title: Lower cranial nerve palsy, aseptic meningitis and hydrocephalus: unusual presentation of primary antiphospholipid syndrome.
abstract: Presentation of primary antiphospholipid syndrome (APS) is usually untrustworthy and unusual presentations are difficult to diagnose on the basis of clinical features alone. This is true especially in young and elderly patients. Cerebral venous thrombosis (CVT) is less frequent than arterial thrombosis in APS. CVT has a wide spectrum of signs and symptoms, which may evolve suddenly or over weeks. It mimics many neurological conditions such as meningitis, encephalopathy, benign intracranial hypertension and stroke. Headache is the most frequent symptom in patients with CVT, and is present in about 80% of cases. The most common pattern of presentation is with a benign intracranial hypertension-like syndrome. Sixth cranial nerve palsy usually manifests as a false localising sign. Patients may have recurrent seizures. Cranial nerve syndromes are seen with venous sinus thrombosis. We present a case of APS with lower cranial nerve palsy, aseptic meningitis and hydrocephalus initially treated as tuberculous meningitis.
authors.affiliation: Hera General Hospital, Medicine, 4a/201, Makkah, Western, 21955, Saudi Arabia.
authors.forename: Abdul Majid
authors.initials: AM
authors.lastname: Wani
authors.forename: Waleed Mohd
authors.initials: WM
authors.lastname: Hussain
authors.forename: Mohamad Ibrahim
authors.initials: MI
authors.lastname: Fatani
authors.forename: Ahmad
authors.initials: A
authors.lastname: Qadmani
authors.forename: Ghassan Adnan Al
authors.initials: GA
authors.lastname: Maimani
authors.forename: Ahmad
authors.initials: A
authors.lastname: Turkistani
authors.forename: Khalid S
authors.initials: KS
authors.lastname: Dairi
authors.forename: Ahmad
authors.initials: A
authors.lastname: Abumatar
authors.forename: Mazen G
authors.initials: MG
authors.lastname: Bafaraj