Reversible posterior leukoencephalopathy syndrome (RPLS) is characterized by sudden onset of headaches, visual disorders, decreased consciousness, and convulsion associated with brain edema occurring in the occipital lobe. Several different causes including malignant hypertension, eclampsia, renal failure, and use of immunosuppressants have been reported in patients with RPLS. Our patient was a 45-year-old man who presented with fever, arthralgia, and melena approximately 1 year previously and received the diagnosis of Wegener's granulomatosis.
View Article and Find Full Text PDFBilateral abducens nerve palsy is an unusual clinical presentation, which could be caused by stroke, aneurysm, trauma and malignant neoplasm. We describe here a patient with bilateral abducens nerve palsy caused by large B cell lymphoma originated from clivus. An 83-year-old woman admitted to our hospital because of diplopia and severe posterior neck pain.
View Article and Find Full Text PDFWe report a 51-year-old man who was admitted to our hospital due to repeated episodes of syncope associated with generalized myasthenic symptoms. Due to myasthenic symptoms with the presence of anti-AchR antoantibody, he was diagnosed as myasthenia gravis (MG) associated with thymoma. However, Holter ECG showed long pause with maximum R-R interval of 3.
View Article and Find Full Text PDFA-46-year-old woman admitted to our hospital because of numbness of bilateral lower limbs and urinary incontinence. The initial neurological examination showed sensory impairment below S1 level with urinary incontinence, indicating epicornus syndrome. Spinal MR imaging demonstrated unremarkable on conventional and enhanced images with Gd-DTPA.
View Article and Find Full Text PDFIt is known that pregnancy influences the relapsing rate of multiple sclerosis (MS); however, interaction between pregnancy and relapse of neuromyelitis optica (NMO), a distinct disease from MS, remains unclear. A 34-year-old woman who 1 year previously had clinical history of Sjögren syndrome complicated by myelitis with the presence of anti-AQP4 antibody in her serum, although there was no optic neuritis involvement, was neurologically normal at time of becoming pregnant. In the 22nd week of her pregnancy, however, she developed abdominal belt-shaped numbness and sensory impairment followed by weakness of bilateral lower limb leading to difficulty of her gait.
View Article and Find Full Text PDFWe reported the case of a 77-year-old female who presented with left hypoglossal paresis and dysarthria due to a small cortical infarction. She was admitted to our hospital because of the sudden onset of dysarthria. A neurological examination revealed deviation of the tongue to the left and paretic dysarthria without motor paralysis in the extremities.
View Article and Find Full Text PDFNihon Naika Gakkai Zasshi
August 2007
A 41-year-old man was admitted with progressive tetraparesis with hypoesthesia. He also presented with purpura in both legs. After admission, joint pain, gastrointestinal tract bleeding, and renal dysfunction developed.
View Article and Find Full Text PDFIntracranial tuberculoma is an infectious disorder, occurring with or without tuberculous meningitis. Although intracranial tuberculoma is rare in developed countries, its frequency has increased in recent years in association with aging and immunocompromised hosts. Because of the low sensitivity of Mycobacterium tuberculosis cultures or of DNA detection from cerebrospinal fluid, diagnosis of intracranial tuberculoma is often difficult.
View Article and Find Full Text PDFHypersensitivity syndrome, a serious systematic reaction to a limited number of drugs, is associated with the reactivation of human herpesvirus 6. A 56-year-old man developed acute limbic encephalitis followed by multiple organ failure during the course of toxic dermatitis induced by aromatic anticonvulsants. The clinical features of skin eruptions, high fever, eosinophilia, and atypical lymphocytosis were compatible with drug hypersensitivity syndrome.
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