title: Acute Hemiparesis in a Healthy Elderly Woman: Where and What Is the Lesion?
abstract: Hemiparesis may be the result of lesions in the contralateral pyramidal tract in the brain or, less frequently, in the ipsilateral pyramidal tract in the upper cervical spinal cord. However, although rare, multiple lesions that simultaneously occur in both of these regions may be the cause of acute hemiparesis, and the clinical symptoms can often be misdiagnosed as a stroke. In addition, the correct diagnosis of these multiple central nervous system (CNS) lesions is very challenging if they are caused by infection from an unexpected microorganism. We evaluated an elderly healthy woman who presented with acute hemiparesis and multiple brain and spinal cord lesions that were confirmed to occur from an infection withPropionibacterium acnes. In this report, the differential diagnosis and histopathological findings are discussed for these multiple CNS lesions in this healthy woman.
authors.affiliation: Department of Neurology, Kyung Hee University College of Medicine , Seoul , South Korea.
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Neurology, Kyung Hee University College of Medicine , Seoul , South Korea.
authors.forename: Sung Hyuk
authors.initials: SH
authors.lastname: Heo
authors.affiliation: Department of Neurology, Kyung Hee University College of Medicine , Seoul , South Korea.
authors.forename: Jin San
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Department of Neurology, Kyung Hee University College of Medicine , Seoul , South Korea.
authors.forename: Dae-Il
authors.initials: DI
authors.lastname: Chang
authors.affiliation: Department of Internal Medicine, Kyung Hee University College of Medicine , Seoul , South Korea.
authors.forename: Ki-Ho
authors.initials: KH
authors.lastname: Park
authors.affiliation: Department of Pathology, Kyung Hee University College of Medicine , Seoul , South Korea.
authors.forename: Ji-Youn
authors.initials: JY
authors.lastname: Sung
authors.affiliation: Department of Nuclear Medicine, Kyung Hee University College of Medicine , Seoul , South Korea.
authors.forename: Il Ki
authors.initials: IK
authors.lastname: Hong
authors.affiliation: Department of Laboratory Medicine, Kyung Hee University College of Medicine , Seoul , South Korea.
authors.forename: Myeong Hee
authors.initials: MH
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Kyung Hee University College of Medicine , Seoul , South Korea.
authors.forename: Bong Jin
authors.initials: BJ
authors.lastname: Park
authors.affiliation: Department of Radiology, Kyung Hee University College of Medicine , Seoul , South Korea.
authors.forename: Woo Suk
authors.initials: WS
authors.lastname: Choi
keywords: Propionibacterium acnes; cerebritis; clinical pathology; hemiparesis; myelitis