Cubital Tunnel Syndrome Caused by Ulnar Nerve Schwannoma in a Patient with Diabetic Sensorimotor Polyneuropathy.

PURPOSE: An uncommon ulnar nerve schwannoma should not be neglected in a diabetic patient with cubital tunnel syndrome, the second most common cause of entrapment neuropathy. CASE REPORT: A 61-year-old woman with a past history of type 2 diabetes mellitus complicated with sensorimotor polyneuropathy presented with progressive numbness and weakness of the left ring and little fingers for one year. A provisional diagnosis of cubital tunnel syndrome was made according to physical examination and electrophysiological studies. The magnetic resonance imaging showed a nodular lesion over ulnar aspect of the left elbow, which was demonstrated to be a schwannoma by histopathology. The patient had moderate improvement after surgical decompression of the left cubital tunnel. CONCLUSION: This case illustrates the heterogeneous group of pathologies causing peripheral neuropathy. The diagnosis of ulnar nerve schwannoma with cubital tunnel syndrome, superimposed with diabetic sensorimotor polyneuropathy, was made carefully according to clinical manifestations as well as a series of electrophysiological, imaging, and pathological studies.

Occipital Condyle Syndrome as an Initial Presentation of Lung Cancer: A Case Report.

PURPOSE: Occipital condyle syndrome (OCS) is a rare cause of headache. This study herein reports a case in which a unique headache and tongue deviation appear as symptoms of the first presentation of a malignant tumor. CASE REPORT: A healthy 67-year-old male presented with a unilateral shooting pain in the occipital region, accompanied by slurred speech and difficulty swallowing. Neurological examinations later revealed atrophy and mild fasciculation of the tongue. The clinical symptoms and MRI results suggested OCS. Screening for tumor markers showed an elevated CEA. The chest CT revealed a lobulated soft-tissue mass in the lower left lobe, and a CTguided biopsy confirmed the diagnosis of adenocarcinoma. A whole body bone scan found multiple foci. The adenocarcinoma was graded pT2bN3M1b, stage IV. The headache improved with a prescription of prednisone, 60 mg to be taken daily. With three months of treatment, clinical examinations showed that the patient was free of pain and that there had been no progression of the atrophy or deviation of the tongue. CONCLUSION: The possible etiology of OCS includes a primary tumor or metastatic lesion that directly invades the base of the skull. Determining the underlying causes of OCS can be challenging, but MR imaging is currently the diagnostic tool of choice. An awareness of the features of OCS in healthy adults may be able to lead to earlier diagnosis of the underlying etiology and efficient relief of the symptoms.

Heavy binge drinking may increase risk of stroke in nonalcoholic hypertensives carrying variant ALDH2*2 gene allele.

PURPOSE: Epidemiologic evidence demonstrates that heavy drinking increases the risk of stroke. However, whether recent heavy drinking affects the incidence of acute stroke in nonalcoholic individuals with the variant allele ALDH2*2 has not been reported. CASE REPORT: Two previously nonalcoholic healthy men suffered from acute ischemic stroke after a single episode of binge drinking. Both patients had one risk factor for stroke (a history of hypertension) and were heterozygous for ALDH2*2. CONCULUSION: The confluence of these factors with stroke has raised the possibility that heavy binge drinking increases the risk of acute stroke in hypertensives with the variant ALDH2*2 gene allele.