| An atypical case of neuro-Whipple: Clinical presentation, magnetic resonance spectroscopy and follow-up. | |
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MedLine Citation:
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PMID: 20674936 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We report a case of a 53-year-old man with a 2-year history of progressive gait and balance disturbance, supranuclear ophthalmoparesis, mild dysarthria and dysmetria. EMG revealed a lower limb axonal sensory-motor neuropathy, while MR imaging demonstrated a small focal lesion in the right frontal lobe, mild diffuse hyperintensity of the periventricular white matter and diffuse brain atrophy. Magnetic resonance spectroscopy revealed a mild decrease in N-acetyl-aspartate peak and an increase in the choline peak in the small right frontal lesion and within 6 voxels of interest in normal appearing cerebral tissue. According to the clinical picture the diagnosis of WD was made by the positivity of PCR for T. whipplei DNA on CSF. After treatment the patient showed a mild clinical improvement although MR images and laboratory test remained unchanged. The MRS findings suggest that the pathological process of the disease diffusely involves the brain. Despite the absence of gastrointestinal involvement WD should be suspected in all complex and atypical neurological pictures, even in presence of peripheral involvement, in order to be able to start treatment promptly. |
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Authors:
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Caterina Pauletti; Francesco Pujia; Massimo Accorinti; Flavia Pauri; Emanuele Tinelli; Federico Bianco; Cristoforo Morocutti; Francesco Fattapposta |
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Publication Detail:
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Type: Case Reports; Journal Article Date: 2010-08-01 |
Journal Detail:
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Title: Journal of the neurological sciences Volume: 297 ISSN: 1878-5883 ISO Abbreviation: J. Neurol. Sci. Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-09-13 Completed Date: 2010-12-28 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0375403 Medline TA: J Neurol Sci Country: Netherlands |
Other Details:
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Languages: eng Pagination: 97-100 Citation Subset: IM |
Copyright Information:
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Copyright 2010 Elsevier B.V. All rights reserved. |
Affiliation:
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Department of Neurology and Otolaryngology, Sapienza University of Rome, Italy. caterina.pauletti@libero.it |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Brain Diseases
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etiology*,
metabolism*,
microbiology,
pathology Choline / metabolism Follow-Up Studies Humans Magnetic Resonance Imaging / methods Magnetic Resonance Spectroscopy / methods* Male Middle Aged Tropheryma / genetics, pathogenicity Whipple Disease / complications*, metabolism*, pathology |
| Chemical | |
Reg. No./Substance:
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62-49-7/Choline |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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