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Vascular neurology questions and answers - part 6

Chỉ có một mối quan hệ không phù hợp tồn tại với hoạt động EEG kịch phát, và các thuốc chống co giật truyền thống nói chung là không hiệu quả. Liều cao của các benzodiazepin có thể ức chế hoạt động myoclonic. Myoclonus nghiêm trọng và kéo dài sứ giả người nghèo tiên lượng và tỷ lệ tử vong cao. | CLINICAL STROKE ANSWERS 155 ter global hypoxic injury. Only an inconsistent relationship exists with paroxysmal EEG activity and traditional anticonvulsants are generally ineffective. High doses of benzodiazepines may suppress the myoclonic activity. Severe and protracted myoclonus heralds poor prognosis and a high mortality. An action myoclonus syndrome described by Lance and Adams occurs after recovery from coma secondary to cerebral ischemia. The intention myoclonus of the Lance-Adams syndrome is seen in awake patients and may be stimulus-activated. Ropper 2004 288. The answer is B. For explanation see Answer 289. 289. The answer is C. Although it is a rare disease this woman has the classic triad of Susac syndrome subacute encephalopathy branch retinal artery occlusions and sensorineural hearing loss. Susac syndrome a microangiopathy involves arterioles of the brain retina and cochlea. Early in its presentation it can be confused with other disorders producing multifocal neurologic symptoms. The lack of systemic symptoms in this woman makes syphilis and lupus less likely and her retinal findings are not seen in multiple sclerosis. Although Cogan syndrome may present with a Ménière syndrome-like symptoms overlapping the vestibular symptoms of Susac syndrome the visual symptoms of Cogan syndrome are due to interstitial keratitis or less commonly uveitis. The MRI picture of Susac syndrome reflects the pathology of a microangiopathy involving both gray and white matter. Lesions are seen in the cerebrum cerebellum and brainstem. Acute or subacute lesions may enhance during the attack and rarely leptomeningeal enhancement is noted. The disease may be monophasic or fluctuating with changes in the MRI lesions over time. Do et al. Am J Neuroradiol 2004 290. The answer is C. The patient has Cogan syndrome with interstitial keratitis granular corneal infiltration and a Ménière-like syndrome with vertigo nausea vomiting tinnitus and gait instability. Patients with Cogan .