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A stroke mimic; focal neurological deficits in benign hereditary chorea?
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J Neurol Neurosurg Psychiatry 2013 Nov; 84(11):e2
Authors: Katie Maw, Ja Johnston, C Rowntree, A Kalhan
University Hospital of Wales; Department of Acute Medicine University Hospital Llandough.
Primary CNS lymphoma (PCNSL) is an aggressive brain tumour which, if left untreated, carries a high rate of rapid deterioration and death with a mean survival of just 1.5-3.3 months.(1) Therefore it's recognition, investigation and prompt treatment is essential. PCNSL most commonly presents with headaches, confusion and focal neurological deficits such as hemiparesis and enhancing white matter lesions on MRI. Neurologists enjoy a diagnostic puzzle, none more so, when an individual with an existing neurological problem presents with symptoms and signs beyond the spectrum of their illness. Such cases frequently present to the medical assessment unit (MAU). We present a stroke mimic of focal neurological deficits in an individual with benign hereditary chorea. This case illustrates the diagnostic challenge and highlights an opportunity to rapidly investigate, diagnose and initiate treatment in the acute setting.
PMID: 24108997 [PubMed - as supplied by publisher]