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Authors: 1Cetean Eliza, 2Puschiţa Maria
Affiliation: 1.Neurology Department,Western University of Arad “Vasile Goldis”
2. Internal Medicine Department, Neurology Department,Western University of Arad “Vasile Goldis”
Abstract: The patient is a 64-year-old male, hypertensive, expressing severe bilateral paresis, more pronounced on the left side with a staggering character, associated with ataxia, leading to impossibility in conducting daily activities as a driver. The performed investigations reveal cervical medullary canal stenosis as well as NCV and EMG with an suggestive pattern of chronic demyelinating inflammatory polyneuropathy. The patient does not tolerate corticosteroids, thus undergoes cervical neurosurgery with a temporarily favorable response at first followed by a worsening neurological clinic condition, subsequent recurrence of symptoms in combination with weight loss, loss of appetite, as well as depressive syndrome. Tomographic investigations conducted during development reveal a thickened gastric wall with suspicion of gastric neoplasm confirmed in subsequent surgery. The conclusion of the complex case, ackwnoledges the hypothesis of a complex paraneoplastic neurological syndrome in a patient with staggering neurological symptomatology with differential diagnoses which raised various discussions regarding case management.
Keywords: paraneoplazic, ataxia, paresthesia, polyneuropathy.
References: 1. Leonida Gherasim, Ioan Alexandru Oproiu, Ovidiu Băjenaru- Actualităţi în medicină internă, Sindroamele Neurologice Paraneoplazice 821-851
2. Dalmau J. Gultekin H.S. Posner J.B Paraneoplastic neurologic syndromes:pathogenesis and physiopathology, Brain Pathol., 1999, 275-284