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Washington University Experience | MYELIN (IMMUNE-MEDIATED) | Inflammatory Demyelination | 12A0 Case 12 History
Case 12 History ---- The patient was a 35-year-old man who presented to our hospital with aphasia and right-sided weakness. At that time he had an MRI scan demonstrating a T2/FLAIR signal abnormality in his left occipital lobe; the lesion was hypointense in T1 weighted images and enhanced with contrast. He underwent CSF studies which failed to show oligoclonal bands. It was felt that he likely had a neoplasm, either glioma or lymphoma, but both infection and demyelination were also considered possibilities. He was placed on a course of steroids and much of his symptomatology improved; however, he was left with residual right-sided numbness, visual field deficit, and mild expressive aphasia. A new MRI examination of the brain two weeks after the first failed to identify enhancement on T1 weighted sequence; however, concern for the precise nature of the disease process prompted a brain biopsy which was performed one week after the second MRI exam
