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1.
Mult Scler Relat Disord ; 32: 64-65, 2019 Jul.
Article in English | MEDLINE | ID: mdl-31035122

ABSTRACT

Diagnosis of biotinidase deficiency is rare and usually made in infancy, through newborn screening or after presenting symptoms. We present the case of 19-year old male with progressive optic atrophy and in a second phase spinal cord syndrome unresponsive to immunosuppressive therapies. After diagnosis of profound biotinidase deficiency, oral biotin substitution was started with partial visual improvement and normalization of gait. This case highlights the possibility of late-onset biotinidase deficiency and its treatable character.


Subject(s)
Biotinidase Deficiency/diagnostic imaging , Biotinidase Deficiency/drug therapy , Optic Atrophy/diagnostic imaging , Optic Atrophy/drug therapy , Spinal Cord Diseases/diagnostic imaging , Spinal Cord Diseases/drug therapy , Biotin/administration & dosage , Biotinidase Deficiency/genetics , Humans , Male , Optic Atrophy/genetics , Spinal Cord Diseases/genetics , Young Adult
2.
Acta Neurol Belg ; 116(4): 451-460, 2016 Dec.
Article in English | MEDLINE | ID: mdl-26786477

ABSTRACT

Susac syndrome is a rare vasculopathy of unknown aetiology, affecting prominently young women and electively targeting brain (encephalopathy), retina (visual field defects), and cochlea (hearing loss), of which optimal treatment has yet to be established. We report clinical, CSF and MRI features together with the long-term outcome in a monocentric series of eight consecutive patients with unusual sex ratio (5 male; 3 female), to define the best diagnostic/therapeutic strategy. Six patients presented with the classical clinical triad within less than 6 months after symptoms onset; two did not suffer from sensorineural hearing loss. All but one received a treatment combining high doses of methylprednisolone and cyclophosphamide intravenously. The first two patients had very delayed diagnosis (6-4 months) resulting in severe cognitive sequelae. The third one had only mildly delayed diagnosis (2 months) with subsequent behaviour impairment and severe right hypoacousia. All three were unable to return to work. The last five patients who had early diagnosis and undelayed aggressive treatment were able to resume their professional activities.


Subject(s)
Anti-Inflammatory Agents/therapeutic use , Immunotherapy/methods , Susac Syndrome/drug therapy , Adult , Female , Humans , Male , Retrospective Studies , Susac Syndrome/physiopathology , Young Adult
4.
Eur Neurol ; 66(4): 210-4, 2011.
Article in English | MEDLINE | ID: mdl-21934313

ABSTRACT

We describe a patient who had four relapses of Miller Fisher syndrome over a period of 20 years. The classical triad - ophthalmoparesis, ataxia and areflexia - was present during the first two attacks; ataxia was not observed during the third episode. The final recurrence was characterized by signs suggestive of a central involvement of the oculomotor pathways, subclinical slowing of the visual-evoked potentials, and peripheral vestibular hyporeactivity. Brain imaging was normal, but high levels of anti-GQ1b IgG antibodies were detectable during the second relapse and persisted after the fourth recurrence despite complete clinical recovery.


Subject(s)
Miller Fisher Syndrome/complications , Vestibular Diseases/etiology , Adolescent , Caloric Tests , Functional Laterality , Humans , Male , Saccades , Vestibule, Labyrinth/physiopathology
5.
Acta Neurol Belg ; 109(2): 91-9, 2009 Jun.
Article in English | MEDLINE | ID: mdl-19681440

ABSTRACT

Neurosarcoidosis is a diagnostic challenge, especially in the absence of systemic involvement, even when cerebral biopsies show noncaseating granulomas. We report a patient with a pineal germinoma associated with a extensive peri- and intra- tumoural granulomatous reaction, who was first diagnosed as possible neurosarcoïdosis. A second patient was initially considered as suffering from Multiple Sclerosis. Brain biopsy showed typical granulomas and gallium scintigraphy revealed other locations of the disease. Unfortunately, he developed a severe, steroid-induced, epidural lipomatosis at the Th3-Th8 levels and died unexpectedly after surgical decompression. Granulomatous inflammation in a tissue obtained by biopsy from a midline lesion should be always considered for the differential diagnosis of germinoma. Corticosteroid-sparing immunosuppressant drugs should be used early in neurosarcoïdosis.


