Case Study in 2008

Creange et al. describe the case of a woman who presented with sudden-onset neuropathy, elevated levels of vascular endothelial growth factor, thrombocytosis, leukocytosis, and thrombosis. Diagnosed with POEMS syndrome, the patient was successfully treated with high-dose chemotherapy and autologous hematopoietic stem-cell transplantation.

This Case Study describes an 18-year-old woman who presented to a stroke center with dysphasia and right hemiparesis. The patient was diagnosed with cocaine-induced cerebral vasculitis. BOLD MRI cerebrovascular reactivity findings were particularly useful in the diagnosis and follow-up of this case, and the authors point to the technique's potential for imaging cerebral vasculitis in general.

This article discusses the case of a 40-year-old man with basilar artery thrombosis, which, after numerous investigations, was found to be attributable to cocaine use. The authors highlight the importance of asking patients about cocaine exposure as part of a routine cardiovascular history, and they provide the first description of the use of thrombolysis to treat cocaine-induced stroke.

This article describes the case of a 54-year-old man who experienced recurrent episodes of transient amnesia over a number of years. The patient was diagnosed with transient epileptic amnesia, and his case provides the first radiological evidence that this syndrome can result from seizure activity in the hippocampus.

This Case Study describes in detail a case of progranulin-associated frontotemporal lobar degeneration (FTLD). The patient was initially asymptomatic, but developed progressive brain atrophy and deficits on neuropsychological testing before the clinical onset of cognitive impairment. The authors use this case as a springboard to discuss advances in the genetics of FTLD with an emphasis on the importance of serial cognitive testing and neuroimaging.

This Case Study describes a 54-year-old man who developed anarthria and quadriplegia in the context of a brainstem stroke. Normal performance on neuropsychological measures administered nonverbally and failure to activate auditory cortices on functional MRI led to a diagnosis of locked-in-syndrome complicated by central deafness.

This Case Study describes a 70-year-old immunocompetent male with rapidly-progressing dementia. Creutzfeldt–Jakob disease was suspected, but a diagnosis of enterovirus encephalitis was confirmed by brain biopsy. The authors discuss the diagnostic challenges presented by this case, and briefly review enteroviral infections of the brain.

This Case Study describes a 64-year-old woman who presented with a 2-year history of itch on her right dorsal forearm. The patient was diagnosed with brachioradial pruritus caused by cervical disc herniation, and the symptoms resolved after surgery to decompress the sixth cervical nerve root. Various alternative treatment options for brachioradial pruritus are discussed.

This article describes the case of a female patient who presented with transient right-sided weakness, and went on to develop further transient neurological signs and symptoms. A diagnosis of amyloid-β-related angiitis was made at autopsy following a sudden, fatal intracerebral hemorrhage. The authors highlight the importance of considering this diagnosis in patients with difficult-to-localize transient neurological symptoms.

This Case Study describes a 63-year-old woman with a history of metastatic breast cancer who presented with rapidly progressing myelopathic symptoms and an elevated titer for the neuromyelitis optic antibody. The appearance of myelopathy correlated with recurrence of the patient's breast cancer on two separate occasions, and the authors suggest this case represents a possible paraneoplastic syndrome associated with the neuromyelitis antibody.

In this Case Study, a 66-year-old man presented with a clinical syndrome consistent with frontal variant frontotemporal dementia, but neuropathological evidence established a diagnosis of frontal variant Alzheimer's disease. The authors provide detailed, longitudinal clinical data describing the course of this rare but increasingly recognized variant of Alzheimer's disease.

This Case Study describes in detail a case of Lafora disease, from its earliest stages through the clinical progression, including detailed neurophysiological studies, diagnostic biopsy and autopsy.

This Case Study describes a 78-year-old man with a pre-existing parkinsonian syndrome who experienced an adverse drug reaction following administration of an antipsychotic in combination with a cholinesterase inhibitor. The patient was diagnosed with a variant of neuroleptic malignant syndrome.

This Case Study describes a 80-year-old patient with lower-body parkinsonism who was diagnosed with vascular parkinsonism on the basis of clinical and neuroimaging findings, but whose gait and, to a lesser extent, cognitive impairments improved following external lumbar drainage. Postmortem neuropathology confirmed a diagnosis of normal pressure hydrocephalus.