Abstract:A 22-year-old right-handed man with recently diagnosed gout and renal insufficiency presented with three months of progressive gait instability and cognitive changes. He initially presented to an outside institution and underwent a broad workup, but an etiology for his symptoms was not found. On subsequent presentation to our institution, his exam revealed multi-domain cognitive dysfunction, spasticity, hyperreflexia and clonus. A broad workup was again pursued and was notable for an MRI of the brain revealing… Show more
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