Presentation is loading. Please wait.

Presentation is loading. Please wait.

Abnormal movements in an unconscious adult Teaching NeuroImages Neurology Resident and Fellow Section © 2018 American Academy of Neurology.

Published byDerick Atkins Modified over 6 years ago

Similar presentations

Presentation on theme: "Abnormal movements in an unconscious adult Teaching NeuroImages Neurology Resident and Fellow Section © 2018 American Academy of Neurology."— Presentation transcript:

1 Abnormal movements in an unconscious adult Teaching NeuroImages Neurology Resident and Fellow Section © 2018 American Academy of Neurology

2 Vignette An 80 year-old gentleman with a history of renal transplant, on tacrolimus, presented with fever (38.3 C) and confusion He rapidly progressed to unresponsiveness and was intubated for airway protection MRI demonstrated leptomeningeal enhancement, and CSF sampling identified varicella zoster by PCR Despite lack of sedation while intubated, he exhibited abnormal movements of the extremities whenever passively manipulated J. Siegler et al. © 2018 American Academy of Neurology

3 Video With passive wrist and finger extension, the patient exhibits sustained clonus of the right upper extremity. Similar observations were observed in the contralateral arm and in the ankles. J. Siegler et al. © 2018 American Academy of Neurology

4 Clinical finding: sustained clonus
Encephalitis due to varicella zoster virus in this patient resulted in acute hyperreflexia Acute spasticity with pathologic hyperreflexia is an uncommon manifestation of several neurologic conditions including acute ischemic stroke, spinal cord injury, and infections of the central nervous system References K McCabe, K Tyler, J Tanabe. Diffusion-weighted MRI abnormalities as a clue to the diagnosis of herpes simplex encephalitis. Neurology 2003; 61(7): J. Siegler et al. © 2018 American Academy of Neurology

Download ppt "Abnormal movements in an unconscious adult Teaching NeuroImages Neurology Resident and Fellow Section © 2018 American Academy of Neurology."

Similar presentations

A 15 YEAR OLD BOY WITH AN ASCENDING SPASTIC PARALYSIS Teaching Video NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.

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.

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 Neonatal Parechovirus Encephalitis: Typical MRI findings.
A 41 year old African patient with „multifocal neurology“ Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.

A 41 year old African patient with „multifocal neurology“ Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.
A 52-year old man with recently diagnosed HIV infection with irregular shaking of his hand Teaching NeuroImages Neurology Resident and Fellow Section ©

A 52-year old man with recently diagnosed HIV infection with irregular shaking of his hand Teaching NeuroImages Neurology Resident and Fellow Section ©
A TWO YEAR OLD GIRL WITH PROGRESSIVE WEAKNESS Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology.

A TWO YEAR OLD GIRL WITH PROGRESSIVE WEAKNESS Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology.
Teaching NeuroImages Neurology Resident and Fellow Section A 57-year-old woman with blurred vision © 2014 American Academy of Neurology.

Teaching NeuroImages Neurology Resident and Fellow Section A 57-year-old woman with blurred vision © 2014 American Academy of Neurology.
Acute neck pain and quadriparesis An 82 year old man with acute neck pain Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy.

Acute neck pain and quadriparesis An 82 year old man with acute neck pain Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy.
48-year-old man with ascending sensory deficits Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology.

48-year-old man with ascending sensory deficits Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology.
A 68 year old woman with a troublesome chin tremor Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.

A 68 year old woman with a troublesome chin tremor Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.
84 year old woman with spells of right upper limb weakness and numbness Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy.

84 year old woman with spells of right upper limb weakness and numbness Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy.
Starry-sky appearance in Rocky Mountain spotted fever Teaching NeuroImages Neurology Resident and Fellow Section © 2015 American Academy of Neurology.

"Starry-sky" appearance in Rocky Mountain spotted fever Teaching NeuroImages Neurology Resident and Fellow Section © 2015 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.

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 Neurology Resident and Fellow Section © 2014 American Academy of Neurology 46 year-old women with acute headache, post seizure confusion.

Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology 46 year-old women with acute headache, post seizure confusion.
Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology A 14 year old male with headache and neck stiffness.

Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology A 14 year old male with headache and neck stiffness.
A 17-year-old girl with encephalomyelitis Teaching NeuroImages Neurology Resident and Fellow Section © 2015 American Academy of Neurology.

A 17-year-old girl with encephalomyelitis Teaching NeuroImages Neurology Resident and Fellow Section © 2015 American Academy of Neurology.
A 50 year old man with progressive tetraparesis and blindness Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.

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.

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.

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.

Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology An unusual cause of conus medullaris syndrome.

Similar presentations

Ads by Google