ABSTRACT
In this case series, we describe a novel observation in which 4 patients with acute ischemic stroke secondary to large vessel occlusion and no history of seizure present with focal seizure activity localizable to a chronic, contralateral infarct. The explanation for this phenomenon is unknown but may be due to a combination of effects involving disrupted interhemispheric inhibitory connections and epileptogenic changes involving chronically infarcted tissue.
ABSTRACT
The authors report a case of a 69-year-old woman with multiple sclerosis treated with fingolimod for duration of over one year who subsequently developed cutaneous large B cell lymphoma. There are few reported cases of lymphoma associated with fingolimod treatment for multiple sclerosis, but rates are higher than expected in the general population. The authors hope to promote awareness of the potential risk of this medication so that more diligent disease surveillance can be performed by both prescribing practitioners of fingolimod and their patients who receive it.
Subject(s)
Fingolimod Hydrochloride/adverse effects , Immunosuppressive Agents/adverse effects , Lymphoma, B-Cell/chemically induced , Multiple Sclerosis/drug therapy , Skin Neoplasms/chemically induced , Aged , Female , HumansABSTRACT
Alexander disease (AxD) is a leukodystrophy, described in infantile, juvenile and adult onset forms, due to mutations in the glial fibrillary acid protein (GFAP) gene. Adult-onset AxD (AOAD) has a range of clinical and radiographic phenotypes with the oldest reported onset in the seventh decade.We report a case of AOAD, with onset in the eighth decade, presenting with slow variant orthostatic tremor, which has not been previously described. Genetic analysis revealed a GFAP variant (c.1158C>A) that has not been previously reported. Our case serves to expand the diagnostic spectrum of AOAD both clinically and genetically.
