title: Fluctuating neurological symptoms in demyelinating disease mimicking an acute ischaemic stroke.
abstract: Fluctuating neurological symptoms in an older patient most often point towards a cerebral ischaemic pathology. The authors present a 66-year-old male patient suffering from a fluctuating right hemiparesis, with an initial diagnosis of ischaemic stroke. The brain and cervical MRI showed demyelinating lesions with abnormal cerebrospinal fluid (CSF) and visual evoked potentials and the patient was successfully treated with intravenous corticosteroids. Demyelinating disease in older patients could be more frequent than expected. It should be considered even in older patients with fluctuating neurological symptoms. MRI and CSF analysis are critical to provide an accurate diagnosis.
authors.affiliation: Neurology Service, Hospital Universitario Central de Asturias, Oviedo, Spain. mglezdelgado@yahoo.es
authors.forename: Montserrat G
authors.initials: MG
authors.lastname: Delgado
authors.forename: Elena
authors.initials: E
authors.lastname: Santamarta
authors.forename: Antonio
authors.initials: A
authors.lastname: Sáiz
authors.forename: Davinia
authors.initials: D
authors.lastname: Larrosa
authors.forename: Raquel
authors.initials: R
authors.lastname: García
authors.forename: Pedro
authors.initials: P
authors.lastname: Oliva
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D003711:Demyelinating Diseases / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000188:drug therapy; D003937:Diagnosis, Differential; D005074:Evoked Potentials, Visual; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009460:Neurologic Examination; D020521:Stroke / Q000175:diagnosis
chemical_list: D000305:Adrenal Cortex Hormones