Cortical @entity50 after LP and high dose steroid in a case clinically XXXX .

@entity1 @entity410 @entity1183 @entity9769 @entity4889 @entity510 @entity3491 @entity49 @entity425 @entity15 @entity230 @entity19312 @entity10 @entity551 @entity50 @entity1229
Role of lumbar puncture and high dose @entity230 have been implicated previously in causing @entity50 in @entity15 . We report a case of clinically @entity3491 who developed @entity50 after Lumbar puncture and high dose @entity230 . Forty two years old gentleman presented with right hand @entity1183 and @entity425 over 1 week. MRI brain and spine showed periventricular and cerebellar white matter lesions suggestive of @entity15 . ANA, ANCA, APLA, B12 and NMO antibody were negative. VEP was normal. CSF showed oligoclonal bands. Post lumbar puncture he received pulse dose of 1gm Methylprednisoplone for 5 days. He developed @entity10 on the 6th day especially on sitting up which improves on lying down. On the 9th day the @entity10 became frontal and continuous with no relief on lying down. He developed generalized tonic clonic @entity410 on the 12th day and MRI brain done revealed @entity50 with bilateral sulcal @entity510 . He was started on low molecular heparin followed by @entity1229 . @entity10 resolved. His thrombophilia screen revealed @entity4889 with heterozygous @entity9769 gene mutation whether Lumbar puncture which caused the low pressure @entity10 along with high dose @entity230 provoked @entity49 in this predisposed @entity1 who had @entity4889 can be debated. There have been many cases reported of similarly of @entity19312 in @entity15 after LP and @entity230 . It can be debated that LP and @entity230 are routinely given simultaneously in @entity15 @entity1 and questionably this can be avoided. CONCLUSION: This is a case of CIS who developed @entity50 post lumbar puncture and mega @entity230 pulse therapy, initially he presented with symptoms similar to @entity10 of @entity551 followed by @entity410 . High index of suspicion of @entity19312 post LP and @entity230 therapy should be considered.
