Case report: subacute tetraplegia in an immunocompromised patient.

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 Neurol

journal_title

BMC neurology

authors

Zeller D,Heidemeier A,Grigoleit GU,Müllges W

doi

10.1186/s12883-017-0814-5

subject

Has Abstract

pub_date

2017-02-10 00:00:00

pages

31

issue

1

issn

1471-2377

pii

10.1186/s12883-017-0814-5

journal_volume

17

pub_type

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