scholarly journals Diplopia: A Rare Manifestation of Neuroborreliosis

2018 ◽  
Vol 2018 ◽  
pp. 1-2
Author(s):  
Ayushi Dixit ◽  
Yesika Garcia ◽  
Lauren Tesoriero ◽  
Charles Berman ◽  
Vincent Rizzo
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Lyme Disease ◽  
Nerve Palsy ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Double Vision ◽  
Presenting Symptoms ◽  
Rare Manifestation ◽  
The Central Nervous System

Early disseminated Lyme disease typically presents with cardiac, rheumatologic, or neurologic symptoms. Though uncommon, Borrelia burgdorferi can invade the central nervous system and cause neuroborreliosis. In these patients, facial palsy, headache, and stiffness of the neck are the most common presenting symptoms. Our case describes a patient with oculomotor nerve palsy manifesting as double vision as the initial presentation of neuroborreliosis.

scholarly journals Isolated 6th cranial nerve palsy: a rare manifestation of tuberculosis

2021 ◽  
Vol 7 (8) ◽  
pp. 1365
Author(s):  
Shehnaz Kantharia ◽  
Rajesh A. Kantharia ◽  
Pradeepkran Reddy P.
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Cranial Nerve ◽  
Nerve Palsy ◽  
Abducens Nerve ◽  
Seventh Cranial Nerve ◽  
Rare Manifestation ◽  
The Central Nervous System ◽  
Open Surgical Procedure ◽  
The Brain

<p>Tuberculosis (TB) is a contagious infection that is usually caused by <em>Mycobacterium tuberculosis</em> bacteria. It usually affects the lungs and also spreads to the brain and spine. In the central nervous system, the neurological manifestations are numerous and varied and usually occur in two major forms, tuberculous meningitis and tuberculoma. Tuberculoma are well defined, granulomatous, space occupying lesions, which can occur anywhere in the central nervous system. Usually, brainstem tuberculoma can cause sixth and seventh cranial nerve affections along with motor and sensory symptoms, which are usually unilateral. Isolated abducens nerve palsy could be attributed to lesions of the nerve along their extra axial course and cause diplopia. Here we are presenting a case report of an 18-year-old boy with isolated sixth nerve palsy due to tuberculosis. The diagnosis of tuberculosis was achieved using interventional radiology for the purpose of biopsy. Using an image guided technique, we could avoid an open surgical procedure. </p>

scholarly journals Oculomotor Nerve Palsy as a Rare Presentation of Large B-Cell Central Nervous System Lymphoma

2020 ◽  
Vol 21 (10) ◽  
Author(s):  
Hossein Golriz ◽  
Shirin Haghighat ◽  
Vahid Reza Ostovan ◽  
Nasrin Shayanfar ◽  
Mansour Parvaresh ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
B Cell ◽  
Nerve Palsy ◽  
Central Nervous System Lymphoma ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Rare Presentation ◽  
Large B Cell

scholarly journals Neuromyelitis optica with brain stem involvement in a middle-aged Ethiopian woman: a case report and review of literature

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Rodas Asrat Kassu ◽  
Hailu Abera Mulatu ◽  
Sisay Gizaw ◽  
Henok Fisseha ◽  
Amir Musema ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Central Nervous System ◽  
Nervous System ◽  
Case Report ◽  
Optic Neuritis ◽  
Neuromyelitis Optica ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Optic Nerves ◽  
The Central Nervous System

Abstract Introduction Neuromyelitis optica is a demyelinating disease of the central nervous system that predominantly affects the optic nerves and spinal cord. In neuromyelitis optica, white blood cells and antibodies primarily attack the optic nerves and the spinal cord, but may also attack the brain. Brainstem manifestation has been described recently. So far, neuromyelitis optica is very rare in Ethiopia and there were only two case reports, but this is the first case report of neuromyelitis optica with brainstem involvement. Case presentation A 47-year-old Addis Ababa woman presented to Saint Paul’s Hospital Millennium Medical College with a history of visual loss of 7 years and bilateral lower limb weakness of 4 days duration. She had bilateral oculomotor nerve palsy. Her past medical history showed systemic hypertension for 18 years and dyslipidemia for 1 year. The objective evaluation of the patient revealed right optic nerve atrophy suggesting optic neuritis and flaccid paraplegia with sensory level at the fourth thoracic vertebra. Diagnostic work-up using electromyography and spinal magnetic resonance imaging revealed demyelinating anterior visual pathway dysfunction and signs of extensive cervicothoracic transverse myelitis from the third cervical to lower thoracic vertebrae, respectively. Then a diagnosis of neuromyelitis optica was established. After treatment with high-dose systemic steroid followed by azathioprine, the patient was stable for several months with significant improvement of vision and lower-extremity weakness with no relapse of symptoms. Conclusion The case described here is a rare inflammatory demyelinating disorder of the central nervous system occurring in East Africa. It reminds clinicians to suspect neuromyelitis optica in a patient who presented with unexplained recurrent optic neuritis to make a timely diagnosis and prevention of permanent neuronal damage. Neuromyelitis optica can also be associated with oculomotor nerve involvement.

