NEUROSCHISTOSOMIASIS PRESENTING AS BRAINSTEM ENCEPHALITIS
| Autor: | J. F. Doherty, Paul Jarman, Philip A. Wilkinson, Michael J. Devine |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Adult
Male Weakness medicine.medical_specialty Ataxia Nystagmus Fluid-attenuated inversion recovery Lower motor neuron Diagnosis Differential Central nervous system disease Dysarthria medicine Animals Humans Diplopia business.industry medicine.disease Schistosomiasis mansoni Surgery medicine.anatomical_structure Anesthesia Encephalitis Neurology (clinical) medicine.symptom business Neuroschistosomiasis Brain Stem |
| Zdroj: | Neurology. 70:2262-2264 |
| ISSN: | 1526-632X 0028-3878 |
| DOI: | 10.1212/01.wnl.0000313839.73358.c0 |
| Popis: | A 43-year-old British man, who had spent the last 18 months working on road building projects in rural Rwanda, presented to hospital in Kigali with a 2-day diarrheal illness, 1 month after swimming in the western shores of Lake Muhazi near Rwesero. Two days later he developed left-sided numbness and weakness and unsteadiness on his feet. HIV testing was negative and CSF examination was normal. No neuroimaging was performed. Dexamethasone, sulfadiazine, pyrimethamine, and broad-spectrum antibiotics were commenced. However, over the following 48 hours he developed worsening headache, diplopia, dysarthria, ataxia, and left hemiparesis. He was repatriated to the United Kingdom. On arrival he was drowsy, orientated, and afebrile. He had profound cerebellar dysarthria. Pupils and fundi were normal. Eye movements were abnormal with a left VIth nerve palsy and multidirectional gaze-evoked nystagmus. There were also left Vth and lower motor neuron VIIth nerve palsies, moderate left hemiparesis, bilateral ataxia, left extensor plantar response, and left hemisensory impairment. Functionally he was able to stand but unable to walk. Examination was otherwise unremarkable. MRI brain demonstrated extensive signal change with marked swelling throughout the pons and lower midbrain (figure, A and B) and patchy enhancement (figure, C and D). Figure MRI and histologic findings (A) Axial FLAIR sequence and (B) … |
| Databáze: | OpenAIRE |
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