There have been few reports of hypoglycemic encephalopathy (HE) with unilateral brain lesion. A 66-year-old male with hypoglycemia, who had history of diabetes and recent poor oral intake, presented with amnesia and confusion. Diffusionweighted imaging (DWI) showed high signal intensity in left hippocampus, which was low on apparent diffusion coefficient (ADC) map. By intravenous glucose, the symptoms improved besides amnesia for hypoglycemic period. Follow-up DWI revealed no lesion and single photon emission computed tomography (SPECT) showed decreased perfusion in left temporo-parieto-frontal area. We experienced a case of HE with a reversible unilateral hippocampal lesion.
Aged ; Amnesia ; Brain* ; Diffusion ; Follow-Up Studies ; Glucose ; Hippocampus ; Humans ; Hypoglycemia ; Magnetic Resonance Imaging* ; Male ; Perfusion ; Tomography, Emission-Computed, Single-Photon

Transient global amnesia (TGA) causes retrograde amnesia, but there have been few reports of retrograde amnesia as a presenting symptom in TGA. A 52-year-old male who had acute amnesia for the past 4 years presented with TGA and recovered within 1 day. Brain magnetic resonance imaging revealed a lesion in the left hippocampus, and brain single-photon emission computed tomography revealed decreased blood flow in the left temporal and frontal areas. We speculated that hippocampal lesion with a frontal perfusion defect can be a cause of TGA.
Amnesia ; Amnesia, Retrograde ; Amnesia, Transient Global ; Brain ; Hippocampus ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Perfusion ; Tomography, Emission-Computed

Although some cases of benign positional vertigo are associated with a chronic ipsilateral sensorineural hearing loss, an association with simultaneous ipsilateral sudden deafness is rare. We report a 53-year old woman with sudden deaf-ness with simultaneous positional vertigo in the same ear characterized by benign paroxysmal positional vertigo of pos-terior semicircular canal type. After a modified Epley particle-repositioning maneuver, the patient's vertigo was resolved. Clinical and neuro-otologic evaluations suggested that the lesion responsible for this patient was probably located within inner ear rather than within the vestibulocochlear nerve. (J Korean Neurol Assoc 19(4):410~412, 2001)
Ear ; Ear, Inner ; Female ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden* ; Humans ; Middle Aged ; Semicircular Canals ; Vertigo* ; Vestibulocochlear Nerve

Few studies have investigated cognitive impairment associated with globus pallidal lesion after acute mountain sickness (AMS). A 54-year-old mountaineer presented with a slowed response, social withdrawal, and apathy after exposure to high altitude. Neuropsychological evaluation revealed impairment in memory and frontal function. MRI revealed bilateral globus pallidal lesions and SPECT revealed decreased blood flow in the left temporal cortex. Symptoms and imaging findings were still impaired after 3 years. We speculate that globus pallidal lesions can cause cognitive dysfunction in AMS.
Altitude ; Altitude Sickness ; Apathy ; Globus Pallidus ; Humans ; Memory ; Middle Aged ; Tomography, Emission-Computed, Single-Photon

No abstract available.
Encephalitis, Viral* ; Histiocytic Necrotizing Lymphadenitis*

A 44-year-old man showed recurrent paroxysmal amnesic attacks following viral encephalitis which, despite antiepileptic treatment, developed into status epilepticus. Interestingly, the amnesic attacks mainly consisted of amnesia for retrograde events. After recovery from status, he showed a persistent amnesia which was characterized as disproportionate retrograde amnesia for the past 20 years. We attribute the amnesic attacks in the acute stage to a transient epileptic amnesia and the profound retrograde amnesia in the chronic stage to status- or infection-related focal brain damage.
Adult ; Amnesia ; Amnesia, Retrograde* ; Brain ; Encephalitis, Viral* ; Humans ; Status Epilepticus

