A 60-year-old woman was travelling on a plane with her spouse when she suddenly developed acute-onset disorientation to time and space. According to her husband, she repetitively questioned her whereabouts and complained of a minor headache. Upon landing, she was immediately brought to the emergency room and subsequent magnetic resonance imaging was performed, which showed multiple punctate 2-3 mm regions of diffusion-weighted imaging hyperintensity in the medial aspects of both temporal lobes. The conglomeration of clinical history and radiological findings was most suggestive of transient global amnesia. This article discussed the background, proposed mechanisms, diagnosis, radiological characteristics and management of transient global amnesia.
A 49-year-old Chinese man with no significant past medical history was evaluated for a two-year history of progressive uncoordinated movements, dysphagia and urinary symptoms. According to his wife, he had given up badminton over a year ago and was
A 54-year-old Chinese man presented with a three-month history of progressive gait instability, leg weakness, bilateral ascending lower limb paraesthesias and numbness. The patient had no significant past medical history. Neurologic exam revealed 4/5 strength for knee extension and flexion bilaterally. Dorsiflexion and plantar flexion were rated at 4−/5 bilaterally. In addition, proprioception and vibration were markedly diminished in the lower limbs. Babinski reflex was downgoing bilaterally. Laboratory testing revealed macrocytic mean corpuscular volume (103 fL), low serum B12 levels (98 pmol/L), and increased serum homocysteine (25 µmol/L) and methylmalonic acid (310 nmol/L) levels. Bloodwork was negative for anti-intrinsic factor antibodies. What does the magnetic resonance (MR) image (Fig. 1) show? CMEArticle
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