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Washington University Experience | INFECTION | Bacteria | Mycoplasma | 2A0 Case 2 History
Case 2 History ---- A 60-year old man presented with status epilepticus after 16 years of progressive motor impairment, dysarthria and cognitive decline. At age 50 he was diagnosed with primary progressive multiple sclerosis with progression of disease despite treatment with methylprednisolone, interferon beta, methotrexate and rituximab. Physical exam showed an alert anarthric man who would regard and follow some commands. He had bilateral internuclear ophthalmoplegia, severe generalized spasticity and clonus with bilateral upgoing toes. CT studies showed progressively prominent calcifications in the central pons and white matter and scattered white matter foci of contrast enhancement on T2/FLAIR. A brain biopsy was performed. He was treated and was alive with disease and a feeding tube 4-5 years later.
