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March 31, 2020; 94 (13) Resident & Fellow Section

Resident & Fellow Rounds

View ORCID ProfileJohn J. Millichap, Roy E. Strowd
First published March 30, 2020, DOI: https://doi.org/10.1212/WNL.0000000000009176
John J. Millichap
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Roy E. Strowd III
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Resident & Fellow Rounds
John J. Millichap, Roy E. Strowd
Neurology Mar 2020, 94 (13) 588-590; DOI: 10.1212/WNL.0000000000009176

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A summary of recently published articles in the Neurology® Resident & Fellow Section

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March 3, 2020, issue

This issue contains a Clinical Reasoning case featuring a 74-year-old man with bilateral foot drop. A Pearls & Oy-sters article showcases the rare primary angiitis of the CNS. In a Teaching NeuroImage, a young boy presents with a rare childhood-onset lower motor neuron disease.

Clinical Reasoning: A case of bilateral foot drop in a 74-year-old man

This case reviews the key clinical findings to be considered when examining a patient with bilateral foot drop.

Page 405

Pearls & Oy-sters: Primary angiitis of the CNS presenting with recurrent intracranial hemorrhage

A patient with acute onset of left hemiparesis, numbness, and dysarthria is presented. The case showcases the diagnostic challenges of rare disease presentation.

Page e992

Teaching NeuroImages: Hopkins syndrome: A rare differential diagnosis of neurogenic monomelic amyotrophy

Hopkins syndrome is a rare disorder presenting with acute flaccid paralysis and can mimic monomelic amyotrophy. This Teaching NeuroImage demonstrates findings in an 11-year-old boy who presented with left thigh weakness.

Page e996

March 10, 2020, issue

This issue contains two Clinical Reasoning articles. The first case is a teenage boy presenting with an immunologic disease that can cause progressive cognitive decline and gait impairment. The second is presented as one of our popular Mystery Cases and involves a middle-aged man with worsening headaches, nausea, and vomiting. Finally, the differential diagnosis of pediatric arterial ischemic stroke in a young girl with cardiac myxomas is explained in the Child Neurology case.

Clinical Reasoning: A 16-year-old boy with progressive cognitive decline and gait impairment

This case discusses the need for early diagnosis of hyperimmunoglobulin E syndrome for effective treatment.

Page 449

Child Neurology: Arterial ischemic stroke in a 12-year-old patient with cardiac myxomas

A 12-year-old girl had cardiac myxoma and developed pediatric arterial ischemic stroke. The patient showed aphasia, disorientation, and agitation.

Page e1103

Clinical Reasoning: A 63-year-old man with gastroenteritis progressing to stupor and quadriparesis

A patient with headache, nausea, and vomiting is presented. The differential diagnosis and important considerations in the diagnosis of CLIPPERS (chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids) are discussed.

Page e1107

March 17, 2020, issue

This issue features an Education Research article on the present state of fellowship training for neuroimmunology and multiple sclerosis in the United States. The first Clinical Reasoning case features a man with insomnia and psychiatric and motor symptoms and the second case a woman with worsening neurologic deficits, in whom neuropathologic features and genetic testing were instrumental in making a diagnosis. The Teaching Video NeuroImage case exhibits intralabyrinthine schwannoma.

Education Research: Multiple sclerosis and neuroimmunology fellowship training status in the United States

This article highlights the need for postgraduate training in multiple sclerosis and neuroimmunology. The study showcases the need for widespread training across neuroimmunologic diagnoses and cross-disciplinary training.

Page 495

Clinical Reasoning: A 45-year-old man with progressive insomnia and psychiatric and motor symptoms

Familial fatal insomnia, a rare autosomal dominant prion disease, presents typically with attention issues, insomnia, and progressive dementia. A patient presented with 6 months of worsening neuropsychiatric and motor symptoms along with severe insomnia.

Page e1213

Clinical Reasoning: A 42-year-old woman with progressive cognitive difficulties and gait imbalance

A 42-year-old woman with a history of psoriatic arthritis presented with difficulty in concentration and task completion as well as gait imbalance.

Page e1219

Teaching Video NeuroImages: Intralabyrinthine schwannoma masquerading as Ménière disease

This case discusses high-resolution MRI as part of the diagnosis of intralabyrinthine schwannoma.

