bias was in the opposite direction in the chronic group. There was no correlation between left hemispatial bias and either positive or negative symptoms, current medication dose, or mood. Results from the Benton test revealed a performance deficit among the patients with schizophrenia compared with controls but was not correlated with performance on the chimeric faces test in the patients. CONCLUSIONS: The results confirm a specific deficit in right hemisphere attentional functions in schizophrenia, which is separate from a general impairment in facial processing. The deficit is most marked in chronic patients but further study is required to determine whether this is a consequence of prolonged illness.