Abstract:
BACKGROUND:Clinical reasoning in Neurology is based on general associations which help to deduce the site of the lesion. However, even "golden principles" may occasionally be deceptive. Here, we describe the case of subacute flaccid tetraparesis due to motor cortical lesions. To our knowledge, this is the first report to include an impressive illustration of nearly symmetric motor cortical involvement of encephalitis on brain MRI. CASE PRESENTATION:A 51 year old immunocompromized man developed a high-grade pure motor flaccid tetraparesis over few days. Based on clinical presentation, critical illness polyneuromyopathy was suspected. However, brain MRI revealed symmetrical hyperintensities strictly limited to the subcortical precentral gyrus. An encephalitis, possibly due to CMV infection, turned out to be the most likely cause. CONCLUSION:While recognition of basic clinical patterns is indispensable in neurological reasoning, awareness of central conditions mimicking peripheral nervous disease may be crucial to detect unsuspected, potentially treatable conditions.
journal_name
BMC Neuroljournal_title
BMC neurologyauthors
Zeller D,Heidemeier A,Grigoleit GU,Müllges Wdoi
10.1186/s12883-017-0814-5subject
Has Abstractpub_date
2017-02-10 00:00:00pages
31issue
1issn
1471-2377pii
10.1186/s12883-017-0814-5journal_volume
17pub_type
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