Question

49 year old develops seizure disorder that is difficult to control. CSF shows lymphocytic pleocytosis and many RBC's. MRI shows T2 hyperintensity in the Left temporal lobe, with gadolinium enhancement in this area in T1 weighted image. EEG shows periodic discharges. Dx?

Answer 1

The 49-year-old patient's symptoms and test results, including seizure disorder, lymphocytic pleocytosis, and RBCs in the CSF, point toward a diagnosis of Hashimoto encephalopathy, rather than Creutzfeldt-Jakob disease.

Step-by-step explanation:

The clinical information provided suggests that the 49-year-old patient with a seizure disorder likely has a diagnosis of HammEpilepsy is a neurological disorder characterized by recurrent seizures. The cause of epilepsy may be an infection, a brain injury, or a tumor.an's variant of Hashimoto encephalopathy (HE), also known as steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT). The combination of seizures that are difficult to control, lymphocytic pleocytosis, and RBCs in the CSF, along with the MRI findings and EEG, are indicative of this disorder. Although the CSF 14-3-3 protein result suggests Creutzfeldt-Jakob disease (CJD), the rapid cognitive decline seen in CJD is not consistent with the patient's symptoms, whereas Hashimoto encephalopathy is characterized by a variety of neurological symptoms , including seizures and cognitive decline, and often responds to steroid treatment.