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 Loss Jiraporn Jitprapaikulsan, MD, M. Tariq Bhatti, MD, Eric R. Eggenberger, DO, and Marie D. Acierno, MD Case 2 Rapidly Progressive Numbness and Weakness After Soft-Tissue Abscess Elia Sechi, MD, and Dean M. Wingerchuk, MD Case 3 Weakness With Neck Flexion Brian G. Weinshenker, MD Case 4 New-Onset Right-Sided Numbness and Double Vision W. Oliver Tobin, MB, BCh, BAO, PhD Case 5 Progressive Left Lower Extremity Weakness and Thoracic Spinal Cord Lesion B. Mark Keegan, MD Case 6 Progressive Spasticity With a Single Magnetic Resonance Imaging Lesion Samantha A. Banks, MD, and Eoin P. Flanagan, MB, BCh Case 7 Fluctuating Vision Loss, Seizures, and Left Parieto-Occipital Mass Alicja Kalinowska-Lyszczarz, MD, PhD, W. Oliver Tobin, MB, BCh, BAO, PhD, Yong Guo, MD, PhD, and Claudia F. Lucchinetti, MD Case 8 Diffuse Pain and Abnormal Brain MRI Findings Andrew McKeon, MB, BCh, MD Case 9 Lesions Found by Chance Dean M. Wingerchuk, MD Case 10 Encephalopathy and Quadriparesis After an Upper Respiratory Tract Infection A. Sebastian Lopez Chiriboga, MD Case 11 Severe Monocular Vision Loss Followed by Gait Difficulty Brian G. Weinshenker, MD Case 12 Multiple Sclerosis and Cognitive Impairment Cristina Valencia-Sanchez, MD, PhD, and Jonathan L. Carter, MD Case 13 New-Onset Gait Difficulty With Kappa Free Light Chains in Cerebrospinal Fluid Maria Alice V. Willrich, PhD, and Ruba S. Saadeh Case 14 A Girl With Back Pain, Paresthesias, and Painful Vision Loss Cecilia Zivelonghi, MD, and Andrew McKeon, MB, BCh, MD Case 15 A Septuagenarian With Progressive Hemiparesis Roman Kassa, MD, and B. Mark Keegan, MD Case 16 Recurrent Demyelinating Episodes I. Vanessa Marin Collazo, MD Case 17 Breakthrough Disease While on Multiple Sclerosis Immunomodulatory Therapy Jonathan L. Carter, MD Case 18 Highly Active Multiple Sclerosis Roman Kassa, MD, and W. Oliver Tobin, MB, BCh, BAO, PhD Case 19 Progressive Gait Difficulties I. Vanessa Marin Collazo, MD Case 20 Progressive Cerebellar Ataxia After Natalizumab Treatment Michel Toledano, MD Case 21 Weakness and Dysarthria After Radiosurgery Andrew McKeon, MB, ChB, MD Section IIAutoimmune Neurologic Disorders (Cases 22-52) Case 22 Fatigue, Blurry Vision, and Swollen Optic Nerves Marie D. Acierno, MD, M. Tariq Bhatti, MD, John J. Chen, MD, PhD, and Eric R. Eggenberger, DO Case 23 Progressive, Symmetrical, Painless Visual Loss in an Elderly Woman Eric R. Eggenberger, DO, Marie D. Acierno, MD, M. Tariq Bhatti, MD, and John J. Chen, MD, PhD Case 24 Personality Changes, Cognitive Decline, and Jerking Movements A. Sebastian Lopez Chiriboga, MD Case 25 Rapidly Progressive Memory Loss, Mood Change, Mutism, and Abnormal Movements Shailee S. Shah, MD, and Marie F. Grill, MD Case 26 Behavioral and Cognitive Changes Followed by Coma Anastasia Zekeridou, MD, PhD Case 27 Episodic Hemiparesis, Cognitive Decline, and Seizures in a Woman With Pernicious Anemia Cristina Valencia-Sanchez, MD, PhD, and Andrew