Subject(s)
Nervous System Diseases , Sarcoidosis , Adult , Brain/pathology , Humans , Magnetic Resonance Imaging , Male , Nervous System Diseases/complications , Nervous System Diseases/diagnosis , Nervous System Diseases/therapy , Sarcoidosis/complications , Sarcoidosis/diagnosis , Sarcoidosis/therapy , Spinal Cord/pathology , Young Adult
6.
Mult Scler ; 15(4): 422-30, 2009 Apr.
Article in English | MEDLINE | ID: mdl-19324980

ABSTRACT

BACKGROUND: There is no specific serum-based biomarker for the diagnosis or prognosis of relapsing-remitting multiple sclerosis (RRMS). OBJECTIVE: We investigated whether levels of IgM antibodies to Glc(alpha1,4)Glc(alpha) (GAGA4) or to a panel of four glucose-based glycans could differentiate MS from other neurological diseases (OND) or predict risk of early relapse following first presentation (FP) of RRMS. METHODS: Retrospective analysis of 440 sera samples of three cohorts: A) FP-RRMS (n = 44), OND (n = 44); B) FP-RRMS (n = 167), OND (n = 85); and C) FP (n = 100). Anti-GAGA4 IgM levels were measured by enzyme immunoassay in cohort-A and cohort-B. Cohort-C IgM antibodies to glucose-based glycan panel were measured by immunofluorescence. RESULTS: FP-RRMS had higher levels of anti-GAGA4 IgM than OND patients (cohort-A, P = 0.01; cohort-B, P = 0.0001). Sensitivity and specificity were 27% and 97% for cohort-A; and 26% and 90% for cohort-B, respectively. In cohort-C, 58 patients experienced early relapse (<24 months), 31 had late relapse (> or =24 months), and 11 did not experience second attack during follow-up. Kaplan-Meier curves demonstrated decrease in time to next relapse for patients positive for the antibody panel (P = 0.02, log rank). CONCLUSIONS: Serum anti-GAGA4 IgM discerns FP-RRMS patients from OND patients. Higher levels of serum anti-alpha-glucose IgM in FP patients predict imminent early relapse.


Subject(s)
Autoantibodies/blood , Glucose/immunology , Immunoglobulin M/blood , Multiple Sclerosis, Relapsing-Remitting/epidemiology , Multiple Sclerosis, Relapsing-Remitting/immunology , Polysaccharides/immunology , Adult , Autoantibodies/immunology , Biomarkers/blood , Female , Follow-Up Studies , Humans , Immunoglobulin M/immunology , Kaplan-Meier Estimate , Male , Middle Aged , Predictive Value of Tests , Prognosis , Recurrence , Retrospective Studies , Risk Factors , Sensitivity and Specificity
7.
Mult Scler ; 15(2): 238-43, 2009 Feb.
Article in English | MEDLINE | ID: mdl-18987103

ABSTRACT

OBJECTIVE: Two pilot studies were conducted to evaluate safety, tolerability, and efficacy of two doses of Protiramer (TV-5010) in patients with relapsing-remitting multiple sclerosis. BACKGROUND: Both glatiramer acetate and TV-5010 are synthetic copolymers comprised the same four amino acids in a defined molar ratio. TV-5010 has higher average molecular weight than Glatiramer acetate and might be hypothesized that glatiramoids with higher molecular weight might be more immunoreactive than lower molecular weight peptides, thus increasing therapeutic potential and allowing for less frequent dosing. METHODS: In the two separate studies, after a 10 week pretreatment period, TV-5010 was given subcutaneously once weekly at 15 mg and 30 mg for 36 weeks. The primary end point was a reduction in the number of magnetic resonance imaging active lesions (i.e., T1-weigthed gadolinium-enhancing and new T2-weighted lesions) between the pretreatment period and the end of study. RESULTS: Both TV-5010 doses were generally well tolerated. The treatment with TV-5010 at a dose of 15 mg/wk did not show any significant effect. In contrast, in patients treated with at a dose of 30 mg/wk, a significant reduction in the mean number of gadolinium-enhancing (-58.8%; P = 0.0013) and new T2-W (-50%; P = 0.0002) lesions was observed. However, a large decrease in the mean number of both gadolinium-enhancing (-55%) and new T2-W (-40%) lesions during the pretreatment period made difficult the interpretation of the efficacy assessments. CONCLUSIONS: Further studies are needed to confirm these preliminary data on safety and efficacy of TV-5010 at a weekly dose of 30 mg.


