Distinct from migraine with aura or hemiplegic migraine, a rare clinical entity of migraine-like headache, transient focal neurologic deficit and CSF pleocytosis (HaNDL) has been known. Although the etiology or pathogenesis is unknown, possibility of viral infection or inflammation has been suggested. We report a 25-year-old man diagnosed as HaNDL with literature review. (J Korean Neurol Assoc 19(3):302~304, 2001)
Adult ; Aphasia ; Headache* ; Humans ; Inflammation ; Leukocytosis* ; Migraine Disorders ; Migraine with Aura ; Neurologic Manifestations*

No abstract available.
Pneumonia*

No abstract available.
Encephalitis* ; Glioma* ; Recurrence*

Meningioma is generally regarded as benign and extracranial metastasis of intracranial meningioma is rare. About 60 cases of distant metastasis of meningioma have now been reported. Angioblastic meningioma, although a rare type, shows rapid growth and sarcomatous change frequently, and has higher incidence of metastasis than other types of meningioma. The authors report a case of malignant angioblastic meningioma arisen in left olfactory groove with multiple metastasis to skeletal system. The available literature regarding these tumors is reviewed.
Incidence ; Meningioma* ; Neoplasm Metastasis*

Anti-leucine-rich glioma inactivated-1 (LGI1) limbic encephalitis (LE) is a rare neurological disorder that has a subacute course of progressive encephalopathy and fasciobrachial dystonic seizures. We report a patient with anti-LGI1 LE that presented with atypical manifestations that complicated the diagnosis. A 62-year-old woman presented with a chronic course of memory disturbance and a subsequent relapse with an altered mental status after 10 months. The patient reported frequent chest pain of squeezing and dull nature, typically lasting 10-30 seconds. The chest pain was related to partial seizures, which were confirmed by video-EEG monitoring. Anti-LGI1 antibody was identified in serum and CSF. The patient's symptoms improved by immune modulation treatment. Patients with anti-LGI1 LE can experience atypical partial seizures, and a chronic relapsing course. Clinical suspicions and video-EEG monitoring are helpful for the early diagnosis and effective immune modulation.
Chest Pain ; Diagnosis ; Early Diagnosis ; Female ; Glioma ; Humans ; Limbic Encephalitis* ; Memory ; Middle Aged ; Nervous System Diseases ; Recurrence ; Seizures

Neurological disorders induced by long-term exposure to organic solvents typically have a slowly progressive clinical course, which may be arrested or even reversed following discontinuation of exposure. We report an unusual case of rapidly progressive toxic leukoencephalomyelopathy in a 29-year-old man who had worked at a chemical factory that used toluene for the manufacture of nylon 66 for 5 years. He presented with progressive weakness of legs, recurrent seizures, and cognitive decline. Widespread white-matter changes in the brain and spinal cord, and myelodysplastic syndrome were noted. He died 6 months after the onset of his symptoms, and autopsy showed discrete multifocal demyelination and necrosis in the central nervous system, and dysplastic cells of erythroid, myeloid, and megakaryotic lineages in blood vessels. The co-occurrence of leukoencephalomyelopathy and myelodysplastic syndrome highlights the vulnerability of the white matter and bone marrow to injury from organic solvents. Intravascular congestion of dysplastic hematopoietic cells might have led to his unusually rapid progression of leukoencephalomyelopathy.
Adult ; Autopsy ; Blood Vessels ; Bone Marrow ; Brain ; Central Nervous System ; Demyelinating Diseases ; Estrogens, Conjugated (USP) ; Humans ; Leg ; Myelodysplastic Syndromes* ; Necrosis ; Nervous System Diseases ; Nylons ; Seizures ; Solvents ; Spinal Cord ; Toluene

Cluster headache (CH) is considered a primary headache syndrome. However, symptomatic cases that resemble CH have also been reported. A patient with cerebral venous thrombosis presented with ipsilateral frontal pain accompanied by ophthalmoparesis, nasal congestion, and lacrimation. The patient's headache showed a dramatic response to oxygen. He experienced no further cluster-like headaches after treatment with an anticoagulant. This case suggests the possible role of venous stasis of the cavernous sinus in cluster-like headache.
Cavernous Sinus ; Cluster Headache ; Estrogens, Conjugated (USP) ; Headache Disorders ; Headache* ; Humans ; Ophthalmoplegia ; Oxygen ; Venous Thrombosis*

BACKGROUND AND PURPOSE: Hypertrophic pachymeningitis (HP) is a rare disease caused by autoimmunity in the meninx that causes various neurologic symptoms, including headache, seizures, weakness, paresthesia, and cranial nerve palsies. Although the first-line therapy for HP is steroids, many HP cases are refractory to steroids or recur when the steroids are tapered. Here we report three HP cases that were successfully treated with rituximab (RTX). METHODS: From an institutional cohort recruited from April 2012 to July 2016, three HP cases that were identified to be steroid-refractory were treated with RTX (four weekly doses of 375 mg/m²). Clinical improvement was assessed by the number of relapses of any neurologic symptom and the largest dural thickness in MRI. RESULTS: All three patients were recurrence-free of neurologic symptoms and exhibited prominent decreases in the dural thickness after RTX treatment. No adverse events were observed in the patients. CONCLUSIONS: We suggest RTX as a second-line therapy for steroid-refractory HP. Further studies are warranted to confirm this observation in a larger population and to consider RTX as a first-line therapy.
Autoimmunity ; Cohort Studies ; Cranial Nerve Diseases ; Headache ; Humans ; Magnetic Resonance Imaging ; Meningitis* ; Neurologic Manifestations ; Paresthesia ; Rare Diseases ; Recurrence ; Rituximab* ; Seizures ; Steroids