Mayo Clinic Cases in Neuroimmunology

Andrew McKeon, Mark Keegan, and Oliver Tobin are Mayo Clinic-based neuroimmunologists. They provide care for patients with diverse immune-mediated CNS diseases 'from cortex to c-fibers', including MS, NMO, and paraneoplastic disorders, both in the Multiple Sclerosis and Autoimmune Neurology Clinics, and diagnostic Neuroimmunology Laboratory. Educational accomplishments include being current or former fellowship program directors at Mayo Clinic, and in research have characterized a number of inflammatory CNS diseases (CLIPPERS and Autoimmune GFAP astrocytopathy).

This book is useful for general neurologists for review on the wards and in clinic, as well as neuroimmunologists.

• Section ICNS Demyelinating Disease (Cases 1-21)Case 1 A Woman With Subacute Painful Vision LossJiraporn Jitprapaikulsan, MD, M. Tariq Bhatti, MD, Eric R. Eggenberger, DO, and Marie D. Acierno, MDCase 2 Rapidly Progressive Numbness and Weakness After Soft-Tissue AbscessElia Sechi, MD, and Dean M. Wingerchuk, MDCase 3 Weakness With Neck FlexionBrian G. Weinshenker, MDCase 4 New-Onset Right-Sided Numbness and Double VisionW. Oliver Tobin, MB, BCh, BAO, PhDCase 5 Progressive Left Lower Extremity Weakness and Thoracic Spinal Cord LesionB. Mark Keegan, MDCase 6 Progressive Spasticity With a Single Magnetic Resonance Imaging LesionSamantha A. Banks, MD, and Eoin P. Flanagan, MB, BChCase 7 Fluctuating Vision Loss, Seizures, and Left Parieto-Occipital MassAlicja Kalinowska-Lyszczarz, MD, PhD, W. Oliver Tobin, MB, BCh, BAO, PhD, Yong Guo, MD, PhD, and Claudia F. Lucchinetti, MDCase 8 Diffuse Pain and Abnormal Brain MRI FindingsAndrew McKeon, MB, BCh, MDCase 9 Lesions Found by ChanceDean M. Wingerchuk, MDCase 10 Encephalopathy and Quadriparesis After an Upper Respiratory Tract InfectionA. Sebastian Lopez Chiriboga, MDCase 11 Severe Monocular Vision Loss Followed by Gait DifficultyBrian G. Weinshenker, MDCase 12 Multiple Sclerosis and Cognitive ImpairmentCristina Valencia-Sanchez, MD, PhD, and Jonathan L. Carter, MDCase 13 New-Onset Gait Difficulty With Kappa Free Light Chains in Cerebrospinal FluidMaria Alice V. Willrich, PhD, and Ruba S. SaadehCase 14 A Girl With Back Pain, Paresthesias, and Painful Vision Loss Cecilia Zivelonghi, MD, and Andrew McKeon, MB, BCh, MDCase 15 A Septuagenarian With Progressive HemiparesisRoman Kassa, MD, and B. Mark Keegan, MDCase 16 Recurrent Demyelinating EpisodesI. Vanessa Marin Collazo, MDCase 17 Breakthrough Disease While on Multiple Sclerosis Immunomodulatory TherapyJonathan L. Carter, MDCase 18 Highly Active Multiple SclerosisRoman Kassa, MD, and W. Oliver Tobin, MB, BCh, BAO, PhDCase 19 Progressive Gait DifficultiesI. Vanessa Marin Collazo, MDCase 20 Progressive Cerebellar Ataxia After Natalizumab TreatmentMichel Toledano, MDCase 21 Weakness and Dysarthria After RadiosurgeryAndrew McKeon, MB, ChB, MDSection IIAutoimmune Neurologic Disorders (Cases 22-52)Case 22 Fatigue, Blurry Vision, and Swollen Optic NervesMarie D. Acierno, MD, M. Tariq Bhatti, MD, John J. Chen, MD, PhD, and Eric R. Eggenberger, DOCase 23 Progressive, Symmetrical, Painless Visual Loss in an Elderly WomanEric R. Eggenberger, DO, Marie D. Acierno, MD, M. Tariq Bhatti, MD, and John