Painful abdominal contractions in patients with Parkinson disease.

We hypothesized that the unusual and painful abdominal contractions in two of our patients with Parkinson disease (PD) were linked to abdominal muscle hypertrophy. The abdominal pain was aggravated by sitting, standing, or walking, and was characterized by a powerful pulling sensation associated with palpable contractions of the rectus abdominis. When the pain decreased, the camptocormia abated.

Characteristic neuroimaging in patients with tumefactive demyelinating lesions exceeding 30 mm.

Background And Purpose: Features of tumefactive demyelinating lesion (TDL) on magnetic resonance imaging (MRI) can facilitate the differential diagnosis of TDL and neoplastic lesions, but vary considerably among patients. The larger TDL grows, the more difficult it becomes to differentiate TDL from neoplastic lesions. The purpose of this study was to elucidate typical MRI features in 12 patients with large TDL (>30 mm in diameter).

Biphasic paraneoplastic brainstem encephalitis associated with anti-Ri antibody.

Brainstem encephalitis is not a classic paraneoplastic syndrome and usually involves monophasic neurological deterioration and has negative magnetic resonance imaging (MRI) findings. We describe a patient with brainstem encephalitis who had elevated anti-Ri antibody levels and double-step neurological deterioration associated with different abnormal lesions on MRI. Immunosuppression with steroids and intravenous immune globulin combined with aggressive treatment of the tumor successfully led to the resolution of brainstem symptoms and MRI lesions.

Isolated inflammatory myopathy with rimmed vacuoles presenting with dropped head.

We describe an unusual case of inflammatory myopathy with rimmed vacuoles associated with dropped head syndrome. Muscle biopsy in our patient revealed variations in fiber size with fiber necrosis and regeneration, accompanied by many rimmed vacuoles and areas of endomysial cell infiltration. Electron microscopy demonstrated autophagic vacuoles and tubulofilamentous inclusions.

Detection of neoplastic meningitis in a patient with gastric cancer by thallium-201 SPECT.

We describe the usefulness of thallium-201 SPECT in a patient with neoplastic meningitis (NM) from gastric carcinoma. Thallium-201 SPECT is of value for the diagnosis of cancer; retention of thallium-201 on delayed images strongly suggests malignancy. NM is a lethal, major neurologic complication of cancer.

Normothermic treatment in acute clinical encephalitis: a case report.

Introduction: Encephalitis is a common infection of the brain, associated with a high risk of mortality and morbidity despite intensive supportive therapy. This report describes a patient with acute clinical meningoencephalitis who responded dramatically when her body temperature was decreased to normothermia (36 to 37 degrees C) in combination with barbiturate therapy.

Case Presentation: A 15-year-old, previously healthy girl presented with a 2-day history of headache and meningeal stiffness and pyrexia.

Cerebral Sinus and Venous Thrombosis Associated with von Willebrand Factor, Independently of Factor VIII.

Background And Purpose: Previous studies have linked procoagulant factor VIII (F VIII) to an increased risk of venous thrombosis, whereas the relation between plasma von Willebrand factor (VWF) and venous thrombosis remains poorly understood. Elevated VWF levels are frequently found in patients with cerebral sinus and venous thrombosis (CSVT), always in association with high F VIII levels. We describe a patient with CSVT accompanied by elevated VWF levels without high F VIII levels.