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Washington University Experience | MYELIN (IMMUNE-MEDIATED) | MS - Brainstem & Cerebellum | 11A0 Case 11 History
Case 11 History ---- The patient was a 74 year old male admitted for terminal care. The patient has a history of several bilateral strokes. The patient also has a long history of diabetes mellitus with secondary chronic renal failure, and retinal hemorrhages. In the fall of 1979 the patient was evaluated for progressive ascites. During the workup the patient was found to have several esophageal varices, antral ulcers and hepatomegaly. All of these findings were felt secondary to congestive heart failure. The patient was admitted on 12/21 with a 1 month history of increasing confusion, lethargy and anorexia. He apparently was having 1-2 seizures per day which consisted of turning of his head to the left with deviation of the eyes to the left. For several weeks before the admission the patient was consistently febrile, and had a -productive cough. He had no oral intake for 4 days PTA. Examination revealed elderly male, lying in bed with Kussmaul respirations. He would regard examiner when his name was called but was otherwise non-communicative and did follow commands. General physical examination was remarkable for ascites. Examination was remarkable for a right central facial infarct and hemiparesis. The patient was rehydrated with some improvement; however, from that point on the patient gradually deteriorated and died 10 days later.
