Case Reports in Neurological Medicine最新文献

{"title":"Probable Postsurgical Parsonage-Turner Syndrome Following Endoscopic Endonasal Pituitary Surgery: A Diagnostic Challenge Case Report: Illustrative Case.","authors":"Mousa Javidialsaadi, Alexi Obillo, Alec Germanwala, Andrew S Ghannad, Ronak H Jani, Isaac Ng, Vikram C Prabhu, Chirag R Patel, Anand V Germanwala","doi":"10.1155/crnm/1964813","DOIUrl":"10.1155/crnm/1964813","url":null,"abstract":"<p><p>Brachial neuritis is a rare inflammatory brachial plexopathy characterized by acute and severe shoulder or upper-extremity pain followed by progressive weakness and sensory disturbances. Commonly associated with viral illness, vaccination, or trauma, it can also occur as a postoperative complication. A 65-year-old gentleman presented with visual loss from a large recurrent pituitary adenoma and underwent an uncomplicated resection. Shortly after surgery, he developed swelling and pain in the right forearm and hand, which later evolved into patchy sensory loss and progressive weakness throughout the arm. Examination demonstrated proximal and distal weakness, muscle wasting, and multifocal sensory deficits without signs of cervical radiculopathy, myelopathy, or carpal tunnel syndrome. Pregabalin and gabapentin provided minimal symptom relief. Electromyography and nerve conduction studies performed 6 weeks later showed a moderate right median mononeuropathy and chronic, inactive C7 radiculopathy, findings that did not fully explain his clinical picture. The clinical presentation was most consistent with probable postsurgical Parsonage-Turner syndrome after exclusion of structural and compressive causes, and the patient improved with physical and occupational therapy, achieving near-complete recovery at 6 months. While early recognition is essential, as electrodiagnostic or radiographic studies may be nondiagnostic, timely therapy can facilitate meaningful functional recovery.</p>","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2026 ","pages":"1964813"},"PeriodicalIF":0.7,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wernicke's Encephalopathy Following Pregnancy Loss: A Case Report and Literature Review.","authors":"Himel Kumar Biswas, Monisha Basak, Mosarrat Mahjabeen, Nazia Ahmed, Rama Biswas","doi":"10.1155/crnm/4526948","DOIUrl":"10.1155/crnm/4526948","url":null,"abstract":"<p><p>A 40-year-old female with no history of alcohol use presented with altered mental status and generalized weakness ten days after dilation and curettage for missed abortion, complicated by persistent vomiting and electrolyte imbalances. Examination revealed confusion and disorientation, without nystagmus, ophthalmoplegia, or ataxia. Brain MRI showed characteristic symmetrical periventricular signal abnormalities consistent with Wernicke's encephalopathy. She was treated with intravenous thiamine (500 mg three times daily for five days), followed by oral supplementation, with gradual resolution of confusion. She was discharged on the 13th hospital day in a hemodynamically and neurologically stable condition. This case highlights that nonalcoholic Wernicke's encephalopathy can occur following surgical procedures complicated by prolonged vomiting and nutritional deficits. Early recognition and prompt thiamine replacement are essential for favorable outcomes.</p>","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2026 ","pages":"4526948"},"PeriodicalIF":0.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13494509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cryptogenic Multifocal Infarctions Involving Brain and Spinal Cord in a Patient With Patent Foramen Ovale: A Case Report.","authors":"Mohamed Zuhail Kizhakka Peediyakkal, Nabil Sherif Mahmood, Ashraf Abdulla Molokhia, Bara Mahmoud F Alqudah, Navaf K Mohamedali, Georgy Itty Paniker, Ahmed Daniyal Nawaz, Abdulqadir Nashwan","doi":"10.1155/crnm/9962894","DOIUrl":"10.1155/crnm/9962894","url":null,"abstract":"<p><p>We report the case of a 46-year-old female with a history of gestational diabetes mellitus (GDM) who presented with acute onset flaccid quadriplegia, respiratory distress, and multifocal cerebral infarctions. Initial clinical suspicion favored inflammatory myelopathy; however, advanced neuroimaging demonstrated a long-segment anterior spinal cord infarction extending from the cervical to upper thoracic region, along with bilateral cerebellar and occipitoparietal infarcts. A patent foramen ovale and hypoplastic vertebral artery suggested a possible embolic and hemodynamic mechanism. This case illustrates the diagnostic complexity in distinguishing vascular infarction from inflammatory myelopathies and underscores the importance of thorough imaging and vascular workup in acute flaccid paralysis.</p>","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2026 ","pages":"9962894"},"PeriodicalIF":0.7,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Novel Use of Robot-Assisted Gait Training in the Treatment of Functional Neurological Disorder: A Case Report.","authors":"Sam Smith, Lydia Caisley Harland, Bernie Bissett, Tapiwa Matangira, Philip Gaughwin","doi":"10.1155/crnm/5007133","DOIUrl":"https://doi.org/10.1155/crnm/5007133","url":null,"abstract":"<p><p>Functional neurological disorder (FND) is a condition defined by neurological symptoms that may be motor, sensory or cognitive in nature and can result in significant functional impairment, including total loss of mobility. There is evidence supporting the use of robotics in other neurological conditions such as stroke and spinal cord injury, but there is currently no published evidence for its use in the treatment of FND. This case using the Hocoma Lokomat robotic exoskeleton device represents the first known case of robot-assisted gait training in the treatment of FND. The aim of this