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Brain stem and cerebellar dysfunction with Legionnaires' disease

P C Baker, T R Price, C D Allen

    Journal of Neurology, Neurosurgery, and Psychiatry
    |November 1, 1981
    PubMed
    Summary
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    Legionnaires' disease can cause severe neurological issues like ataxia and gaze paralysis, even in patients with bipolar disorder. Recovery from these neurological complications may be slow and incomplete.

    Area of Science:

    • Neurology
    • Infectious Diseases

    Background:

    • Legionnaires' disease, a severe pneumonia, can present with extrapulmonary manifestations.
    • Neurological complications of Legionnaires' disease are rare but can be debilitating.

    Observation:

    • A 37-year-old male with bipolar disorder developed Legionnaires' disease pneumonia.
    • The patient exhibited severe neurological symptoms including dysarthria, ataxia, gaze paralysis, and downbeat nystagmus.

    Findings:

    • The patient experienced significant neurological deficits following Legionnaires' disease.
    • Six-month follow-up revealed only partial recovery, with persistent limb and gait ataxia.

    Implications:

    • Diagnosing neurological complications of Legionnaires' disease is challenging in patients with pre-existing psychiatric conditions and psychotropic medication use.

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  • This case highlights the importance of considering infectious etiologies for new-onset neurological disorders, even in complex patient populations.