Acta Neurologica Taiwanica

An 80-year-old woman with a history of rheumatoid arthritis, hypertension, and hyperlipidemia, and no family history of hyperkinesis developed suddenly involuntary movement and visited our hospital two-day after onset. Neuro-examination revealed hemichorea-hemiballismus in the right side of the body, including the face (Suppl. video). Blood tests revealed neither hyperglycemia nor acanthocyte. Brain MRI showed acute microbleeding in the left subthalamic nucleus (Figure 1A-C). Although she was treated with haloperidol (max...

PURPOSE: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis, among the paraneoplastic syndromes, is a recently characterized autoimmune encephalitis most commonly associated with antibodies against subunits of the NMDAR in the central nervous system. As a paraneoplastic syndrome, anti-NMDAR encephalitis is commonly associated with ovarian teratomas, small cell lung carcinomas and testicular germ cell tumors. To our knowledge, there have been no cases with primary central nervous system lymphoma (PCNSL), a rare type of extranodal non-Hodgkin's lymphoma, without lymph node involvement associated with anti-NMDAR encephalitis...

Vaccine-induced immune thrombotic thrombocytopenia (VITT), also known as thrombosis with thrombocytopenia syndrome, is a rare complication of ChAdOx1 nCoV-19 (AZD1222) vaccine administration. The overall incidence of VITT worldwide is one case per 100 000 exposures. Because of the high mortality rate from VITT, thorough monitoring is crucial to predict the risk of occurrence. The underlying risk factors for VITT are not fully understood. Potential risk factors include sex (female) and young age (less than 50 years), but further research must be conducted to confirm these assumptions...

OBJECTIVE: To study the clinico- radiological profile and outcome of isolated paramedian hemipontine infarcts. MATERIALS AND METHODS: This is a prospective cross- sectional study. 50 consecutive patients admitted between January 2019 and December 2020 with a diagnosis of isolated paramedian hemipontine stroke were included. The locations of the infarcts were classified as follows- caudal; middle; rostral; dorsomedian; caudal and middle; and middle and rostral pons...

PURPOSE: Cytotoxic lesions of corpus callosum (CLOCCs) are associated with many disease entities. Serious neurological complications after coronavirus disease 2019 (COVID-19) vaccination are rare. CASE REPORT: A 20-year-old man presented with severe headache for 2 days. He had received the first dose of ChAdOx1nCoV-19 COVID-19 vaccine 5 days ago. Persistent dull headache occurred on the third day after vaccination and intensified gradually to awaken him from sleep at night...

PURPOSE: Myasthenia gravis (MG) is the most common autoimmune disease that affects the neuromuscular junction and can cause weakness in various muscle groups. The most commonly affected muscles are the eye, facial, and neck flexors. Focal or dominant weakness of the triceps muscle is rare. In this case, we aimed to describe a rare form of MG consisting of selective or dominant triceps muscle weakness. CASE REPORT: We present a 45-year-old male patient whose initial complaints were diplopia and ptosis...

OBJECTIVE: The purpose of this study was to investigate the effects of Crocin on brain neuroterophins, cognition, sensory and motor dysfunction and compare to fingolimod effects in toxic-induced demyelination with Ethidium Bromide EB in female Wistar rats. METHODS: Animals were assigned in to 8 groups; Sham, Sham operated (ShOp), EAE, crocin treated, Vehicle, Fingolompd (Fing) and fingolimod + crocin (Cr+Fing). Demyelination was induced by single dose injection of 10 μl of EB 0...

This narrative review aims to elucidate an emerging state of consciousness termed "cognitivemotor dissociation", characterized by brain activity patterns closely resembling those observed in healthy individuals. This distinctive phenomenon is notably evident in patients diagnosed with comatose states, unresponsive wakefulness states, or minimally conscious states. Employing functional magnetic resonance imaging or electroencephalography holds promise for identifying cognitive-motor dissociation. The emergence of cognitive-motor dissociation not only introduces a fresh conceptual framework but also provides valuable predictive insights into outcomes and prognoses for individuals with disorders of consciousness...

A 13-year and 4-month-old girl was brought to the emergency department due to fever, dizziness,vomiting, and blurred vision. Laboratory data revealed hyperglycemia with an HbA1C of 7.3 percent, ketonuria, and lactic acidosis. The initial impression was diabetic ketoacidosis. During admission, recurrent focal impaired awareness seizures were noted, and magnetic resonance imaging of the brain revealed multiple brain infarctions in the bilateral cerebrum. Mitochondrial gene report showed A3243 G with 64 percent heteroplasmy, and mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes was diagnosed...

PURPOSE: Kidney transplant recipients are at a high risk of both stroke and infection. We report this case to inform readers of the possibility of the occurrence of Listeria monocytogenes brain abscess despite treatment with low dose trimethoprim-sulfamethoxazole. CONCLUSION: Physicians should monitor unusual stroke symptoms and consider Listeria brain abscess as a differential diagnosis. This case suggests that listeria brain abscesses can potentially cause temporary neurological deficits akin to a stroke, despite trimethoprim-sulfamethoxazole prophylaxis, but these symptoms resolve without necessitating surgical intervention...

