Drs Gary Lau, Henry Mak, Raymand Lee, Richard Chang, Windsor Mak, Gilberto Leung, Brian Kot, Edward Hui, Yat Fung Shea, Koon Ho Chan, Joseph Kwan, Jacky Lee and Anderson Tsang
This cranial MRI is from a young woman who presented with low-grade fever, confusion, visual hallucinations and status epilepticus. Significant orofacial dyskinesias and autonomic dysfunction was also noted. Lumbar puncture was performed and cerebrospinal fluid (CSF) revealed mild lymphocytic predominant leukocytosis and slightly elevated protein. CSF glucose was within normal range and CSF for microbiological…
A middle-aged woman was admitted with drowsiness, weakness of all four limbs and visual impairment. Physical examination revealed that the patient had bilateral complete ophthalmoplegia, generalized weakness and spasticity,with brisk reflexes and bilateral upgoing plantar reflexes. A hyper-intense lesion at the level of the midbrain was noted on cerebral MRI (Figure 1). Cerebro-spinal fluid examination…