A central nervous system metastasis of melanoma with stroke-like onset of left-lower quadrantanopsia.

Autor: Arakawa A; Department of Neurology Tokyo Teishin Hospital Tokyo Japan., Mitsutake A; Department of Neurology Tokyo Teishin Hospital Tokyo Japan., Hideyama T; Department of Neurology Tokyo Teishin Hospital Tokyo Japan., Sato T; Department of Neurology Tokyo Teishin Hospital Tokyo Japan., Katsumata J; Department of Neurology Tokyo Teishin Hospital Tokyo Japan., Seki T; Department of Neurology Tokyo Teishin Hospital Tokyo Japan., Maekawa R; Department of Neurology Tokyo Teishin Hospital Tokyo Japan., Ohno M; Department of Cerebrospinal Oncology National Cancer Center Hospital Tokyo Japan., Narita Y; Department of Cerebrospinal Oncology National Cancer Center Hospital Tokyo Japan., Shiio Y; Department of Neurology Tokyo Teishin Hospital Tokyo Japan.
Jazyk: angličtina
Zdroj: Journal of general and family medicine [J Gen Fam Med] 2020 Feb 11; Vol. 21 (3), pp. 77-79. Date of Electronic Publication: 2020 Feb 11 (Print Publication: 2020).
DOI: 10.1002/jgf2.301
Abstrakt: "Stroke mimics" mean diseases presenting with acute neurological impairments that are taken for stroke. Discriminating them is crucial to avoid improper treatment or delayed correct treatment. We describe a 48-year-old woman presenting with a sudden onset of scintillating scotoma and left-lower quadrantanopsia. Hyperacute cerebral infarction was suspected. However, brain magnetic resonance imaging (MRI) revealed a mass at the cortico-medullary junction in the right occipital lobe. We diagnosed her as metastatic melanoma. We suspected that neurological deficits can be attributed to seizure, and therefore introduced levetiracetam. She showed neurological improvement immediately. Our case demonstrated the importance of considering brain tumor as a differential diagnosis in patients presenting with acute-onset neurological deficits. In addition to appropriate treatment of tumor, the use of newer antiepileptic drugs resulted in good neurological prognosis in metastatic brain tumors.
Competing Interests: Dr Narita has received an honorarium from Chugai Pharmaceutical Co., Ltd and conducted contract research with AbbVie GK, Ono Pharmaceutical Co., Ltd., Stella Pharma Co., Ltd., Sumitomo Heavy Industries, Ltd., and Nihon Medi‐Physics Co., Ltd. The other authors state that they have no conflict of interest. All the authors state they have no conflict of interest with Otsuka Pharmaceutical Co., Ltd. or UCB Japan Co. Ltd, the distributor of levetiracetam.
(© 2020 The Authors. Journal of General and Family Medicine published by John Wiley & Sons Australia, Ltd on behalf of Japan Primary Care Association.)
Databáze: MEDLINE
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