A 71-year-old man with a rash and severe sensorimotor neuropathy

Article Abstract:

A 71-year-old man with respiratory failure, a rash and muscle weakness was diagnosed with axonal polyneuropathy and immunoglobulin A (IgA) myeloma. He had a long history of alcoholism and diabetes but had been in stable health until two or three months prior to hospital admission. Upon examination, he was found to have severe nerve damage and significant depletion of nerve fibers. His muscle weakness and wasting and respiratory failure progressed rapidly. His symptoms indicated that he had an axonal polyneuropathy, and the rapid progression indicated that the diabetes and alcoholism were not the cause. His illness resembled Guillain-Barre syndrome except that his nerves were excitable on testing. A sample of his bone marrow revealed plasma cells, indicating that he had multiple myeloma. Specifically, he had an excess of IgA cells. Polyneuropathy can be associated with multiple myeloma, and occasionally the disorder mimics Guillain-Barre syndrome.

Cases, Multiple myeloma, Polyneuropathies

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An 18-year-old man with severe headache, pleocytosis, and ataxia

Article Abstract:

An 18-year-old male high-school student was hospitalized with severe headache, uncoordinated movements, and slurred speech. He also had symptoms resembling influenza. A diagnostic report confirmed Q fever after suspected infectious cerebellitis, viral meningitis or leptospirosis were ruled out. Tetracycline is often given as a precaution, although Q fever usually resolves without intervention. The patient initially received ceftriaxone and doxycycline and was discharged after two days. He may have been exposed to contaminated animal wastes while cleaning public parks.

Diagnosis, Physiological aspects, Ataxia, Q fever, Meningoencephalitis

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Concussion

Article Abstract:

A case study of 64-year-old woman who showed brief convulsion immediately after the fall from icy walk and unresponsiveness for less than 1 minute is presented. The patient had a concussion complicated by an impact-related seizure but could be safely discharged to the care of a trusted person who was given written instructions to check on the patient for 24 hour period for return of drowsiness, vomiting, confusion, weakness, or increased headache.

United States, Case studies, Brain, Concussion, Case study

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