RESUMO
Sporadic Creutzfeldt-Jakob disease (sCJD) can have varied clinical presentation depending upon the genotype at codon 129. The common presenting clinical features of sCJD are rapid onset cognitive impairment, ataxia, psychosis and visual signs (field defects, distortion, cortical blindness). Alien limb sign was first described in patients with corpus callosal tumors and later with other neurodegenerative conditions like corticobasal degeneration. Alien hand complaints as the presenting feature of sCJD has been described in literature, but simultaneous alien hand and leg has been rarely described as presenting feature of sCJD. We describe here a case of a 55-year-old man who presented with progressive left alien hand and leg as the sole clinical manifestation of probable sCJD.
RESUMO
A 27-year-old woman was diagnosed with juvenile myoclonic epilepsy since the age of 13 and was on valproate therapy. She had a single episode of demyelinating illness while on valproate therapy. Two years earlier, her medication was changed to lamotrigine to avoid the teratogenic effects of valproate, after which the frequency of her demyelinating events increased to four episodes in 1.5â years, satisfying the revised McDonald criteria for multiple sclerosis. Valproate has been shown to restore T-cell homoestasis and ameliorate pathogenesis of experimental allergic encephalomyelitis, a mouse model of multiple sclerosis. Therefore, we propose a potential dual role of valproate in patients with co-existent juvenile myoclonic epilepsy and multiple sclerosis.
Assuntos
Esclerose Múltipla/tratamento farmacológico , Epilepsia Mioclônica Juvenil/tratamento farmacológico , Ácido Valproico/uso terapêutico , Adulto , Anticonvulsivantes/uso terapêutico , Encéfalo/patologia , Diagnóstico Diferencial , Feminino , Humanos , Imageamento por Ressonância Magnética , Esclerose Múltipla/complicações , Esclerose Múltipla/diagnóstico , Epilepsia Mioclônica Juvenil/complicações , Epilepsia Mioclônica Juvenil/diagnósticoAssuntos
Tumores Neuroectodérmicos Primitivos Periféricos/diagnóstico , Neoplasias da Coluna Vertebral/diagnóstico , Vértebras Torácicas , Biópsia por Agulha , Criança , Diagnóstico Diferencial , Humanos , Biópsia Guiada por Imagem , Imageamento por Ressonância Magnética , Masculino , Tomografia Computadorizada por Raios XAssuntos
Vértebras Cervicais/patologia , Osteocondroma/patologia , Neoplasias da Coluna Vertebral/patologia , Adulto , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/cirurgia , Humanos , Masculino , Osteocondroma/diagnóstico por imagem , Osteocondroma/cirurgia , Radiografia , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Neoplasias da Coluna Vertebral/cirurgia , Adulto JovemRESUMO
A 60-year-old man presented with a 25-day history of acute onset instability of gait, tremulousness of limbs and involuntary eye movements. Examination revealed presence of opsoclonus, myoclonus and ataxia, without any loss of motor power in the limbs. Prompt investigations were directed towards identifying an underlying malignancy which is often associated with this type of clinical scenario. CT of the brain was normal and cerebrospinal fluid examination showed lymphocytic pleocytosis. A cavitatory lesion was found in the right lung base on the high-resolution CT of the chest and histopathological examination of this lung mass showed small cell lung carcinoma. The patient was managed symptomatically with levetiracetam and baclofen and referred to oncology department for resection of the lung mass.
Assuntos
Neoplasias Pulmonares/diagnóstico , Síndrome de Opsoclonia-Mioclonia/etiologia , Carcinoma de Pequenas Células do Pulmão/diagnóstico , Baclofeno/uso terapêutico , Humanos , Levetiracetam , Pulmão/diagnóstico por imagem , Pulmão/patologia , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Relaxantes Musculares Centrais/uso terapêutico , Síndrome de Opsoclonia-Mioclonia/tratamento farmacológico , Piracetam/análogos & derivados , Piracetam/uso terapêutico , Radiografia , Carcinoma de Pequenas Células do Pulmão/complicações , Carcinoma de Pequenas Células do Pulmão/tratamento farmacológicoRESUMO
A young girl presented with a 1-month history of constitutional symptoms, headache and vomiting and 7-day history of left hemiparesis. Neuroimaging showed the 'trapped temporal horn' sign, suggestive of focal obstructive hydrocephalus at the foramen of Monro. Analysis of the cerebrospinal fluid and other investigations revealed a tubercular aetiology. The patient was managed with a ventriculoperitoneal shunt and antitubercular medications.