Subject(s)
Immunosuppressive Agents/administration & dosage , Multiple Sclerosis, Relapsing-Remitting/drug therapy , Peptides/administration & dosage , Adult , Chemistry, Pharmaceutical , Dose-Response Relationship, Drug , Female , Glatiramer Acetate , Humans , Immunosuppressive Agents/adverse effects , Immunosuppressive Agents/chemistry , Injections, Subcutaneous , Male , Molecular Weight , Peptides/adverse effects , Peptides/chemistry , Pilot Projects , Treatment Outcome
8.
BMJ Case Rep ; 20092009.
Article in English | MEDLINE | ID: mdl-21686639

ABSTRACT

Lyme disease is a multisystemic disorder caused by an epizootic organism of the spirochete group, called Borrelia burgdorferi, which is transmitted to humans by ticks of the genus Ixodes. Lyme neuroborreliosis may occur during the early dissemination phase, most often as a painful meningo-radiculitis and very rarely as a radiculo-myelitis, whereas encephalomyelitis is observed in the late phase. We report the case of a patient with an early subacute poliomyelitis-like syndrome closely matching the selective involvement of the anterior horns and roots of the cervical spinal cord seen on magnetic resonance imaging. This condition improved with appropriate antibiotics.

9.
BMJ Case Rep ; 20092009.
Article in English | MEDLINE | ID: mdl-21686762

ABSTRACT

Lyme disease is a multisystemic disorder caused by an epizootic organism of the spirochete group, called Borrelia burgdorferi (Bb), which is transmitted to humans by ticks of the genus Ixodes. Lyme neuroborreliosis may occur during the early dissemination phase, most often as a painful meningo-radiculitis and very rarely as a radiculo-myelitis, whereas encephalomyelitis is observed in the late phase. We report the case of a patient with an early subacute poliomyelitis-like syndrome closely matching the selective involvement of the anterior horns and roots of the cervical spinal cord seen on magnetic resonance (MR) imaging. This condition improved with appropriate antibiotics.

10.
Acta Neurol Belg ; 108(3): 99-102, 2008 Sep.
Article in English | MEDLINE | ID: mdl-19115673

ABSTRACT

We report two new cases of mitoxantrone-related leukemia occurring in two patients with multiple sclerosis (MS), 14 and 18 months after the last infusion of the drug. One patient was successfully treated. We were able to collect 29 other cases in the literature. Most of them were single reports but some were described within cohorts of mitoxantrone-treated MS patients. The incidence rate was 0.65% from all cohorts totalizing 2299 patients. Acute promyelocytic leukemia with the translocation t(15;17) was over-represented in the MS population in comparison with cancer patients also treated with mitoxanrone. The occurrence of leukemia was dose-independent and appeared with a mean delay of 20 months after the end of the treatment.


