Clinical Reasoning: A young man with reversible paralysis, cerebral white matter lesions, and peripheral neuropathy

作者：Le Zhong, Kai Yan, Chentao Liu, Jinjie Xue, Lingqian Wu, Fei Yin · 发表于：Neurology · 年份：2012 · DOI：10.1212/wnl.0b013e3182661eca · 被引用次数：10 · 研究领域：Hereditary Neurological Disorders、Neurological diseases and metabolism、Peripheral Neuropathies and Disorders

A 17-year-old boy experienced 3 consecutive episodes of transient tetraplegia or monoparesis over the course of 5 days, after a week of low-grade fever. He was alert but had dysarthria and diplopia during the attacks. The paresis persisted for 5 to 7 hours and resolved completely. Three years prior, he had presented with a 1-day episode of transient right hemiparesis and dysarthria, and recovered completely without any treatment. At that time, cerebral MRI showed bilateral symmetric confluent hyperintense lesions in the parieto-occipital region and splenium and genu of the corpus callosum on T2-weighted images (figure). Three months later, these MRI abnormalities were markedly reduced (figure). Figure Brain MRI Episode 1: transverse T2-weighted brain MRI shows confluent hyperintense lesions in the temporal-occipital region and splenium and genu of the corpus callosum (A). (B) Hypointensity in the same regions, evidence of reduced diffusion. Episode 2: (C) recurrent …