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Iliopsoas Hematomas in a Patient with Progressive Encephalomyelitis with Rigidity and Myoclonus
Rui Shimazaki1, Masako Mukai1, Utako Nagaoka1
1Department of Neurology, Tokyo Metropolitan Neurological Hospital, Japan.
Abstract:
Progressive encephalomyelitis with rigidity and myoclonus (PERM) is a rare and severe syndrome characterized by rigidity of the limb and truncal muscles, brainstem signs, myoclonus, and hyperekplexia. Iliopsoas hematoma is a serious complication of bleeding disorders that occurs most commonly in patients with hemophilia and also in association with anti-coagulant drug treatment. We herein present a case of PERM complicated with bilateral iliopsoas hematomas. His neurological symptoms improved after immunotherapy, and thereafter the iliopsoas hematomas disappeared. Neurologists should consider iliopsoas hematomas as a serious potential complication of PERM.
Insights
Progressive encephalomyelitis with rigidity and myoclonus (PERM) can lead to serious iliopsoas hematomas. Early immunotherapy may resolve both neurological symptoms and these rare bleeding complications.
Area of Science:
- Neurology
- Hematology
Background:
- Progressive encephalomyelitis with rigidity and myoclonus (PERM) is a rare neurological disorder.
- Iliopsoas hematomas are serious bleeding complications, often seen in hemophilia or with anticoagulant use.
Observation:
- This report details a rare case of PERM complicated by bilateral iliopsoas hematomas.
- The patient presented with neurological symptoms characteristic of PERM and concurrent hematomas.
Findings:
- Neurological symptoms of PERM improved significantly following immunotherapy.
- The bilateral iliopsoas hematomas resolved after the immunotherapy treatment.
Implications:
- This case highlights the potential for iliopsoas hematomas as a complication in PERM patients.
- Neurologists should be vigilant for iliopsoas hematomas in patients diagnosed with PERM.