Subject(s)
Leukemia, Myeloid, Acute/chemically induced , Leukemia, Promyelocytic, Acute/chemically induced , Mitoxantrone/adverse effects , Multiple Sclerosis/drug therapy , Adult , Analgesics/adverse effects , Analgesics/therapeutic use , Female , Humans , Leukemia, Myeloid, Acute/drug therapy , Leukemia, Myeloid, Acute/genetics , Leukemia, Promyelocytic, Acute/drug therapy , Leukemia, Promyelocytic, Acute/genetics , Male , Middle Aged , Mitoxantrone/therapeutic use , Oncogene Proteins, Fusion/genetics , Translocation, Genetic
11.
Acta Neurol Belg ; 108(3): 103-6, 2008 Sep.
Article in English | MEDLINE | ID: mdl-19115674

ABSTRACT

We report the case of a 23-year-old male patient who suddenly developed right hemiparesis, cerebellar ataxia, dysarthria, and bilateral dysmetria. Brain magnetic resonance (MR) examination demonstrated hyperacute ischaemic lesions within the pons. CSF analysis revealed a high protein content, lymphocytic pleocytosis, and oligoclonal IgG bands not present in the serum. Elevated IgM and IgG anti-Borrelia burgdorferi antibodies were shown in both serum and CSF samples, associated with an intrathecal synthesis of these antibodies. Ischaemic CNS lesions have been rarely observed as the first manifestation of Lyme neuroborreliosis. The putative mechanism for parenchymal ischaemia is the local extension of inflammatory changes from meninges to the wall of penetrating arterioles.


Subject(s)
Borrelia burgdorferi/immunology , Brain Ischemia/etiology , Lyme Neuroborreliosis/complications , Pons/pathology , Acute Disease , Diagnosis, Differential , Humans , Immunoglobulin G/blood , Immunoglobulin G/cerebrospinal fluid , Immunoglobulin M/blood , Immunoglobulin M/classification , Lyme Neuroborreliosis/diagnosis , Lyme Neuroborreliosis/parasitology , Magnetic Resonance Imaging/methods , Male , Young Adult
14.
Neurology ; 67(6): 944-53, 2006 Sep 26.
Article in English | MEDLINE | ID: mdl-17000959

ABSTRACT

OBJECTIVE: To conduct systematic long-term follow-up (LTFU) of patients in the Prevention of Relapses and Disability by Interferon beta-1a Subcutaneously in Multiple Sclerosis (PRISMS) study to provide up to 8 years of safety, clinical and MRI outcomes on subcutaneous (s.c.) interferon (IFN) beta-1a in relapsing-remitting multiple sclerosis (RRMS). METHODS: The original cohort of 560 patients was randomized to IFNbeta-1a, 44 or 22 microg three times weekly (TIW) or to placebo; after 2 years, patients on placebo were rerandomized to active treatment and the blinded study continued for a further 4 years. The LTFU visit was scheduled 7 to 8 years after baseline. RESULTS: LTFU was attended by 68.2% of the original PRISMS study cohort (382/560 patients). 72.0% (275/382) were still receiving IFNbeta-1a s.c. TIW. Patients originally randomized to IFNbeta-1a 44 microg s.c. TIW showed lower Expanded Disability Status Scale progression, relapse rate and T2 burden of disease up to 8 years compared with those in the late treatment group. Brain parenchymal volume did not show differences by treatment group. Overall, 19.7% of patients progressed to secondary progressive MS between baseline and LTFU (75/381). No new safety concerns were identified and treatment was generally well tolerated. CONCLUSIONS: Despite the limitations inherent in any long-term study (for example, potential differences between returning and nonreturning patients), these results indicate that patients with relapsing-remitting multiple sclerosis can experience sustained benefit over many years from early interferon beta-1a subcutaneous therapy three times weekly compared with patients whose treatment is delayed. This effect was more apparent in the patients receiving the higher dose.


