title: Multiple cerebral and cerebellar infarcts as the first clinical manifestation in a patient with Churg-Strauss syndrome: case report and literature review.
abstract: OBJECTIVE
  Churg-Strauss syndrome (CSS) is a rare autoimmune disease with small-vessel vasculitis. Neurological manifestation of CSS is common. Central nervous system is less frequently involved than that of peripheral nervous system.
  
  
  METHODS
  We report a case of 60-year-old man who presented with acute onset of right hemiparesis and impaired cognition. The presence of hypereosinophilia, asthma, sinusitis and extravascular eosinophil accumulation led to the diagnosis of Churg-Strauss syndrome. Brain magnetic resonance imaging (MRI) revealed multiple infarcts in bilateral cerebral and cerebellar hemispheres. The neurophysiology study did not reveal peripheral neuropathy. The patient was effectively treated with methylprednisolone, cyclophosphamide and warfarin.
  
  
  CONCLUSIONS
  Symptoms and signs of central nervous system can be the initial neurological manifestation of CSS patients. CSS should be considered while patients have stroke and hypereosinophilia. In our patient, there is a good response to timely steroid, immunosuppressant and anticoagulant therapies.
authors: Department of Neurology, Cathay General Hospital, Taipei, Taiwan.
authors: Meng-Ju
authors: MJ
authors: Cheng
authors: Pai-Hao
authors: PH
authors: Huang
authors: Pin-Wen
authors: PW
authors: Liao
authors: Jen-Tse
authors: JT
authors: Chen
authors: Tsuey-Ru
authors: TR
authors: Chiang
mesh_terms: D000818:Animals; D020520:Brain Infarction / Q000209:etiology*; D002531:Cerebellum / Q000473:pathology*; D002540:Cerebral Cortex / Q000473:pathology*; D015267:Churg-Strauss Syndrome / Q000150:complications* / Q000473:pathology; D038524:Diffusion Magnetic Resonance Imaging; D004452:Echocardiography; D004699:Endocardium / Q000378:metabolism / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000473:pathology