Tuberculomas in the spine are estimated to be 15 to 50 times less common than those occurring in the cranium. We experienced a case of intramedullary spinal tuberculoma and brain tuberculoma associated with pulmonary tuberculosis. A 39-year-old male was referred to the National Medical Center via emergency room because of urinary difficulty and lower limb weakness for 3 days. He had been treated with anti-tuberculosis regimens against pulmonary tuberculosis for 20 days. Spinal MRI revealed intradural intramedullary tuberculoma at T5. On the 21st day at the hospital, a generalized seizure attacked him. Brain MRI revealed multiple tuberculoma in both hemispheres, brainstem and cerebellum. He was treated anti-tuberculosis regimens and corticosteroids for 9 months. His condition improved clinically and radiologically. We report this case with a review of the literature.
Adrenal Cortex Hormones ; Adult ; Brain Stem ; Brain* ; Cerebellum ; Emergency Service, Hospital ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Male ; Seizures ; Skull ; Spine ; Tuberculoma* ; Tuberculosis, Pulmonary*

Eating the meat of pheasants which was killed by potassium cyanide, a 27 year old man developed several symptoms of minor intoxication. A few days later, the patient became mute, apathy, somnelent and indifferent but without any parkinsonia features or dementia. On CT brain scan, bilateral symmetrical and non-enhancing focal low densities are noticed in basal ganglia, similar to the carbon monoxide intoxication.
Adult ; Apathy ; Basal Ganglia ; Brain* ; Carbon Monoxide ; Dementia ; Eating ; Humans ; Meat ; Potassium Cyanide

Cerebral venous sinus thrombosis and acute renal failure are well known cornplications of paroxysmal nocturnal hemoglobinuria(PNH). 53 year old rnan was admitted to the hospital because of headache and gerleralized convulsion. Contrast enharlced CT scan revealed empty delta sign in superior sagital sinus and acute renal failure developed within 2 weeks of admissiorL The diagnosis of PNH depended on positive HAM test and low leukocyte alkaline phosphatase(LAP). The prognosis was relativley good on the treatrnent with anticoagulant, anticonvulsant, antiplatelets and steroid.
Acute Kidney Injury* ; Diagnosis ; Headache ; Hemoglobinuria, Paroxysmal* ; Humans ; Leukocytes ; Middle Aged ; Prognosis ; Seizures ; Sinus Thrombosis, Intracranial* ; Tomography, X-Ray Computed

Symmetrical bilateral thalamic infarction is a rare cerebrovascular disease, caused by occlusion of the paramedian thalamic arteries. The clinical manifestations of this disease are much different from classical thalamic syndrome, with disturbance of consciousness, memory, eye movement and behavior. Observing two cases of bilateral symmetrical thalamic infarction on CT scan with characteristic clinical findings in Medical Center, pertinent literature were reviewed.
Arteries ; Consciousness ; Eye Movements ; Infarction* ; Memory ; Thalamic Diseases ; Tomography, X-Ray Computed

Cerebrotendinous xanthomatosis-is a very rare, automsomal recessive disorder which characterized by xanthomatous deposits in multiorgan system. The main clinical features include pyramidal, cerebellar and brain stem dysfunction, juvenile cataracts, dementia and xanthomas, especially on Achilles tendon and other tissues. We experienced a patient, 43 year old male who showed cataract, mild cerebellar dysfunction and multiple xanthomas as well as recently developed right hemiparesis. The tendinous xanthomatosis was confirmed pathologically and the brain CT scan showed cortical atrophy, demyelination and multifocal cerebromalacia, which correlated with neurologic manifestation of this patient and with neuropathologic findings of cerebrotendinous xanthomatosis. The EEG showed generalized slowing of background activities.
Achilles Tendon ; Adult ; Atrophy ; Brain ; Brain Stem ; Cataract ; Cerebellar Diseases ; Cerebral Infarction* ; Dementia ; Demyelinating Diseases ; Electroencephalography ; Encephalomalacia ; Humans ; Male ; Neurologic Manifestations ; Paresis ; Tomography, X-Ray Computed ; Xanthomatosis ; Xanthomatosis, Cerebrotendinous*

A 29 year old woman came to the hospital due to headache, facial edema, amenorrhea and galactorrhea. On the lahoratory studies, not only hyperprolactinemia and pituitary enlargement, but also primary hypothyroidism were found. Symptomatic and radiological resolution could be achieved by the thyroid hormone replacement only. This case emphasizes the need for evaluation of thyroid status in patients vith presumptive prolacin producing pituitary tumors before initiation of the therapy for hyperprolactinemia.
Adult ; Amenorrhea ; Edema ; Female ; Galactorrhea ; Headache ; Humans ; Hyperprolactinemia* ; Hypothyroidism* ; Pituitary Neoplasms ; Pregnancy ; Thyroid Gland