Subject(s)
Adjuvants, Immunologic/therapeutic use , Interferon-beta/therapeutic use , Multiple Sclerosis, Relapsing-Remitting/prevention & control , Adult , Analysis of Variance , Brain/pathology , Cohort Studies , Disability Evaluation , Disease Progression , Dose-Response Relationship, Drug , Double-Blind Method , Drug Administration Schedule , Drug Evaluation , Female , Humans , Injections, Subcutaneous/methods , Interferon beta-1a , Magnetic Resonance Imaging/methods , Male , Multiple Sclerosis, Relapsing-Remitting/pathology , Retrospective Studies , Secondary Prevention , Severity of Illness Index , Single-Blind Method , Time Factors , Treatment Outcome
15.
J Neurol Neurosurg Psychiatry ; 77(8): 938-42, 2006 Aug.
Article in English | MEDLINE | ID: mdl-16844949

ABSTRACT

OBJECTIVE: To study cerebrospinal fluid (CSF) and serum samples from 34 consecutive patients suspected of having varicella-zoster virus (VZV) infection of the central nervous system (CNS). POPULATION AND METHODS: The patients were divided into three groups. The first group consisted of 27 patients with a rash in one to three dermatomes and clinical suspicion of meningitis and radiculitis; among them, three subgroups were distinguished according to the affected dermatome: ophthalmicus (n = 9), oticus (n = 11) and cervico-thoraco-lumbar zoster (n = 7). Four cases of zoster sine herpete (ZSH) were included in the second group: these patients presented with either radiculitis (n = 2) or meningoencephalitis (n = 2), without cutaneous eruption. The third group consisted of three patients with a generalised rash and encephalitis. A polymerase chain reaction (PCR) for VZV DNA and antigen-driven immunoblots for oligoclonal anti-VZV antibodies were carried out on all CSF samples. RESULTS: PCR of the CSF was positive in 44% of the patients from the first group, mainly within the first 7 days after eruption. In addition, intrathecal synthesis of anti-VZV antibodies was detected in 37% of patients, always after an interval of 7 days (p<0.0001). Among the four patients with ZSH, a positive VZV PCR was detected in three patients and CSF-specific oligoclonal anti-VZV antibodies in two. PCR was also positive in the CSF of two of the three patients with generalised rash and encephalitis; local production of anti-VZV antibodies was seen in a second CSF sample in one patient, and was also present in the third patient. CONCLUSION: Amplification of VZV DNA by PCR in the CSF and antigen-driven immunoblots have important diagnostic value in suspected VZV infection, although their presence depends on the timing of the CSF sampling. VZV is thought to be a causative agent in unexplained cases of meningitis associated with radiculitis or focal CNS symptoms, even in the absence of skin manifestations. In such patients, rapid diagnosis by this combined approach permits early antiviral treatment.


Subject(s)
Central Nervous System Viral Diseases/genetics , Central Nervous System Viral Diseases/immunology , Herpes Zoster/genetics , Herpes Zoster/immunology , Herpesvirus 3, Human/genetics , Herpesvirus 3, Human/immunology , Adolescent , Adult , Aged , Aged, 80 and over , Antigens, Viral/analysis , Central Nervous System Viral Diseases/cerebrospinal fluid , Central Nervous System Viral Diseases/diagnosis , Cerebrospinal Fluid/virology , DNA, Viral/analysis , Female , Herpes Zoster/cerebrospinal fluid , Herpes Zoster/diagnosis , Humans , Immunoblotting , Male , Middle Aged , Oligoclonal Bands , Polymerase Chain Reaction
16.
Eur J Neurol ; 13(5): 499-504, 2006 May.
Article in English | MEDLINE | ID: mdl-16722976

ABSTRACT

L-2-Hydroxyglutaric (L-2-HG) aciduria is a rare inherited metabolic disease usually observed in children. Patients present a very slowly progressive deterioration with cerebellar ataxia, mild or severe mental retardation, and various other clinical signs including extrapyramidal and pyramidal symptoms, and seizures. The disease is characterized by increased levels of L-2-HG in body fluids such as urine and cerebrospinal fluid. We report on two sisters from consanguineous parents, in whom L-2-HG aciduria was diagnosed at an adult age. Although magnetic resonance imaging and spectroscopic findings were severely abnormal in both, they experienced a different clinical course. The older sister presented with severe mental retardation, recurrent epileptic seizures, and progressive deterioration in her ability to walk and to talk; she is now confined to a wheelchair with severe speech deficit. In contrast, the younger sister only had a few epileptic seizures in childhood and moderate mental retardation, is still able to walk, and performs manual work, and has a social life in a specialized institution for moderately mentally handicapped persons. For the two patients, a complete deletion of exon 9 was demonstrated in a gene located on chromosome 14q22.1, which most probably encodes for L-2-hydroxyglutarate dehydrogenase. The pathological findings observed in this metabolic disorder could therefore be related to a toxic effect of L-2-hydroxyglutarate on the central nervous system, although the presence of other toxic metabolites cannot be excluded.


