Rapidly Progressive Quadriplegia and Encephalopathy.
JAMA Neurol
; 73(11): 1363-1366, 2016 Nov 01.
Article
in En
| MEDLINE
| ID: mdl-27598246
A woman aged 77 years was transferred to our neurocritical care unit for evaluation and treatment of rapidly progressive motor weakness and encephalopathy. Examination revealed an ability to follow simple commands only and abnormal movements, including myoclonus, tongue and orofacial dyskinesias, and opsoclonus. Imaging study findings were initially unremarkable, but when repeated, they demonstrated enhancement of the cauda equina nerve roots, trigeminal nerve, and pachymeninges. Cerebrospinal fluid examination revealed mildly elevated white blood cell count and protein levels. Serial electrodiagnostic testing demonstrated a rapidly progressive diffuse sensory motor axonopathy, and electroencephalogram findings progressed from generalized slowing to bilateral periodic lateralized epileptiform discharges. Critical details of her recent history prompted a diagnostic biopsy. Over time, the patient became completely unresponsive with no further abnormal movements and ultimately died. The differential diagnosis, pathological findings, and diagnosis are discussed with a brief review of a well-known yet rare diagnosis.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Quadriplegia
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Rabies
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Bites and Stings
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Brain Diseases
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Chiroptera
Type of study:
Etiology_studies
Limits:
Aged
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Animals
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Female
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Humans
Language:
En
Journal:
JAMA Neurol
Year:
2016
Document type:
Article
Country of publication:
United States