A 74-year old woman with progressive amnesia

Slides:



Advertisements
Similar presentations
Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology A 74 year-old woman with cerebral edema after myelography.
Advertisements

A 15 YEAR OLD BOY WITH AN ASCENDING SPASTIC PARALYSIS Teaching Video NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.
63 year-old woman with subacute parkinsonism Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology.
Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology Neonatal Parechovirus Encephalitis: Typical MRI findings.
Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology A 68 year old woman with transient ptosis on awakening.
A 52-year old man with recently diagnosed HIV infection with irregular shaking of his hand Teaching NeuroImages Neurology Resident and Fellow Section ©
A 62-year-old man with progressive action tremor and a 74-year-old man with progressive ataxia Teaching NeuroImages Neurology Resident and Fellow Section.
A 68 year old woman with a troublesome chin tremor Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.
Muscle cramps and a raised creatine kinase. Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.
A patient with red dot on the forehead A 32-year old woman presented with red dot on her forehead and eyelid ecchymosis Teaching NeuroImages Neurology.
A 30 year old man with sub-acute ataxia Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology.
Neurology Resident and Fellow Section 40 year old woman with left arm pain, numbness, and weakness Teaching NeuroImages © 2013 American Academy of Neurology.
Teaching NeuroImages: A 38-year-old woman with chronic progressive dysarthria, and gait disturbance. by Keon-Joo Lee, Jangsup Moon, Soon-Tae Lee © 2014.
Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology 46 year-old women with acute headache, post seizure confusion.
A 43-year-old man with decreased consciousness Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology.
Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology A 54 year old man with progressive apathy and cognitive.
A 50 year old man with progressive tetraparesis and blindness Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.
A 38-year-old patient with partial seizures Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology.
47-year-old with progressive upper limb weakness Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology.
Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology An unusual cause of conus medullaris syndrome.
A 30-year male with cognitive decline and unsteady gait Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.
A 4 year old girl presenting with short stature Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology.
Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology A 23 month old full term male with seizures.
68 year old man with aphasia and facial droop © 2014 American Academy of Neurology Teaching NeuroImages Neurology Resident and Fellow Section.
Teaching NeuroImages A 54-year-old man with progressive muscle weakness, hand tremor, tongue and perioral fasciculation Neurology Resident and Fellow Section.
21 YEAR OLD FEMALE WITH PROGRESSIVE WEAKNESS Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.
A 22 years old man with slow movements and mounding phenomenon © 2013 American Academy of Neurology Teaching NeuroImages Neurology Resident and Fellow.
A 26 year old woman with headache, diplopia, and pulsatile tinnitus Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy.
Teaching NeuroImages Neurology Resident and Fellow Section A 32-year-old woman presented with headaches, ataxia, diplopia © 2015 American Academy of Neurology.
A 21-year-old male with rapidly- progressive cortical visual loss Teaching NeuroImages Neurology Resident and Fellow Section © 2015 American Academy of.
A 4 Year Old Boy With Proptosis of Left Eye Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology.
6-year-old boy with progressive neurologic decline Teaching NeuroImages Neurology Resident and Fellow Section © 2015 American Academy of Neurology.
A 71 year old man with rapid onset of anterograde amnesia Teaching NeuroImages Neurology Resident and Fellow Section © 2015 American Academy of Neurology.
“Now you see it...” A broadly-distributed ictal rhythm easily missed on bipolar montage. Teaching NeuroImages Neurology Resident and Fellow Section © 2014.
Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology MRI-visible Virchow-Robin Perivascular Spaces in Cerebral.
Patient with painful ophthalmoplegia after traffic accidents
71-year-old Man with Nystagmus and Oscillpsia
Neurology Resident and Fellow Section
A 71-YEAR-OLD FEMALE WITH MULTIPLE CRANIAL NERVE PALSIES
Teaching NeuroImages Neurology Resident and Fellow Section
A 15 YEAR OLD BOY WITH AN ASCENDING SPASTIC PARALYSIS
Teaching NeuroImages Neurology Resident and Fellow Section
Neurology Resident and Fellow Section
Teaching Video NeuroImages Neurology Resident and Fellow Section
A 55 year-old with lung cancer and leg numbness
A 58-year-old man with cerebellar ataxia
Neurology Resident and Fellow Section
Neurology Resident and Fellow Section
20-year-old male with progressive status epilepticus
A 54-year old woman with subacute encephalopathy
A 10 month old boy with macrocephaly
Resident and Fellow Section
Abnormal movements in an unconscious adult Teaching NeuroImages Neurology Resident and Fellow Section © 2018 American Academy of Neurology.
Neurology Resident and Fellow Section
with headache and seizures
A 6 years old girl with progressive strabismus and vision loss
68-year-old patient with memory impairment
A 7 month old boy with Glutaric Aciduria and flexor spells
A 64-year-old female with progressive parkinsonian syndrome
A 50-year-old man with progressive dysautonomia and leg stiffness
Figure 1 Cerebral MRI during the disease course Cerebral MRI with multiple cerebral supratentorial lesions during the disease course: periventricular lesions.
A 45 YEAR OLD WOMAN WITH PROGRESSIVE WEAKNESS
Figure Chronic inflammatory demyelinating polyneuropathy–like picture in patient with proven Creutzfeldt-Jakob disease (A) Example of partial conduction.
MR scan of brain in four patients presenting as mimics of prion disease. MR scan of brain in four patients presenting as mimics of prion disease. (A) C9orf72.
Figure 2 Cerebral and spinal MRI (A) Restricted diffusion of both optic nerves (arrows) on diffusion-weighted and apparent diffusion coefficient imaging.
A 26-year-old Turkish male with progressive spastic gait and premature alopecia Teaching NeuroImages Neurology Resident and Fellow Section  © 2015 American.
A 2 year old girl with progressive neurological deficits
Huma Samar et al. JACEP 2017;j.jacep
Teaching NeuroImages Neurology Resident and Fellow Section
A treatable case of subacute encephalopathy
Presentation transcript:

A 74-year old woman with progressive amnesia Teaching NeuroImages Neurology Resident and Fellow Section © 2018 American Academy of Neurology

Vignette A 74-year-old female developed amnesia that rapidly progressed over 6 months. She exhibited no apparent neurological abnormalities, except for cognitive decline. Mini-mental state examination was 20/30, mainly involving orientation and recent memory. Electroencephalogram revealed no periodic synchronous discharge. Cerebrospinal fluid analysis was negative for 14-3-3 protein. Sugiyama, et al © 2018 American Academy of Neurology

Imaging Brain MRI at 6 months after onset revealed increased signal intensity in the cerebral cortices with swelling on diffusion- (A and C) and T2-weighted images (B and D) (white arrows). Sugiyama, et al © 2018 American Academy of Neurology

Cerebral cortex swelling in Creutzfeldt-Jakob disease with V180I mutation Premortem diagnosis of Creutzfeldt–Jakob disease with V180I mutation, especially in early stage, merely based on clinical features is difficult.1, 2 MRI revealed cortical swelling that is associated with V180I mutation and prompts genetic testing.1, 2 1. Jin K, Shiga Y, Shibuya S, et al. Clinical features of Creutzfeldt-Jakob disease with V180I mutation. Neurology 2004;62:502-505. 2. Iwasaki Y, Mori K, Ito M, et al. An autopsy case of Creutzfeldt-Jakob disease with a prion protein gene codon 180 mutation presenting with pathological laughing and an exaggerated startle reaction. Neuropathology 2017;37:575-581. Sugiyama, et al © 2018 American Academy of Neurology