Subject(s)
Brain/pathology , Epilepsy/urine , Glutarates/urine , Intellectual Disability/urine , Metabolism, Inborn Errors/urine , Mutation , Adult , Age of Onset , Electromyography , Epilepsy/genetics , Female , Humans , Intellectual Disability/genetics , Magnetic Resonance Imaging , Metabolism, Inborn Errors/diagnosis , Metabolism, Inborn Errors/genetics , Siblings
17.
Eur Neurol ; 55(2): 80-3, 2006.
Article in English | MEDLINE | ID: mdl-16567945

ABSTRACT

Amphiphysin, a synaptic vesicle protein, is an auto-immune target in rare cases of paraneoplastic neurological disorders. We report two additional cases with distinct neurological syndromes and paraneoplastic anti-amphiphysin antibodies. The first patient, a 59-year-old man, presented with cerebellar and cranial nerve dysfunction and small cell lung carcinoma. The second, a 77-year- old woman, presented with left brachial plexopathy followed by sensorimotor neuropathy and breast carcinoma.


Subject(s)
Autoimmune Diseases/diagnosis , Brachial Plexus Neuropathies/diagnosis , Encephalitis/diagnosis , Nerve Tissue Proteins/immunology , Paraneoplastic Syndromes/diagnosis , Rhombencephalon , Aged , Autoimmune Diseases/immunology , Brachial Plexus/immunology , Brachial Plexus/pathology , Brachial Plexus Neuropathies/immunology , Breast Neoplasms/diagnosis , Breast Neoplasms/immunology , Carcinoma, Small Cell/diagnosis , Carcinoma, Small Cell/immunology , Cerebellar Ataxia/diagnosis , Cerebellar Ataxia/immunology , Cranial Nerve Diseases/diagnosis , Cranial Nerve Diseases/immunology , Encephalitis/immunology , Female , Humans , Lung Neoplasms/diagnosis , Lung Neoplasms/immunology , Lymphatic Metastasis/diagnosis , Lymphatic Metastasis/immunology , Magnetic Resonance Imaging , Male , Middle Aged , Neurologic Examination , Paraneoplastic Syndromes/immunology , Rhombencephalon/immunology , Rhombencephalon/pathology , Tomography, X-Ray Computed
18.
Acta Neurol Belg ; 106(4): 215-8, 2006 Dec.
Article in English | MEDLINE | ID: mdl-17323839

ABSTRACT

Transient neuroimaging features indicating primary cortical and secondary subcortical white matter cytotoxic oedema have been described in association with prolonged or intense seizures. We describe the unusual condition of recurrent ictal cortical blindness due to focal occipital status epilepticus, in the context of chronic hepatic failure. There was a close association between the onset and disappearance of clinical, electrophysiological and magnetic resonance imaging abnormalities.


Subject(s)
Blindness, Cortical/etiology , Hepatic Encephalopathy/complications , Liver Failure/complications , Status Epilepticus/complications , Anticonvulsants/therapeutic use , Blindness, Cortical/drug therapy , Blindness, Cortical/physiopathology , Brain Edema/drug therapy , Brain Edema/etiology , Brain Edema/physiopathology , Chronic Disease , Electroencephalography , Fatal Outcome , Female , Hepatic Encephalopathy/physiopathology , Humans , Magnetic Resonance Imaging , Middle Aged , Recurrence , Status Epilepticus/drug therapy , Status Epilepticus/physiopathology , Visual Cortex/drug effects , Visual Cortex/physiopathology
19.
Acta Neurol Belg ; 105(2): 81-5, 2005 Jun.
Article in English | MEDLINE | ID: mdl-16076061