McKeon, MB, BCh, MD Case 28 Rapidly Progressive Dementia and Thyroid AntibodiesAmy C. Kunchok, MBBS, MMED, and Eoin P. Flanagan, MB, BCh Case 29 Goosebumps and Memory Loss Jeffrey W. Britton, MD, Bhavya Narapureddy, MBBS, and Divyanshu Dubey, MBBS Case 30 A Patient With Headache and Progressive Tremor Anastasia Zekeridou, MD Case 31 A Man With Flulike Symptoms and Hemorrhagic Brain Lesions Michel Toledano, MD Case 32 Hearing Loss, Imbalance, and Diplopia in a 44-Year-Old Man Michelle F. Devine, MD, Divyanshu Dubey, MBBS, and Sean J. Pittock, MD Case 33 Chorea, Ataxia, and Disturbed Sleep John C. Feemster, and Erik K. St. Louis, MD, MS Case 34 Rapidly Progressive Gait and Coordination Difficulties Andrew McKeon, MB, BCh, MD Case 35 Dancelike Movements in a Patient With a History of Rash Andrew McKeon, MB, BCh, MD Case 36 Body Spasms in a Woman With Thyroid Disease Andrew McKeon, MB, BCh, MD Case 37 Stiffness, Spasms, and Frequent Falls in a 41-Year-Old ManMichelle Devine, MD, and A. Sebastian Lopez Chiriboga, MD Case 38 Rapid-Onset Weakness and Numbness in a Patient With Systemic Lupus Erythematosus Floranne C. Ernste, MD Case 39 Progressive Quadriparesis and Cancer Elia Sechi, MD, and Eoin P. Flanagan, MB, BCh Case 40 Progressive Numbness, Burning Pain, Imbalance, and Dryness Shahar Shelly, MD, and Divyanshu Dubey, MBBS Case 41 Ascending Painful Paresthesias, Progressive Ataxia, and Bilateral Foot Drop Rocio Vazquez Do Campo, MD, and Divyanshu Dubey, MBBS Case 42 Painless, Symmetric, Ascending Weakness and Sensory Loss Christopher J. Klein, MD Case 43 Difficult-to-Treat Polyradiculoneuropathy Marcus V. R. Pinto, MD, MS, and P. James B. Dyck, MD Case 44 Autoimmune Peripheral Nervous System Hyperexcitability Christopher J. Klein, MD Case 45 Orthostatism, Constipation, and Early Satiety Kamal Shouman, MD, and Eduardo E. Benarroch, MD Case 46 Constipation and Syncope Michelle F. Devine, MD, and Sean J. Pittock, MD Case 47 Bulbar-Predominant Weakness Jennifer A. Tracy, MD, and Vanda A. Lennon, MD, PhD Case 48 Difficulty Climbing the Stairs Anastasia Zekeridou, MD, PhD, and Vanda A. Lennon, MD, PhD Case 49 Rapidly Progressive Proximal Weakness Teerin Liewluck, MD, and Margherita Milone, MD, PhD Case 50 Progressive Weakness and Rash Margherita Milone, MD, PhD, and Teerin Liewluck, MD Case 51 "Restlessness" After Cancer Diagnosis and Treatment Anastasia Zekeridou, MD, PhD Case 52 Sudden Onset of Diplopia and a Skeletal Muscle Antibody John R. Mills, PhD Section IIIOther Inflammatory CNS Disorders and Neuroimmunologic Mimics (Cases 53-83) Case 53 Diplopia, Orbital Pain, and Vision Loss in a Middle-Aged Woman Lauren M. Webb, and Eoin P. Flanagan, MB, BCh Case 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, PhD Case 55 A Woman With Progressive Gait Difficulty and White Matter Abnormalities Adrian Budhram, MD, and Ralitza H. Gavrilova, MD Case 56 Progressive Asymmetrical Limb Impairment and Cognitive Decline With Leukoencephalopathy B. Mark Keegan, MD Case 57 