Neuro-immunology

Neuromyelitis Optica

The set of MRIs shown here are from a middle-aged woman with neuromyelitis optica (NMO) – an autoimmune astrocytopathy. She was diagnosed with left sided optic neuritis 18 months ago, at that time presenting with subacute onset of left eye visual loss, as well as ...

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Multiple Sclerosis

The set of cranial MRIs shown here are from a young woman with a known history of relapsing-remitting multiple sclerosis. In the first scan (T2W axial cut), we can see multiple T2 hyperintense lesions involving bilateral cerebral cortices (Figure 1). These lesions are noted to be of a juxta-cortical and also peri-ventricular ...

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Thymoma

In this contrast thoracic CT scan of a middle-aged woman with newly diagnosed seropositive generalized myasthenia gravis, an abnormal thymic lesion (present in the anterior mediastinal compartment) could be seen  (Figure 1). The patient was referred to the Cardiothoracic Surgeons where she received a thymectomy via ...

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Autoimmune Encephalitis

This cranial MRI is from a young woman who presented with low-grade fever, confusion, visual hallucinations and status epilepticus. Significant orofacial dyskinesias and autonomic dysfunction was also noted. Lumbar puncture was performed and cerebrospinal fluid (CSF) revealed mild lymphocytic predominant leukocytosis and slightly elevated protein. ...

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Bickerstaff’s Encephalitis

A middle-aged woman was admitted with drowsiness, weakness of all four limbs and visual impairment. Physical examination revealed that the patient had bilateral complete ophthalmoplegia, generalized weakness and spasticity,with brisk reflexes and bilateral upgoing plantar reflexes. A hyper-intense lesion at the level of the midbrain ...

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