ABSTRACT

Between June 1995 and November 1998, 228 patients with relapsing-remitting Multiple Sclerosis started treatment with glatiramer acetate (Copaxone) 20 mg once daily in the frame of a "compassionate use" protocol in 15 Belgian centers. Following an average treatment period of 5.8 years, treating neurologists were requested to fill in follow-up forms indicating neurological disability status and side effects during the previous 6 months. These data were available for 134 patients. In this group, the Expanded Disability Status Scale (EDSS) improved in 26.3% of patients. An additional 36.8% of patients remained neurologically stable. The Ambulation Index (AI) showed similar results: 12.5% of patients improved, 50% of patients remained stable, and 37.5% worsened. Only 10% of patients dropped out due to several reasons. The adverse events occurring in the period preceding the follow-up survey were non-serious and consistent with the current product information of glatiramer acetate. Among the 94 patients no longer followed-up in the compassionate program, reasons for lost to follow-up were obtained for 63; most of them (41) had stopped GA treatment or switched to another disease-modifying treatment. Overall these results are very similar to the ones reported in the extension study of the pivotal trial (Johnson et al., 2000), and indicate that patients treated with glatiramer acetate have a better outcome than expected on the basis of the natural course of the disease. Despite limitations of the study design, this report confirms the sustained efficacy of glatiramer acetate in reducing the disease progression in patients with relapsing-remitting multiple sclerosis treated in day-to-day clinical practice.


Subject(s)
Immunosuppressive Agents/administration & dosage , Multiple Sclerosis, Relapsing-Remitting/drug therapy , Peptides/administration & dosage , Adolescent , Adult , Belgium , Disease Progression , Female , Follow-Up Studies , Glatiramer Acetate , Health Surveys , Humans , Immunosuppressive Agents/adverse effects , Luxembourg , Male , Middle Aged , Multiple Sclerosis, Relapsing-Remitting/physiopathology , Netherlands , Patient Compliance , Peptides/adverse effects , Secondary Prevention , Time Factors , Treatment Outcome
20.
Acta Neurol Belg ; 105(2): 89-93, 2005 Jun.
Article in English | MEDLINE | ID: mdl-16076063

ABSTRACT

We describe clinical and magnetic resonance (MR) features in a 69-year-old, Caucasian woman presenting with an unusual meningeal onset of cerebral schistosomiasis. Magnetic resonance work-up demonstrated supra- and infratentorial lesions with prominent brainstem involvement contrasting with the paucisymptomatic clinical presentation. Because of a recent stay in Uganda, including swimming in Lake Victoria, a diagnosis of neuroschistosomiasis was suggested. Serological tests and rectal biopsy confirmed the putative diagnosis. The patient was successfully treated with praziquantel at a dose of 50 mg/kg/day for 15 days. Brain MRI abnormalities improved dramatically within two months.


Subject(s)
Medulla Oblongata/pathology , Medulla Oblongata/parasitology , Neuroschistosomiasis/pathology , Schistosoma mansoni/physiology , Schistosomiasis mansoni/complications , Aged , Animals , Anthelmintics/administration & dosage , Cerebrovascular Circulation/physiology , Dizziness/etiology , Dizziness/pathology , Dizziness/physiopathology , Encephalitis/drug therapy , Encephalitis/parasitology , Encephalitis/pathology , Female , Headache/etiology , Headache/pathology , Headache/physiopathology , Humans , Magnetic Resonance Imaging , Medulla Oblongata/physiopathology , Meninges/parasitology , Meninges/pathology , Meninges/physiopathology , Neuroschistosomiasis/drug therapy , Neuroschistosomiasis/parasitology , Ovum/cytology , Ovum/physiology , Praziquantel/administration & dosage , Schistosomiasis mansoni/drug therapy , Temporal Lobe/parasitology , Temporal Lobe/pathology , Temporal Lobe/physiopathology , Treatment Outcome , Uganda
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