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Washington University Experience | MISCELLANEOUS | Neurosarcoid - no PNS | 15A0 Case 15 History
Case 15 History (AANP 1999 Case 10) ---- This 42 year old right handed woman complained of headache of several months duration, altered mental status with gradual progression to a nonverbal, disoriented state. Neurologic examination revealed intact cranial nerves, increased tone in all extremities, left side more than right with clonus in the left lower extremity. Deep tendon reflexes were hyperactive. Babinski sign was negative. Repeated CSF examinations showed pleocytosis but routine cultures for bacteria and fungi were negative. Angiogram performed four months before demise was non-contributory. Initial CT was normal. Three months after the onset of symptoms, basal ganglionic and periventricular white matter lesions were noted on MRI. She expired in spite of broad spectrum antifungal, antibacterial and antiviral drugs. ---- At autopsy the brain weighed 1,050 grams. The leptomeninges were opaque and demonstrated subarachnoid purulent exudate. The pertinent findings were mild ventricular dilatation slight brown discoloration of the basal ganglia and white matter. (AANP Diagnostic Slide Session 1999, Case 10)
