Elzbieta Wirkowski

Hashimot's encephalopathy-response to intravenous immunoglobulin.

BACKGROUND Hashimotos encephalopathy is an unusual brain disorder consisting of focal and diffuse cerebral dysfunction that may present in a stroke-like fashion. Treatment has consisted of steroids and immunosuppression. Treatment with a potentially less toxic modality such as intravenous immunoglobulin (IVIG), if found to be effective, might offer an alternative approach to these patients. CASE DESCRIPTION We present an 82-year-old woman who developed headache, changes in mental status, and multifocal neurological deficits. Investigation revealed significantly elevated titers of antithyroid antibodies. Treatment with prednisone and methotrexate was unsuccessful. Treatment with monthly courses of IVIG resulted in marked clinical improvement. CONCLUSION Hashimotos encephalopathy may be more common than is generally recognized. A trial of IVIG should be considered for patients with this devastating condition.

Hypersexuality and Stroke: A Role for the Basal Ganglia?

Hyposexuality after stroke has been frequently observed, but hypersexuality as a sequela of stroke has been less commonly documented. Damage to limbic structures, especially in the temporal lobes, has

Spectacular Shrinking Deficit Associated with Congenital Bicuspid Aortic Valve

Bicuspid aortic valve represents the most common congenital heart abnormality. In the absence of endocarditis, the association between bicuspid aortic valve and cerebral ischemia has only recently bee