J. Chen, MD, PhDCase 24 Personality Changes, Cognitive Decline, and Jerking Movements A. Sebastian Lopez Chiriboga, MDCase 25 Rapidly Progressive Memory Loss, Mood Change, Mutism, and Abnormal MovementsShailee S. Shah, MD, and Marie F. Grill, MDCase 26 Behavioral and Cognitive Changes Followed by ComaAnastasia Zekeridou, MD, PhDCase 27 Episodic Hemiparesis, Cognitive Decline, and Seizures in a Woman With Pernicious AnemiaCristina Valencia-Sanchez, MD, PhD, and Andrew McKeon, MB, BCh, MDCase 28 Rapidly Progressive Dementia and Thyroid AntibodiesAmy C. Kunchok, MBBS, MMED, and Eoin P. Flanagan, MB, BChCase 29 Goosebumps and Memory LossJeffrey W. Britton, MD, Bhavya Narapureddy, MBBS, and Divyanshu Dubey, MBBSCase 30 A Patient With Headache and Progressive TremorAnastasia Zekeridou, MDCase 31 A Man With Flulike Symptoms and Hemorrhagic Brain LesionsMichel Toledano, MDCase 32 Hearing Loss, Imbalance, and Diplopia in a 44-Year-Old ManMichelle F. Devine, MD, Divyanshu Dubey, MBBS, and Sean J. Pittock, MDCase 33 Chorea, Ataxia, and Disturbed SleepJohn C. Feemster, and Erik K. St. Louis, MD, MSCase 34 Rapidly Progressive Gait and Coordination DifficultiesAndrew McKeon, MB, BCh, MDCase 35 Dancelike Movements in a Patient With a History of RashAndrew McKeon, MB, BCh, MDCase 36 Body Spasms in a Woman With Thyroid DiseaseAndrew McKeon, MB, BCh, MDCase 37 Stiffness, Spasms, and Frequent Falls in a 41-Year-Old ManMichelle Devine, MD, and A. Sebastian Lopez Chiriboga, MDCase 38 Rapid-Onset Weakness and Numbness in a Patient With Systemic Lupus ErythematosusFloranne C. Ernste, MDCase 39 Progressive Quadriparesis and CancerElia Sechi, MD, and Eoin P. Flanagan, MB, BChCase 40 Progressive Numbness, Burning Pain, Imbalance, and DrynessShahar Shelly, MD, and Divyanshu Dubey, MBBSCase 41 Ascending Painful Paresthesias, Progressive Ataxia, and Bilateral Foot DropRocio Vazquez Do Campo, MD, and Divyanshu Dubey, MBBSCase 42 Painless, Symmetric, Ascending Weakness and Sensory LossChristopher J. Klein, MDCase 43 Difficult-to-Treat PolyradiculoneuropathyMarcus V. R. Pinto, MD, MS, and P. James B. Dyck, MDCase 44 Autoimmune Peripheral Nervous System HyperexcitabilityChristopher J. Klein, MDCase 45 Orthostatism, Constipation, and Early SatietyKamal Shouman, MD, and Eduardo E. Benarroch, MDCase 46 Constipation and SyncopeMichelle F. Devine, MD, and Sean J. Pittock, MDCase 47 Bulbar-Predominant WeaknessJennifer A. Tracy, MD, and Vanda A. Lennon, MD, PhDCase 48 Difficulty Climbing the StairsAnastasia Zekeridou, MD, PhD, and Vanda A. Lennon, MD, PhDCase 49 Rapidly Progressive Proximal WeaknessTeerin Liewluck, MD, and Margherita Milone, MD, PhDCase 50 Progressive Weakness and RashMargherita Milone, MD, PhD, and Teerin Liewluck, MDCase 51 "Restlessness" After Cancer Diagnosis and TreatmentAnastasia Zekeridou, MD, PhDCase 52 Sudden Onset of Diplopia and a Skeletal Muscle AntibodyJohn R. Mills, PhDSection IIIOther Inflammatory CNS Disorders and Neuroimmunologic Mimics (Cases 53-83)Case 53 Diplopia, Orbital Pain, and Vision Loss in a Middle-Aged WomanLauren M. Webb, and Eoin P. Flanagan, MB, BChCase 54 A Young Man With Visual Field Loss, Decreased Hearing, and Confusion M. Tariq Bhatti, MD, Eric R. Eggenberger, DO, Marie