Table of Contents
Washington University Experience | MYELIN (NON-IMMUNE MEDIATED) | CADASIL | 1A0 Case 1 History
Case 1 History ---- The patient was a 68 year old male veterinarian with a history of multiple sclerosis, initially diagnosed in the mid-1970s. He presented with a lack of ability to phonate in addition to spastic paraparesis. An August 1989 MRI examination showed evidence of demyelinating disease in the cerebral hemispheres, as well as in the brainstem and cerebellum. He had a video fluoroscopic study of swallowing physiology in September of 1989 which showed extreme difficulty with voluntary as well as involuntary phases of swallowing with continuous aspiration which resulted in the placement of a gastrostomy tube in January 1990. In November 1993 MRI was repeated and demonstrated increased signal intensity in the white matter on the balanced and T-weighted images throughout both cerebral hemispheres and brainstem. Some of the lesions suggested ischemic changes. His family history is remarkable for the presence of his son who also carries the diagnosis of MS. The son’s MS history is atypical; specifically, his CSF was negative for increased IgG or oligoclonal bands; but had a slightly increased protein of 45. The father's MRI examination demonstrated multiple white matter lesions most consistent with an ischemic process. His son has a history of severe migraine headaches.
