Discussions By Condition: I cannot get a diagnosis.

cant come to a diagnosis

Posted In: I cannot get a diagnosis. 2 Replies
  • Posted By: yogi_rkr
  • December 7, 2010
  • 05:27 AM

hi all,
a young lady with features of dystonia and mild cognitive decline of about 2 yrs duration(ct shows cerebellar atrophy and a large cisterna magna) having acute encephalopathic features and seizures of 1 week duration.
counts are normal LP is unremarkable and rpt ct shows no fresh changes.
she has low grade fever but no definite localizing signs.
what could the reason for acute deterioration be.
what other tests could be done to identify the cause.

Reply Flag this Discussion

2 Replies:

  • This sounds slim because the disease is so rare, but I would assume you've tackled all the popular ones. Creutzfeldt–Jakob disease? Variant, Familial or Sporadic? Cognitive issues such as memory difficulties which will soon turn to dementia, personality changes, depression. Neurological problems. Jerky movements. Cerebellar Ataxia, seizures. NSE is sometimes elevated, dystonia, numbness in the limbs. Poor balance and clumsiness. Good luck getting your answers.
    Anonymous 42789 Replies
    • December 7, 2010
    • 06:44 AM
    • 0
    Flag this Response
  • Interesting...I don't think the cisterna magna is a real issue that would help diagnose her.However, the cerebral atrophy, along with the seizures and encephalitis-type features, is a good indication that your patient might be suffering from Dawson's encephalitis.If you check the CSF again, you might find an increase of antimeasle antibodies. There might also be a right shift differential smear.Possibly an ANA for lupus celebritis?
    keanhe 86 Replies
    • December 7, 2010
    • 08:57 AM
    • 0
    Flag this Response
Thanks! A moderator will review your post and it will be live within the next 24 hours.