RESUMEN
POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) syndrome is a rare disorder that can mimic chronic inflammatory demyelinating polyradiculopathy (CIDP). In this report, we present a case of a man with a new diagnosis of POEMS syndrome and a clinical picture of CIDP. He had prostate cancer (s/p prostatectomy) with known diffuse bony osteosclerotic lesions and a monoclonal gammopathy of undetermined significance (MGUS). The objective of this report is to highlight the importance of recognizing POEMS as a rare condition, differentiating it from CIDP, and initiating treatment as soon as possible. The diagnosis of POEMS can be delayed due to its extensive variety of clinical manifestations, and the extensive workup needed for the diagnosis.
RESUMEN
Giant cell arteritis (GCA), also known as temporal arteritis is the most common of the systemic vasculitides. It occurs in individuals older than 50 years of age and peaks in incidence in the seventh decade. The gold standard for diagnosis of GCA is temporal artery biopsy (TABx) which will show transmural inflammation, but a negative biopsy does not rule out the disease. We present a case of a 66-year-old male with a classic clinical presentation of temporal arteritis with a normal erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and negative bilateral temporal artery biopsies. He was discharged on prednisone. Ten days later, he unilaterally stopped his corticosteroid treatment leading to a recurrence of symptoms and conversion to seropositivity (ESR negative and CRP positive). The objective of this article is to point out that the diagnosis of temporal arteritis is clinical and is not discarded by a negative TABx. Patients with classic clinical manifestations of temporal arteritis but with a negative TABx should be treated aggressively.
RESUMEN
Leptomeningeal carcinomatosis (LMC) is an uncommon disease that unfortunately has a rapid deterioration and a very poor prognosis with a devastating outcome. There has been an associated increase in the incidence of the leptomeningeal disease recently. There is a low percentage of LMC, around five percent of patients with metastatic disease. LMC has been presented in solid tumors such as breast cancer, lung cancer, melanoma, and GI malignancies. LMC is less likely reported in ovarian cancers. The clinical presentation of LMC is variable and will express according to where the cancer cells infiltrate. The malignant cells can travel with the cerebrospinal fluid (CSF) and deposit on the brain, cerebellum, spinal cord, cranial nerves, and spinal roots. We report this case as a clinical anatomical exercise for healthcare professionals.
RESUMEN
Current guidelines do not include radiologic assessment of the carotid arteries before catheter ablation procedures. There are multiple studies describing the risks of periprocedural cardioembolic strokes during cardiac ablation procedure but none describing the risks of periprocedural watershed strokes due to hypoperfusion during cardiac ablation. It is critically important for neurologists, cardiologists, and all other associated health-care workers to recognize the risks of neurologic complications, such as watershed strokes, before cardiac procedures are performed. We are presenting an 84-year-old male who presented to the emergency room with complaints of vision changes after a cardiac ablation procedure for atrial fibrillation. He described spotty vision with decreased visual acuity in both eyes. Magnetic resonance imaging of the brain showed multiple strokes bilaterally. Based on the radiologic features, all the strokes happened at approximately the same time. Of note, subsequent computed tomography angiography of the head and neck showed 65%-70% bilateral stenosis of the internal carotid arteries.
RESUMEN
Since the first case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was reported in Wuhan, China, in December 2019, Coronavirus - 19 (COVID-19) has become a global pandemic with multiple neurological complications. In December 2020, two vaccines have been approved in the United States for the prevention of COVID-19. We report a case of Guillain-Barre Syndrome (GBS) after receiving the first dose of Pfizer - COVID-19 vaccine.