A Woman With Fever, Confusion, and Seizures Michel Toledano, MD Case 58 Encephalopathy With Alternating Hemispheric MRI Abnormalities Andrew McKeon, MB, BCh, MD Case 59 Rapid-Onset Hemibody Sensory Loss, Incoordination, and Muscle Jerking Andrew McKeon, MB, BCh, MD, and Nicholas L. Zalewski, MD Case 60 A History of Sarcoidosis and a New Brain Lesion Andrew McKeon, MB, BCh, MD, and Julie E. Hammack, MD Case 61 Headache and Hemiparesis in Middle Age Catalina Sanchez Alvarez, MD, and Kenneth J. Warrington, MD Case 62 Subacute Cognitive Decline in an 86-Year-Old Woman With Prior Lobar Intracerebral Hemorrhage Stephen W. English Jr, MD, MBA, and James P. Klaas, MD Case 63 A 75-Year-Old Man With 5 Days of Progressive Gait Difficulties and Confusion Julie E. Hammack, MD Case 64 Night Sweats and Paraparesis David N. Abarbanel, MD, and Ivan D. Carabenciov, MD Case 65 A Woman With Headaches and a Tumefactive Brain Lesion Andrew McKeon, MB, BCh, MD Case 66 Behavioral Change, Seizures, and Temporal Lobe Lesion Stuart J. McCarter, MD, and Andrew McKeon, MB, BCh, MD Case 67 A Young Woman With Vessel Dissection and Brainstem Lesions Burcu Zeydan, MD, and Orhun H. Kantarci, MD Case 68 Headache, Uveitis, and Leptomeningeal Enhancement Orhun H. Kantarci, MD Case 69 Weakness and Punctate Enhancement W. Oliver Tobin, MB, BCh, BAO, PhD Case 70 Bilateral Paresthesias in Crohn Disease Amy C. Kunchok, MBBS, and Andrew McKeon, MB, BCh, MD Case 71 Seizures and Enhancing Brain Lesions Josephe Archie Honorat, MD, PhD, and Andrew McKeon, MB, BCh, MD Case 72 A Man With Recurrent Headache and Focal Neurologic Deficits Jaclyn R. Duvall, MD, and Jerry W. Swanson, MD, MHPE Case 73 Headache, Radicular Pain, and Enhancing Lesions W. Oliver Tobin, MB, BCh, BAO, PhD Case 74 Seizures 3 Months After Endarterectomy Andrew McKeon, MB, BCh, MD, and Robert D. Brown Jr, MD, MPH Case 75 Progressive Bilateral Arm Pain, Gait Disturbance, Constipation, and Urinary Retention Ivan D. Carabenciov, MD, and Michael W. Ruff, MD Case 76 A Woman With Subacute Numbness of the Trunk, Arms, and Legs Eoin P. Flanagan, MB, BCh Case 77 A Septuagenarian With Progressive Lower Extremity Weakness and Pain Nicholas L. Zalewski, MD Case 78 Acute Quadriparesis in a Smoker Nicholas L. Zalewski, MD Case 79 A 25-Year-Old Man With Recurrent Back Pain and Rapid-Onset Paraplegia Nicholas L. Zalewski, MD Case 80 Progressive Myelopathy After Neck Pain Eoin P. Flanagan, MB, BCh Case 81 Progressive Imbalance and Visual Impairment in a Patient With Diabetes Neeraj Kumar, MD Case 82 Progressive Myelopathy After Spine Surgery Andrew McKeon, MB, BCh, MD, and Nicholas L. Zalewski, MD Case 83 Altered Mental Status During the COVID-19 Pandemic Sara Mariotto, MD, Silvia Bozzetti, Maria Elena De Rui, Fulvia Mazzaferri, Andrew McKeon, MB, BCh, MD, and Sergio Ferrari Section IVQuestions and Answers Section I: Questions, Answers, Suggested ReadingSection II: Questions, Answers, Suggested ReadingSection III: Questions, Answers, Suggested Reading