Behcet's disease (BD) is a multisystem disorder presenting recurrent oral and genital ulcerations as well as ocular lesions, involving the nervous system in a subgroup of patients. BD develops at a young age and is frequently presented with an acute or subacute brainstem syndrome or hemiparesis, as well as with other various neurological manifestations, the syndrome is often included in the differential diagnosis of multiple sclerosis, stroke of the young adult, and other neurological disorders. Transverse myelitis (TM) is a clinical syndrome in which an immune-mediated process causes neural injury to the spinal cord, resulting in varying degrees of weakness, sensory alterations and autonomic dysfunction. Spinal Neuro-behcet's disease is rare case. We reported a 33-year old man who had been treated for BD for 3 years.
Brain Stem ; Diagnosis, Differential ; Humans ; Multiple Sclerosis ; Myelitis, Transverse ; Nervous System ; Nervous System Diseases ; Neurologic Manifestations ; Paresis ; Spinal Cord ; Stroke ; Ulcer ; Young Adult

BACKGROUND AND OBJECTIVES: Many neurologists are unaware of the drop attack that may occur from an inner ear dysfunction especially in elderly. We performed this study to investigate the clinical features and results of quantitative audiovestibular tests in six elderly patients (> or =65 years of age) who presented with drop attacks attributable to an inner ear pathology. MATERIALS AND METHOD:Group was divided into Meniere's syndrome (4) or non-Meniere peripheral vestibulopathy (2). Standard dizziness questionnaire and quantitative audiovestibular function testing were performed. RESULTS:Episodes were described as a sudden push to the ground in four or a violent illusionary movement of environment leading to a fall in two. All cases gave a history of prior vertiginous episodes and vestibular testing revealed unilateral caloric paresis. Ipsilateral hearing loss was documented in four cases. CONCLUSIONS:Our results suggest that otologic causes should be considered in the differential diagnosis of the drop attack in elderly, even if the symptoms and signs were not consistent with Meniere's syndrome.
Aged* ; Diagnosis, Differential ; Dizziness ; Ear, Inner ; Hearing Loss ; Humans ; Meniere Disease ; Paresis ; Pathology ; Surveys and Questionnaires ; Syncope*

Dengue fever is an acute febrile disease caused by the dengue virus, which belongs to the family Flaviviridae. The increasing number of people traveling abroad has increased the number of cases of imported dengue fever in Korea. The most common symptoms in patients with dengue fever are malaise, fever, musculoskeletal pain, headache, nausea, vomiting, and abdominal pain. Neurological manifestations such as myelitis, encephalitis, and cranial nerve palsies have been recognized as clinical consequences of dengue infection, but meningitis is a rare complication. We report the case of a 38-year-old man who presented with fever, headache, and nuchal rigidity while traveling in Vietnam. The etiology of meningitis was confirmed by the presence of dengue IgM antibody in his serum. This case report highlights the potential of dengue infection as a cause of meningitis.
Abdominal Pain ; Adult ; Cranial Nerve Diseases ; Dengue ; Dengue Virus ; Encephalitis ; Fever ; Flaviviridae ; Headache ; Humans ; Immunoglobulin M ; Korea ; Meningitis ; Muscle Rigidity ; Musculoskeletal Pain ; Myelitis ; Nausea ; Neurologic Manifestations ; Vietnam ; Vomiting

While it is generally considered that tuberculous meningitis (TBM) causes various vascular complications, there have been few reports of moyamoya syndrome following TBM. A 23-year-old female was diagnosed as TBM. Preliminary brain MRA yielded normal findings. Follow-up MRA and cerebral angiography conducted 1.5 years later yielded findings that were consistent with moyamoya disease. They showed no interval change after 2 years, and the patient had no neurological deficits. This patient with TBM subsequently developed moyamoya syndrome during the course of antituberculosis medication.
Brain ; Cerebral Angiography ; Female ; Follow-Up Studies ; Humans ; Moyamoya Disease ; Tuberculosis, Meningeal ; Young Adult