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There are many research methods available to psychologists in their efforts to understand, describe, and explain behavior and the cognitive and biological processes that underlie it.

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Case 309.

Paulo Puac-Polanco¹, Nader Zakhari¹, Gerard H Jansen¹

¹From the Division of Neuroradiology, Department of Radiology, Radiation Oncology, and Medical Physics (P.P.P., N.Z., C.T.), and Department of Pathology and Laboratory Medicine (G.H.J.), University of Ottawa, The Ottawa Hospital Civic Campus, 1053 Carling Ave, Ottawa, ON, Canada K1Y 4E9; and Neuroscience Program, The Ottawa Hospital Research Institute, Ottawa, Canada (C.T.).

|August 22, 2022

Summary

This summary is machine-generated.

This case highlights a diagnostic challenge in a 64-year-old man with progressive neurological symptoms. Extensive workup, including cerebrospinal fluid analysis and MRI, was initially inconclusive, necessitating repeat imaging.

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Area of Science:

Neurology
Neuroimmunology

Background:

A 64-year-old male with a history of chronic obstructive pulmonary disease (COPD) presented with a 6-month history of progressive neurological deficits.
Symptoms included lightheadedness, balance and coordination difficulties, dysarthria, and cognitive changes.

Observation:

Clinical examination revealed slurred speech, positive Romberg sign, impaired finger-to-nose and rapid alternating movements, and ataxic gait.
Initial brain MRI showed left supratentorial abnormalities.
Cerebrospinal fluid analysis demonstrated pleocytosis, elevated protein, oligoclonal bands, and a high immunoglobulin G index.

Findings:

Despite a comprehensive initial workup for various causes, a definitive diagnosis remained elusive.
Repeat brain MRI was performed two weeks after admission to further investigate the findings.

Implications:

This case underscores the complexity of diagnosing neurological disorders presenting with atypical symptoms.
The findings emphasize the importance of serial imaging and thorough cerebrospinal fluid analysis in challenging diagnostic scenarios.