case study was to determine if robot-assisted gait training (RAGT) could be a viable treatment option to improve mobility for patients with FND. Over 9 weeks, the 34-year-old patient completed 15 RAGT sessions. Outcome measures included the functional ambulation category (FAC), functional independence measure (FIM), 10-m walk test (10MWT) and Oxford manual muscle strength testing (MMT). At the conclusion of the RAGT programme, the patient had achieved independent walking: FAC improved from 0/5 to 5/5, FIM Locomotion improved from 1/7 to 7/7, FIM Total improved from 56 to 123 and the 10 MWT was completed in 37.45 s. The patient's muscle strength improved from 0/5 to 5/5 in all lower limb muscle groups (MMT). At 6 months postintervention, the patient reported zero FND relapses or functional impairments. RAGT can be considered a potential intervention option in FND, specifically in cases with gait impairments, and can be associated with dramatic improvements in strength and mobility. This is the first case of a patient with FND successfully completing RAGT in the treatment of gait-related impairments. Studies exploring feasibility and patient acceptability of this novel therapy in FND are now warranted.</p>","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2026 ","pages":"5007133"},"PeriodicalIF":0.7,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13478720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiographic Enhancing Progression Without Molecular or Histologic Progression in IDH-Mutant Grade 2 Astrocytoma Treated With an IDH Inhibitor: A Case Report.","authors":"Carolina Pusec, Karam Han, Krithi Gopinath, Michelle Mackay, Alan Lozier, Tejus A Bale, Ankush Bhatia","doi":"10.1155/crnm/5250404","DOIUrl":"10.1155/crnm/5250404","url":null,"abstract":"<p><p>Central nervous system (CNS) World Health Organization (WHO) Grade 2 isocitrate dehydrogenase (IDH)-mutant astrocytomas are classified as low-grade gliomas with typically slow growth for many years followed by eventual malignant transformation and death. Here, we present a case of a patient with an IDH-mutant Grade 2 astrocytoma who developed early radiographic tumor progression per Response Assessment in Neuro-Oncology (RANO) 2.0 as evidenced by new enhancement on MRI T1 postcontrast 4 months after initiation of an IDH inhibitor. Subsequent re-resection, one month later (or five months postinitiation of ivosidenib treatment), of the enhancing signal retained the Grade 2 designation without any histological or molecular progression per CNS WHO 2021 criteria. Specifically, the Ki-67 proliferative index remained stable at approximately 2%, and copy number alterations were largely unchanged, including no <i>CDKN2A/B</i> homozygous deletion and relatively low chromosome copy number complexity. On histological examination, there was no elevation in mitotic activity and no features of necrosis or microvascular proliferation to suggest a more aggressive phenotype. The tumor demonstrated increased gemistocytic morphology and rare foci of foamy macrophages, as compared to prior. Following the second resection, the patient received sequential radiation therapy and adjuvant temozolomide chemotherapy treatment and has remained clinically stable on observation with surveillance MRIs for over 18 months. This case highlights the importance of re-resection in IDH-mutant gliomas, identifies the potential limitations of the response assessment criteria to differentiate treatment effect from true tumor progression, and emphasizes the need for ongoing investigation into novel genetic alterations, molecular signatures, and histologic markers to more accurately predict radiographic tumor behavior and guide more personalized, targeted treatment strategies for patients with IDH-mutant gliomas.</p>","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2026 ","pages":"5250404"},"PeriodicalIF":0.7,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13422751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148629679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effective Treatment of Anti-GAD65 Limbic Encephalitis-Associated Epilepsy Despite Delayed Immunotherapy: A Brief Report.","authors":"Ghadah Bughaith, Ghadeer Mahdi, Mohammad Ashkanani","doi":"10.1155/crnm/7926284","DOIUrl":"10.1155/crnm/7926284","url":null,"abstract":"<p><p>A 44-year-old woman was referred to our epilepsy center for evaluation of refractory seizures persisting for 36 years. Diagnostic workup revealed anti-glutamic acid decarboxylase 65 limbic encephalitis (anti-GAD65 LE), supported by markedly elevated serum anti-GAD65 antibody titers and a compatible clinical presentation. Following initiation of a 6-month course of intravenous immunoglobulin (IVIG), seizure frequency decreased substantially, from 12 to 16 focal seizures per day to approximately one brief focal seizure per month. This was accompanied by improvements in cognition, psychiatric symptoms, and overall clinical function. This case highlights the potential for meaningful therapeutic response to immunotherapy despite prolonged diagnostic delay.