Cerebrospinal Fluid Cytology of Lyme Neuroborreliosis: A Report of 3 Cases with Literature Review

2015 ◽  
Vol 59 (4) ◽  
pp. 339-344 ◽  
Author(s):  
Juan Xing ◽  
Lisa Radkay ◽  
Sara E. Monaco ◽  
Christine G. Roth ◽  
Liron Pantanowitz
Keyword(s):  
Central Nervous System ◽  
Flow Cytometry ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Lyme Disease ◽  
B Cell ◽  
Plasma Cells ◽  
Lyme Neuroborreliosis ◽  
Chain Analysis ◽  
The Central Nervous System

Lyme disease can affect the central nervous system causing a B-cell-predominant lymphocytic pleocytosis. Since most reactions to infection in the cerebrospinal fluid (CSF) are typically T-cell predominant, a B-cell-predominant lymphocytosis raises concern for lymphoma. We present 3 Lyme neuroborreliosis cases in order to illustrate the challenging cytomorphological and immunophenotypic features of their CSF specimens. Three male patients who presented with central nervous system manifestations were diagnosed with Lyme disease. The clinical presentation, laboratory tests, CSF cytological examination and flow-cytometric studies were described for each case. CSF cytology showed lymphocytic pleocytosis with increased plasmacytoid cells and/or plasma cells. Flow cytometry showed the presence of polytypic B lymphocytes with evidence of plasmacytic differentiation in 2 cases. In all cases, Lyme disease was confirmed by the Lyme screening test and Western blotting. In such cases of Lyme neuroborreliosis, flow cytometry of CSF samples employing plasmacytic markers and cytoplasmic light-chain analysis is diagnostically helpful to exclude lymphoma.

scholarly journals Multiple Sclerosis Revealed by Anterior Uveitis

2020 ◽  
Vol 2 (5) ◽  
Author(s):  
Sidi Dahi ◽  
Mehdi Khamaily ◽  
Joumany Brahim Salem ◽  
Imane Tarib ◽  
Mounia Bouchaar ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Central Nervous System ◽  
Nervous System ◽  
Inflammatory Disease ◽  
Anterior Uveitis ◽  
Oculomotor Nerve ◽  
Ocular Involvement ◽  
Atypical Case ◽  
Autoimmune Inflammatory Disease ◽  
The Central Nervous System

Multiple sclerosis is an autoimmune inflammatory disease of the central nervous system, leading to the formation of foci of demyelination. Ocular involvement is quite frequent and multiple, dominated by inflammatory optic neuropathies, oculomotor nerve damage, nystagmus and uveitis. We report an atypical case of multiple sclerosis revealed by an anterior unilateral synechiatic hypertensive uveitis in a young patient of 27 years.

Nervous System Lyme Disease

2017 ◽  
Author(s):  
John J. Halperin
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Lyme Disease ◽  
Borrelia Burgdorferi ◽  
Clinical Manifestations ◽  
Cerebrospinal Fluid Examination ◽  
The Central Nervous System ◽  
Cranial Neuropathies ◽  
Lymphocytic Meningitis

Nervous system involvement occurs in 10% to 15% of patients infected with Borrelia burgdorferi, B. afzelii, or B. garinii, the tick-borne spirochetes responsible for Lyme disease and its European counterparts. Common clinical manifestations include lymphocytic meningitis, facial and other cranial neuropathies, and painful mononeuropathies such as Lyme radiculitis. Diagnosis requires appropriate clinical, epidemiological, and laboratory evidence. Appropriately interpreted serologic testing is highly reliable; cerebrospinal fluid examination is often informative if the central nervous system is involved. Several week courses of widely available oral or parenteral antimicrobials are curative in most patients.

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