Since the EEG study is without harm and pain, it has often been applied to headache sufferers,and many articles have been reported on the findings therefrom in other countries, but rare in Korea. An analysis of clinical and EEG features in 980 headache subjects in National Medical Center is presented. 1. In 980 cases of headache, 542 cases are female and about two thirds of the patients are between 20 and 49 years of age. 2. The distribution of patients contains functional headache (368 cases), tension headache (221 cases). Vascular headache (201 cases) and headache by organic brain diseases (93 cases) in orders. 3. The incidence of EEG abnormalities is 15.1% (147 cases) and most of the findings are dysrrhythmia I or II. The generalized abnormality is more common than focal. 4. Abnormal EEG findings are most common in patients with headache with seizure disorder (54.7%), followed by organic brain diseases (47.3%), and vascular headache (15.3%). In contrast, functional headache and tension headache reveal very low occurrence of EEG abnormalities. 5. There is a tendency of reverse relationship between symptom duration and incidence of EEG abnormalities but no close relationship between the characters of headache and EEG findings.
Brain Diseases ; Electroencephalography* ; Epilepsy ; Female ; Headache* ; Humans ; Incidence ; Korea ; Tension-Type Headache ; Vascular Headaches

Solitary plasmacytoma, in contrast to the disseminated neoplastic proliferation of plasma cells with marked infiltration of multiple organ system in multiple myeloma, is plasma cell neoplasm of a single focus occuring either in bone or soft tissue. The association between a solitary plasmacytoma and peripheral neuropathy is rare, and it is a progressive sensorimotorneuropathy, with a raised CSF protein and mixed demyelination and axonal loss in nerve biopsy. Localized radiotherapy indeed proves to be effective of not only arresting the progress of the neuropathy but also allowing a degree of recovery. We experienced a 55-year-old male with a solitary plasmacytoma and peripheral neuropathy confirmed by the radiologic studies, immunohistochemical stain of nasopharyngeal mucosa biopsy and sural nerve biopsy, which has loss of myelinated fiber and axonal degeneration. Until now, the reported cases are very rare in Korea, so we presented a case of solitary plasmacytoma associated with peripheral neuropathy.
Axons ; Biopsy ; Demyelinating Diseases ; Humans ; Korea ; Male ; Middle Aged ; Mucous Membrane ; Multiple Myeloma ; Myelin Sheath ; Neoplasms, Plasma Cell ; Peripheral Nervous System Diseases* ; Plasma Cells ; Plasmacytoma* ; Radiotherapy ; Sural Nerve

Twenty patients with clinically definite multiple sclerosis were seen at the Department of Neurology, Severance Hospital between 1984 and 1991 and their clinical features ar.d multimodality evoked potential findings were analyzed. We could not find any significant differences in sex ratio, age of onset, and clinical courses from the study results of Japanese and Western groups. However, visual disturbances at the onset and optic-spinal or optic-spinal-brainstem involvements, which are known to be characteristic features of oriental patients, were also noted to be the most common features in our study. Multimodality evoked potential studies were performed and abnorrnal recordings by at least one of the examinations were found in all but one patient. VEP yielded most frequent abnormalities Diagnostic yield of BAEP increased from overall 43% to 83% in cases having brainstem samploms or sings and the increase was much higher than those seen in VEP of SSEP. Increase or increase in latency as occasionall noticed during follow up but majority of patients did not show significant changes in EP {indings. In one patient however. EP abnorrnalities showed improvement in 2 follow up exarninations during 4 years and 7 months despit the evident aggravation in clinical features. Evoked potentials can give valuable information in the diagnosis of multiple scierosis but further studies are necessary to evaluate their usefulness in the follow up examination.
Age of Onset ; Asian Continental Ancestry Group ; Brain Stem ; Diagnosis ; Evoked Potentials* ; Follow-Up Studies ; Humans ; Multiple Sclerosis* ; Neurology ; Sex Ratio

In nonsystemic vasculitic neuropathy, clinically only nerves are affected : there are no or few constitutional symptoms or serological abnormalities. The clinical and pathological features are those of an ischemic neuropathy caused by a necrotizing vasculitis of small arterioles. This is a case report of nonsystemic vasculitic neuropathy in a 22-year-old male who has the distal symmetric poIyneuropathy as a symptom of localized vsaculitis. The sural nerve biopsy showed a few myelin digestion chamber suggesting axonal degeneration. The patient was treated with steroid daily with gradual clinical and electorophysiological improvement.
Arterioles ; Axons ; Biopsy ; Digestion ; Humans ; Male ; Myelin Sheath ; Sural Nerve ; Vasculitis ; Young Adult