</p>","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2026 ","pages":"7926284"},"PeriodicalIF":0.7,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13424610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148652899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presentation of Neurological Rosai-Dorfman Disease Over 12 Years: A Case Report.","authors":"Sam E Gary, Serdar Akkol, Harshadayani J Kumar, Christina Appin, Xiaosi Han","doi":"10.1155/crnm/8933434","DOIUrl":"10.1155/crnm/8933434","url":null,"abstract":"<p><p>Rosai-Dorfman disease (RDD) is a rare, non-Langerhans cell histiocytosis that classically presents with cervical lymphadenopathy. Neurological involvement occurs in less than 5% of cases and is often associated with extra-axial lesions. Diagnosis of RDD in the setting of neurological deficits is challenging, as RDD often mimics meningioma and neurosarcoidosis on neuroimaging. Herein, we describe a case report of a 50-year-old African American man who was previously treated with radiation for presumed meningioma of the brainstem 12 years prior to the current presentation. The brainstem lesion progressed to include the pachymeninges despite radiation, and the patient developed papilledema and involvement of the bilateral cochlea. Lack of response to radiation, involvement of the pachymeninges, and development of papilledema and bilateral hearing loss led to an updated diagnosis of neurosarcoidosis. On current presentation, the patient was brought to the emergency department for altered mental status, seizures, and left-sided hemiparesis. Initial workup was negative for stroke, meningitis, and toxic or metabolic encephalopathies. Long-term electroencephalography confirmed seizures originating from the right frontal lobe, which was controlled with antiseizure medications. Magnetic resonance imaging revealed worsening diffuse brainstem and pachymeningeal enhancement of the bilateral cerebral convexities, suggesting progression of the disease. Workup for systemic malignancy revealed a hypodense soft tissue mass encasing the left kidney, raising concern for metastatic disease. Biopsy of the meninges and the renal mass confirmed RDD with multiorgan involvement. Diagnosis of RDD in this patient marks the longest duration from onset to diagnosis ever reported, indicating the need for tissue diagnostics in uncertain cases.</p>","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2026 ","pages":"8933434"},"PeriodicalIF":0.7,"publicationDate":"2026-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148599285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RETRACTION: A Severe Alzheimer's Disease Patient Improved by Intravenous Mesenchymal Stem Cell Transplant.","authors":"Case Reports In Neurological Medicine","doi":"10.1155/crnm/9873498","DOIUrl":"https://doi.org/10.1155/crnm/9873498","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.1155/2024/8353492.].</p>","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2026 ","pages":"9873498"},"PeriodicalIF":0.7,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13374565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuronal Intranuclear Inclusion Disease: A Case Report With Insights Into Clinical Features and Potential Therapeutic Implications.","authors":"Lingqiong Xia, Jianhua Chen, Fuying Liu, Fei Feng, Nanqu Huang, Yong Luo","doi":"10.1155/crnm/3279987","DOIUrl":"10.1155/crnm/3279987","url":null,"abstract":"<p><p>Neuronal intranuclear inclusion disease (NIID) is a chronic progressive neurodegenerative disorder characterized by the formation of eosinophilic intranuclear inclusion bodies in the nuclei of neurons in the central, peripheral, and autonomic nervous systems, as well as visceral organs. The clinical presentation of this disease is diverse, manifesting as headaches, fever, altered consciousness, dementia, seizures, sensory and motor disturbances, and autonomic dysfunction, making it prone to misdiagnosis in clinical practice. This article reports a case of NIID diagnosed through skin biopsy and genetic testing, along with a review of relevant literature. It provides an overview of the characteristics and diagnosis of NIID, emphasizing the importance of early diagnosis and comprehensive treatment in managing this rare neurological disorder.</p>","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2026 ","pages":"3279987"},"PeriodicalIF":0.7,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregabalin-Induced Myoclonus in a Patient Without Kidney Dysfunction.","authors":"Sokena Zaidi, Patrick D Lyden","doi":"10.1155/crnm/8902603","DOIUrl":"10.1155/crnm/8902603","url":null,"abstract":"<p><p>Pregabalin is FDA-approved for the treatment of neuropathic pain associated with diabetes, postherpetic neuralgia, spinal cord injury, and as an adjunctive treatment for partial seizures and thus is a commonly prescribed agent in the primary care, neurological, and pain management settings. Adverse effects of pregabalin include dizziness, somnolence, diplopia, blurry vision, and respiratory depression, as well as delayed dermatological hypersensitivity reactions and weight gain. Pregabalin dosing is influenced by renal function, and dose adjustment should be considered in all patients. A much rarer but serious adverse effect of pregabalin is myoclonus. There have been a few case reports of negative myoclonus in patients treated with both pregabalin and gabapentin; however, these patients tend to have renal dysfunction and typically present with altered mentation. Furthermore, these patients are often treated in the context of refractory epilepsy and are treated with other antiepileptic drugs, some of which can also result in myoclonus. Brief episodes of confusion, diplopia, word-finding difficulty, or other transient neurological deficits, which could be concerning for acute ischemic events in the setting of pregabalin use, have never been described. Here, we present a case report of a patient on long-term pregabalin without renal dysfunction who initially presented as a stroke alert for transient neurological deficits followed by jerking movements consistent with positive myoclonus, which is much less commonly reported than negative myoclonus in the setting of pregabalin usage.</p>","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2026 ","pages":"8902603"},"PeriodicalIF":0.7,"publicationDate":"2026-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13310513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148343997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}