Highlights
A 35 year old male had a generalized seizure a week after symptoms of daily fever, rigors, and throat discomfort.
He was hospitalized.
Magnetic resonance imaging brain showed multiple bilateral scattered infarcts.
COVID-19 swab test came positive.
An elaborate panel of tests for young strokes, cardiac work-up was normal.
At home, he complained of some visual blurring, slowing in thought processing, occasional loss of words.
His face became significantly pigmented.
A young male, COVID-19 positive, showed multiple scattered infarcts.
Exaggerated pro-thrombotic activity of the nature of a cytokine storm, is the probable cause.
Paraneoplastic limbic encephalitis (PLE) is a rare disorder that typically follows a chronic or subacute course of personality changes, memory loss, seizures, and hallucinations. Early diagnosis is difficult, and characteristic symptoms can be mimicked by a variety of conditions. We present a case of PLE, initially presenting as acute herpetic encephalitis.
Normal pressure hydrocephalus (NPH) is a potentially reversible syndrome characterized by enlarged cerebral ventricles (ventriculomegaly), cognitive impairment, gait apraxia, and urinary incontinence. A critical review of the current prospectives in the diagnosis and treatment of both idiopathic and secondary NPH has been done in our article. NPH is an important cause of potentially reversible dementia, frequent falls, and recurrent urinary infections in the elderly. The clinical and imaging features of NPH may be incomplete or nonspecific, posing a diagnostic challenge for medical doctors, and often requiring expert assessment to minimize unsuccessful surgical treatments. Recent advances resulting from the use of noninvasive magnetic resonance imaging methods for quantifying cerebral blood flow, in particular arterial spin-labeling, and the frequent association of NPH and obstructive sleep apnea, offer new avenues to understand and treat NPH.
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