tailieunhanh - Neurology Study Guide - part 5

Các biểu hiện lâm sàng có thể trình bày sâu sắc hoặc subacutely có dấu hiệu của sự tham gia của tiểu não, chẳng hạn như thân mình và chân tay mất điều hòa, dysarthria, rung giãn nhãn cầu, oscillopsia, và như vậy. Các triệu chứng khác bao gồm buồn nôn và ói mửa | 94 9. Tumors ovary and female genital tract as well as small cell cancer of the lung and Hodgkin s lymphoma. The clinical manifestation can present acutely or sub-acutely with signs of cerebellar involvement such as truncal and limb ataxia dysarthria nystagmus oscillop-sia and so on. Other symptoms include nausea and vomiting and in some cases changes in mental status with decreased sensorium cognitive impairment and limb weakness. Therefore paraneoplastic cerebellar degeneration should be considered in a patient with progressive cerebellar dysfunction particularly in middle-aged women presenting with severe ataxia dysarthria and downbeat nystagmus. Laboratory Tests The discovery of circulating antineuronal autoantibodies in some PCD patients has supported the theory of an autoimmune etiology Dropcho . Anti-Purkinje cell antibodies APCA also called anti-Yo found in some cases may indicate the possibility of an underlying malignancy in particular breast ovarian or female genital tract cancer. Foster Kennedy Syndrome Due to Olfactory Groove Meningioma Vignette A 56-year-old accountant complained of incessant frontal headache of one year s duration. His family noted that he lost interest in his work began acting inappropriately and showed very little emotion to his wife s sudden death 4 months earlier. Neurological examination indicates a forgetful man with right anosmia optic atrophy and concentric narrowing of the visual field. A left disc edema is noted. Summary 56-year-old man with headache personality changes memory loss and focal findings Right anosmia and optic atrophy. Left papilledema. Localization Frontal lobe Subfrontal area with involvement of olfactory bulb or tract and ipsilateral optic nerve. Diagnosis and Differential Diagnosis Loss of smell can be an early and important symptom of intracranial neoplasm particularly when considering meningiomas of the sphenoidal ridge and olfactory groove gliomas of the frontal lobe and parasellar masses causing .