Recurrent coma developed in a young woman!

±Ç¿À´ë dolbaeke at hanmail.net
Tue Feb 22 06:14:14 EST 2000


How are you?  neuroscientists of this world.

We have a difficulty in managing and assessing a patient who shows recurrent
brainstem dysfunction and recovery. we presented the case at followed
sentences. Whoever reads this presentation and get a comment or advise
please make an letter to us to prevent and manage correctly the same kinds
of  patients.
thank you!

E -mail: dolbaeke at hanmail.net
Fax: 82-53-250-7840
department of neurology,
Dongsan Medical center,
Keimyung university,
Daegu, South Korea.

CASE report

Ok-Ryun Kim    female/43years old

 December 26, 1996 when she was 39 years old she admitted at our hospital to
evaluate the cause of dizziness, ataxic gait and diplopia which were been
persisting for several days. At the next day, she was alert and there were
bilateral gaze evoked horizontal nystagmus and decreased pain and
temperature sensation over the left face. The movement of extraocular
muscles were within full range and other cranial nerve were intact by
examination. there were hemiplegia at right side to the degree of which
cannot elevate extremities fully. Deep tendon reflexes were mildy increased
at right lower extremities and the extensor plantar reflex were flexion. The
cerebellar sign were impaired on both sides.
  we managed her with intravenous heparin and intravenous corticosteroid
during admission. In spite of the therapy, her neurological symptom were
aggravated. after 1 week of admission,  her consciousness level fell to
semicomatose  state and Doll's eye movement were impaired in both horizontal
and vertical test at both side. The pupil dilated to 6 mm symmetrically and
showed sluggish light reflex. Complete quadriplegia developed and deep
tendon reflexes were increased and bilateral positive extensor plantar
reflex were checked. After this, slow improvement followed to complete
recovery after 1 month. brain MRI at admission were normal and other routine
laboratory test and blood and CSF cultures showed no abnormal findings.

  after discharged from our hospital, she lived normal life without any
neurological sequelae.

Please give us some advice!
We will wait for your kind and sincere reply.
thank you

E -mail: dolbaeke at hanmail.net
Fax: 82-53-250-7840
department of neurology,
Dongsan Medical center,
Keimyung university,
Daegu, South Korea.







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