A summary of recently published articles in the Neurology® Resident & Fellow Section
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October 5, 2021, Issue
Pearls & Oy-sters: Trigeminal Nerve Dysfunction as the Key Diagnostic Clue to Listeria Rhombencephalitis
This study describes a case of listeria rhombencephalitis in which trigeminal nerve dysfunction was the primary presenting feature and the key to arriving at the correct diagnosis. Listeria rhombencephalitis is difficult to diagnose because it mimics other causes of brainstem lesions, and clinicians should maintain an index of suspicion in such cases.
Page e1457
Child Neurology: Recurrent Brainstem Strokes and Aphthous Ulcers in a Child With Mutations in the ADA2 Gene
The unusual presentation of adenosine deaminase 2 deficiency shown in this study is an instructive example of this treatable condition, and the rapid diagnosis of which is key to achieving positive patient outcomes.
Page 696
Teaching NeuroImage: Abducens Nerve Palsy With Ipsilateral Excessive Eye Tearing Attributed to an Internal Carotid Artery Sympathetic Plexus Schwannoma
Sympathetic plexus schwannoma is rare. This case reviews the neuroanatomic and pathophysiologic factors that influenced this uncommon condition.
Page e1461
Teaching NeuroImage: Concomitant Brain and Spine Lesions due to Multiple Nutritional Deficiencies
When multiple nutritional deficiencies coexist, imaging may demonstrate a constellation of metabolic findings. The patient described in this case developed an unusual combination of dorsal column, corticospinal tract, and corpus callosum lesions after pathologic food restriction and a vegetarian diet.
Page e1464
October 12, 2021, Issue
Teaching NeuroImage: Nonalcoholic Wernicke Encephalopathy
This article's description of an easily treatable yet underdiagnosed condition illustrates the importance of considering nonalcoholic Wernicke encephalopathy among the many possible pathologic sources of malnutrition or malabsorption.
Page e1541
Future of Neurology & Technology: Virtual and Augmented Reality in Neurology and Neuroscience Education: Applications and Curricular Strategies
Augmented and virtual reality technology remains a fascinating and timely topic; this study explores the potential for AR and VR to be leveraged in educational, practical, and surgical sectors. The authors also explore the potential limitations and challenges to be overcome about these technologies.
Page 740
Pearls & Oy-sters: A 32-Year-Old Woman With Recurrent Weakness and Paresthesias
In patients with GBS who develop recurrence of symptoms weeks to months after their presentation, clinicians should consider treatment-related fluctuations, recurrent GBS, or that the diagnosis is actually CIDP. This case is a valuable teaching tool on the importance of accurate diagnosis of CIDP, which is often difficult to distinguish from GBS and other related disorders.
Page e1537
Teaching NeuroImage: Notched Delta and Angelman Syndrome
The “notched delta” EEG pattern is typically found in readings of patients with Angelman syndrome—this study presents an excellent example of that pattern and is instructive for residents and fellows studying genetic disorders.
Page e1543
Teaching Video NeuroImage: Choreoathetosis and Focal Dystonia in Vitamin B12 Deficiency
This study describes a patient presenting with both common (pernicious anemia) and uncommon (choreoathetosis and dystonia) complications of B-12 deficiency. The accompanying video demonstrates the patient's condition before and after B-12 supplementation.
Page e1545
October 19, 2021, Issue
Teaching NeuroImage: Ganglion Cell Patterns Localize Anterior Visual Pathway Lesions
This case demonstrates the utility of optical coherence tomography, typically used in neuro-ophthalmology, in the testing and treatment of patients with pituitary tumors. The article and its accompanying images are of educational value for neurology trainees.
Page e1637
Pearls & Oy-sters: Labyrinthine Infarction Mimicking Vestibular Neuritis
When evaluating patients with acute vestibular syndrome, the bedside HINTS examination is helpful in differentiating central from peripheral pathology but can miss a labyrinthine infarction. Clinicians should be aware of the vascular supply to the cerebellar flocculus and inner ear from the AICA as illustrated in this case.
Page 787
Clinical Reasoning: An 81-Year-Old Woman Who Insisted the Hospital Was Her Home
This patient experienced acute right middle cerebral artery cardioembolic stroke, a common condition, accompanied by the uncommon presentation of reduplicative paramnesia to place (RPP). RPP is a fixed delusional belief that a familiar place has been duplication (e.g., the hospital was her home).
Page e1632
Teaching NeuroImage: Isolated Unilateral Hypoglossal Nerve Palsy due to Skull Base Meningioma
The often subtle presentation of isolated, unilateral hypoglossal nerve palsy is well described in this study; this case is of interest to trainees because it illustrates both the difficulty of recognizing this pathology and the importance of considering more conservative treatment approaches, as was done in this case.
Page e1639
October 26, 2021, Issue
Teaching NeuroImage: Histopathologically Confirmed Intracranial Enchondroma/Low-Grade Chondrosarcoma and IDH1-Mutated Diffuse Glioma in Ollier Disease
This study illustrates a rare condition involving skeletal deformities and glioma. The study highlights the importance of monitoring patients with IDH mutations for possible malignancies and related complications.
Page e1747
Clinical Reasoning: A 2-Day-Old Boy With Sudden Cardiac Arrest and Encephalopathy
This study describes an unusual presentation of a rarely seen neonatal form of CPT2 deficiency. The authors describe the differential diagnosis for a previously healthy neonate who experienced cardiac arrest and highlight the case's possible implications for future genetic studies.
Page e1743
Pearls & Oy-sters: POEMS Syndrome: An Eloquent Acronym for a Rare Disease You Don't Want to Miss
Although the syndrome described in this study is rarely seen in clinical settings, the case is an excellent example of the differential diagnosis for rare conditions and highlights considerations that should be made in such cases.
Page 835
Teaching Video NeuroImage: New STUB1 Variant Causes Chorea, Tremor, Dystonia, Myoclonus, Ataxia, Depression, Cognitive Impairment, Epilepsy, and Superficial Siderosis
This study discusses a case in which several members of a family exhibited a range of movement disorders that seemed to be caused by a new heterozygous splice variant in STUB1. The authors highlight this mutation as a relevant differential diagnosis to Huntington disease and related disorders.
Page e1749
Teaching Video NeuroImage: Papilledema and Cavernous Sinus Fistula Caused by Occipital Dural Arteriovenous Malformation in a Patient With Postoperative Laryngeal Cancer
The case of dural fistula resulting from bilateral internal jugular vein occlusion reported in this study is an important one for residents and fellows studying neuro-oncology because it demonstrates a possible complication of this treatment for laryngeal neck cancer.
Page e1751
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