Reprint requests: William F. Young, M.D., Fort Wayne Neurological Center, 2622 Lake Avenue, Fort Wayne, IN 46805-5410. Email: [email protected] Cervical spondylotic myelopathy (CSM) is the most common cause of spinal dysfunction in the elderly (77). It is also the most common cause of nontraumatic spastic paraparesis and quadriparesis. In one series, 23.6% of all patients presenting with nontraum...

A 41-year-old woman originally from West Africa presented with a 3-week history of generalized weakness. Clinical examination demonstrated quadriparesis, urinary incontinence, and reduced level of consciousness. The imaging of the neuraxis revealed multiple bilateral cerebral lesions, including basal ganglia and midbrain. Spinal cord imaging showed lesions in the conus medullaris (figure). The ...

Hypothyroidism and distal renal tubular acidosis causing hypokalemic paralysis (HP) have been described only in four female patients. HP as the initial manifestation of uncomplicated diabetes has been reported only in three young males. We report two middle-aged patients presenting with gradual-onset areflexic quadriparesis and neck flop, associated with urinary potassium losses, and recovering...

Guillain-Barre syndrome (GBS) manifests as acute flaccid weakness of limbs, and is considered a monophasic illness. But recurrences have been reported. Published case studies suggest that 15% of patients who had GBS will have recurrent attacks. We describe a 66-year-old lady who presented with acute onset descending, symmetrical, areflexic, flaccid quadriparesis that progressed to respiratory f...

Childhood primary angiitis of the central nervous system (cPACNS) is a rare and a potentially fatal cause of childhood stroke. The disease poses a diagnostic dilemma for the clinicians due to overlapping and varied clinical manifestations such as headache, focal acute neurological deficits, cognitive impairment, or encephalopathy. We report a young boy who presented with low-grade fever and hea...

common autosomal-dominant genetic disorders with an incidence of approximately 1:3,500. Vascular abnormalities associated with NF-1 include stenotic or occlusive diseases, aneurysms, arteriovenous malformations and, rarely, arteriovenous fistula (AVF). Association of arteriovenous fistula with NF-1 is rare with a few cases of vertebral AVF having been reported (1-3). Endovascular occlusion of t...

Kaur J, et al. BMJ Case Rep 2017. doi:10.1136/bcr-2017-220092 DESCRIPTION A man aged 33 years presented with a 10-year progressive history of difficulty in walking with poor gripping of flip-flops on feet. It was further associated with foot drop and weakened handgrip. There was a recent history of multiple falls and difficulty in climbing stairs or standing from a squatting position. Family hi...

Porphyria refers to a rare group of genetically inherited or acquired disorders that arise due reduced metabolic activity any the enzymes in haem biosynthetic pathway. Defect enzyme causes presentation symptoms porphyria. The epidemiology Acute Intermittent (AIP) is complicated because its rarity and delay diagnosis. We present case seven-year-old girl who presented with multisystem involvement...