PURPOSE: To present a rare case of diabetic striatopathy in a child with type 1 diabetes mellitus with reversible unilateral hemichorea hemiballismus. CONCLUSION: A high index of suspicion is required to make a diagnosis of DS in children presenting with abnormal movement disorder and characteristic neuroimaging findings in a background of uncontrolled DM.

Multiple sclerosis is a chronic debilitating disease with unknown pathogenesis. Recent studies indicated that pathogen recognition receptors such as Toll-like receptor 4 may have a role in pathogenesis of MS. The aim of the study was to evaluate the association of rs1927911 polymorphism in TLR4 gene with MS.

The typical presentation of multifocal motor neuropathy (MMN) is progressive asymmetric limb weakness. Cranial neuropathy is rare. We report a 28-year-old woman with cranial and bulbar palsies but with typical electrophysiological features of MMN by multifocal motor conduction blocks and serological markers of anti-ganglioside GM1 antibodies. The previous consensus on the treatment of MMN is intravenous immunoglobulins, but our patient responded to oral steroids and had clinical and electrophysiological improvement under continuous low-dose prednisolone treatment...

PURPOSE: This study aims to investigate the effect of edaravone in preventing cisplatin-induced brain damage. METHODS: Forty female Wistar albino rats were included in the study. 4 groups were created. In group 1 (control group) (n=10), neither any drugs were given nor anything was performed. Group 2 (cisplatin group) (n=10), single dose 7.5 mg/kg cisplatin was given. In group 3 (edaravone group) (n=10), single dose 1 mg/kg edaravone was administered. Group 4 (cisplatin+ edaravone group) (n=10), single dose 7...

Behcet's disease; it is a vascular-inflammatory chronic recurrent disease that can affect many systems in the body. Millard Gubler syndrome is one of the brainstem syndromes that occurs due to lesions involving the ventral part of the caudal pons. We wanted to present a case of Millard Gubler syndrome, which developed due to Behçet's syndrome lesion in the pons ventral region in a patient who presented with limitation of outward gaze on the left, inability to close the left eye completely, inability to completely wrinkle the left side of the forehead, and loss of contralateral muscle strength...

Bilateral medial medullary infarction is a rare subtype of stroke.The typical heart-shaped appearance on magnetic resonance imaging is pathognomonic for bilateral medial medullary syndrome. Vertebrobasilar dolichoectasia is a condition characterized by tortuous dilatation and marked enlargement of the basilar and vertebral arteries, and it may cause posterior circulation infarction. We present the case of a 55-year-old female patient with complaints of speech disorder, regression in consciousness, and difficulty breathing...

Myalgia (also called muscle pain or muscle ache) is a symptom associated with many diseases, including fibromyalgia, neurodegenerative diseases, degenerative spine diseases, etc. Myalgia is a major medical problem affecting 60~85% of the population (lifetime prevalence). However, our understanding of chronic myalgia is still limited and effective treatment for intractable myalgia like fibromyalgia is still lacking. Although multifactorial, one known source of muscle pain is tissue acidosis. Experimental muscle pain can be induced by the intramuscular infusion of a buffered acidic solution in humans...

Dear Editor, we would like to share ideas on the publication "Guillain-Barré Syndrome Following the BNT162b2 mRNA COVID-19 Vaccine [1]." In order to advance our understanding of this consequence, Algahtani et al. describe a case of Guillain-Barré syndrome following the first dose of the BNT162b2 mRNA COVID-19 vaccination [1]. Guillain-Barré syndrome following COVID-19 vaccination is treatable, according to Algahtani et al. [1]. The advantages of providing the vaccination exceed the dangers, according to Algahtani et al...

A 70-year-old woman with a history of hypertension developed acute onset of severe tightness headache accompanied by vomiting. Patient reported having right diplopia and occasional and temporary right peripheral facial paralysis for two weeks. Neurological examination revealed only a right squint. Cerebral multi-detector computed tomographic angiography (MD-CTA) and Magnetic Resonance Imaging (MRI) revealed a giant right internal carotid aneurysm (2.7 cm) at the cavenous segment (Figure 1A, 1B). No abnormalities were noted in subarachnoid spaces and white - grey matter...

INTRODUCTION Visual snow (VS) is a rare condition that is characterized by continuous dynamically flickering dots in the entire visual field that imitate the 'static' or 'snow' of an analogue television set that is not connected to the antenna (1). VS was first described in 3 of 10 migraineurs patients who presented with a spectrum of positive visual symptoms (2). The symptoms of VS can persist for many years. Although VS might be expressed in patients with migraine as visual aura, persistent VS has been accepted as a distinct clinical entity and termed as visual snow syndrome (VSS) independently from migraine...