D. Acierno, MD, and John J. Chen, MD, PhDCase 55 A Woman With Progressive Gait Difficulty and White Matter AbnormalitiesAdrian Budhram, MD, and Ralitza H. Gavrilova, MDCase 56 Progressive Asymmetrical Limb Impairment and Cognitive Decline With LeukoencephalopathyB. Mark Keegan, MDCase 57 A Woman With Fever, Confusion, and SeizuresMichel Toledano, MDCase 58 Encephalopathy With Alternating Hemispheric MRI AbnormalitiesAndrew McKeon, MB, BCh, MDCase 59 Rapid-Onset Hemibody Sensory Loss, Incoordination, and Muscle JerkingAndrew McKeon, MB, BCh, MD, and Nicholas L. Zalewski, MDCase 60 A History of Sarcoidosis and a New Brain LesionAndrew McKeon, MB, BCh, MD, and Julie E. Hammack, MDCase 61 Headache and Hemiparesis in Middle AgeCatalina Sanchez Alvarez, MD, and Kenneth J. Warrington, MDCase 62 Subacute Cognitive Decline in an 86-Year-Old Woman With Prior Lobar Intracerebral HemorrhageStephen W. English Jr, MD, MBA, and James P. Klaas, MDCase 63 A 75-Year-Old Man With 5 Days of Progressive Gait Difficulties and ConfusionJulie E. Hammack, MDCase 64 Night Sweats and ParaparesisDavid N. Abarbanel, MD, and Ivan D. Carabenciov, MDCase 65 A Woman With Headaches and a Tumefactive Brain LesionAndrew McKeon, MB, BCh, MDCase 66 Behavioral Change, Seizures, and Temporal Lobe LesionStuart J. McCarter, MD, and Andrew McKeon, MB, BCh, MDCase 67 A Young Woman With Vessel Dissection and Brainstem LesionsBurcu Zeydan, MD, and Orhun H. Kantarci, MDCase 68 Headache, Uveitis, and Leptomeningeal EnhancementOrhun H. Kantarci, MDCase 69 Weakness and Punctate EnhancementW. Oliver Tobin, MB, BCh, BAO, PhDCase 70 Bilateral Paresthesias in Crohn DiseaseAmy C. Kunchok, MBBS, and Andrew McKeon, MB, BCh, MDCase 71 Seizures and Enhancing Brain LesionsJosephe Archie Honorat, MD, PhD, and Andrew McKeon, MB, BCh, MDCase 72 A Man With Recurrent Headache and Focal Neurologic DeficitsJaclyn R. Duvall, MD, and Jerry W. Swanson, MD, MHPECase 73 Headache, Radicular Pain, and Enhancing LesionsW. Oliver Tobin, MB, BCh, BAO, PhDCase 74 Seizures 3 Months After EndarterectomyAndrew McKeon, MB, BCh, MD, and Robert D. Brown Jr, MD, MPHCase 75 Progressive Bilateral Arm Pain, Gait Disturbance, Constipation, and Urinary RetentionIvan D. Carabenciov, MD, and Michael W. Ruff, MDCase 76 A Woman With Subacute Numbness of the Trunk, Arms, and LegsEoin P. Flanagan, MB, BChCase 77 A Septuagenarian With Progressive Lower Extremity Weakness and PainNicholas L. Zalewski, MDCase 78 Acute Quadriparesis in a SmokerNicholas L. Zalewski, MDCase 79 A 25-Year-Old Man With Recurrent Back Pain and Rapid-Onset ParaplegiaNicholas L. Zalewski, MDCase 80 Progressive Myelopathy After Neck PainEoin P. Flanagan, MB, BChCase 81 Progressive Imbalance and Visual Impairment in a Patient With DiabetesNeeraj Kumar, MDCase 82 Progressive Myelopathy After Spine SurgeryAndrew McKeon, MB, BCh, MD, and Nicholas L. Zalewski, MDCase 83 Altered Mental Status During the COVID-19 PandemicSara Mariotto, MD, Silvia Bozzetti, Maria Elena De Rui, Fulvia Mazzaferri, Andrew McKeon, MB, BCh, MD, and Sergio FerrariSection IVQuestions and AnswersSection I: Questions, Answers, Suggested ReadingSection II: Questions, Answers, Suggested ReadingSection III: Questions, Answers, Suggested Reading