Case report: subacute tetraplegia in an immunocompromised patient

Please always quote using this URN: urn:nbn:de:bvb:20-opus-157576
  • 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 tetraparesisBackground: 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.show moreshow less

Download full text files

Export metadata

Additional Services

Share in Twitter Search Google Scholar Statistics
Metadaten
Author: Daniel ZellerORCiD, Anke Heidemeier, Götz Ulrich Grigoleit, Wolfgang Müllges
URN:urn:nbn:de:bvb:20-opus-157576
Document Type:Journal article
Faculties:Medizinische Fakultät / Institut für diagnostische und interventionelle Radiologie (Institut für Röntgendiagnostik)
Medizinische Fakultät / Neurologische Klinik und Poliklinik
Medizinische Fakultät / Abteilung für Molekulare Innere Medizin (in der Medizinischen Klinik und Poliklinik II)
Language:English
Parent Title (English):BMC Neurology
Year of Completion:2017
Volume:17
Issue:31
Source:BMC Neurology (2017) 17:31. DOI: 10.1186/s12883-017-0814-5
DOI:https://doi.org/10.1186/s12883-017-0814-5
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Tag:CMV; case report; encephalitis; motor cortex; tetraparesis
Release Date:2018/02/19
Collections:Open-Access-Publikationsfonds / Förderzeitraum 2017
Licence (German):License LogoCC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International