Yap Lauren E, Chen Huanwen, Ganji Sarah, Calabria Samuel E, Serrano Edwin J, Stemer Andrew B, Tirol Francis G, Jazebi Noushin
Department of Neurology, MedStar Georgetown University Hospital, Washington, DC, USA.
National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
Neurohospitalist. 2024 Jul;14(3):356-360. doi: 10.1177/19418744241245454. Epub 2024 Apr 1.
Acute focal neurological deficits demand immediate evaluation. In this report, we present the case of a woman 20-some years of age with a history of hemolytic anemia and thrombocytopenia who presented with altered mental status and focal neurological deficits including aphasia, acute left gaze preference, right homonymous hemianopsia, right lower facial weakness, and right arm and leg weakness. Extensive neurological and hematological workup revealed that the patient suffered from focal status epilepticus associated with an extreme delta brush patten on electroencephalogram, likely secondary to thrombotic thrombocytopenic purpura. This case underscores the connection between hematological disorders and the neurological axis, emphasizing the critical role of integrating the neurological examination and neuroimaging findings to formulate an effective management plan.
急性局灶性神经功能缺损需要立即评估。在本报告中,我们介绍了一名20多岁的女性病例,她有溶血性贫血和血小板减少病史,出现了精神状态改变和局灶性神经功能缺损,包括失语、急性向左凝视偏好、右侧同向性偏盲、右侧面下部无力以及右侧手臂和腿部无力。广泛的神经学和血液学检查发现,该患者患有局灶性癫痫持续状态,脑电图显示有极端的δ刷状波模式,可能继发于血栓性血小板减少性紫癜。本病例强调了血液系统疾病与神经轴之间的联系,强调了整合神经学检查和神经影像学结果以制定有效管理计划的关键作用。