Page e1227

March 24, 2020, issue

This issue features 2 Clinical Reasoning cases. The first case features a man with super-refractory status epilepticus and the second showcases a woman intubated at the hospital following a week of fatigue and drowsiness. The Child Neurology case features a case of ethylmalonic encephalopathy with a novel variation in ETHE1.

Clinical Reasoning: Ketogenic diet in adult super-refractory status epilepticus

This article details the case of a man developing super-refractory status epilepticus following a car accident. An alternative treatment of ketogenic diet for super-refractory status epilepticus is highlighted.

Page 541

Clinical Reasoning: A young healthy woman with difficult-to-wean acute ventilator dependence

The patient with fatigue and drowsiness was intubated after hypercapnic respiratory failure. MRI revealed Chiari malformation, which is a consideration for investigation of respiratory failure.

Page e1340

Child Neurology: Ethylmalonic encephalopathy

A boy presented with developmental decline due to ethylmalonic encephalopathy, a rare autosomal recessive disorder. Exome sequencing revealed a variation of the ETHE1 gene.

Page e1336

March 31, 2020, issue

This issue features a Mystery Case describing an 82-year-old man presenting with tongue tremor. Next, there is a Pearls and Oy-sters article that describes the diagnosis of a middle-aged man with worsening gait and slurred speech. Finally, there are two Teaching NeuroImages cases, one on trochlear nerve schwannoma and the other showing superior compression of the left oculomotor nerve in a middle-aged woman.

Mystery Case: Symptomatic isolated tongue tremor of cortical origin due to stroke

An 82-year-old man presented with tongue tremor. This case indicates that spontaneous tongue tremor may occur following cortical ischemic stroke.

Page 591

Pearls & Oy-sters: Progressive ataxia and palatal tremor: Imaging and disease course

This case describes a man who came to clinic with 3 years of worsening gait and slurred speech. The case is unique in that the patient experienced spontaneous resolution of tremor but worsening gait ataxia.

Page e1445

Teaching NeuroImages: Trochlear nerve schwannoma

The case of a woman with binocular vertical diplopia on downgaze is presented.

Page e1448

Teaching NeuroImages: Pupil-sparing compression of oculomotor nerve by posterior cerebral artery vessel

Neuro-ophthalmic examination was performed on a woman presenting a 30-year history of worsening left blepharoptosis.

Page e1450

Footnotes

  • Editor's Blog: NPub.org/rfblog

  • Neurology Podcast: NPub.org/rf

  • Resident & Fellow Clinical Reasoning Book: NPub.org/crb

  • Resident & Fellow ePearls: NPub.org/epearls

  • Resident & Fellow Child Neurology Book NPub.org/cnbook

  • © 2020 American Academy of Neurology

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    • March 17, 2020, issue
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    • Footnotes
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Related Articles

  • Clinical Reasoning: A case of bilateral foot drop in a 74-year-old man
  • Pearls & Oy-sters: Primary angiitis of the CNS presenting with recurrent intracranial hemorrhage
  • Teaching NeuroImages: Hopkins syndromeA rare differential diagnosis of neurogenic monomelic amyotrophy
  • Clinical Reasoning: A 16-year-old boy with progressive cognitive decline and gait impairment
  • Child Neurology: Arterial ischemic stroke in a 12-year-old patient with cardiac myxomas
  • Clinical Reasoning: A 63-year-old man with gastroenteritis progressing to stupor and quadriparesis
  • Education Research: Multiple sclerosis and neuroimmunology fellowship training status in the United States
  • Clinical Reasoning: A 45-year-old man with progressive insomnia and psychiatric and motor symptoms
  • Clinical Reasoning: A 42-year-old woman with progressive cognitive difficulties and gait imbalance
  • Teaching Video NeuroImages: Intralabyrinthine schwannoma masquerading as Ménière disease
  • Clinical Reasoning: Ketogenic diet in adult super-refractory status epilepticus
  • Clinical Reasoning: A young healthy woman with difficult-to-wean acute ventilator dependence
  • Child Neurology: Ethylmalonic encephalopathy
  • Mystery Case: Symptomatic isolated tongue tremor of cortical origin due to stroke
  • Pearls & Oy-sters: Progressive ataxia and palatal tremorImaging and disease course
  • Teaching NeuroImages: Trochlear nerve schwannoma
  • Teaching NeuroImages: Pupil-sparing compression of oculomotor nerve by posterior cerebral artery vessel

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