Questions posted in the Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.

Question Title: Help needed in Puerto Rico

Forum: Neurology Forum
Topic: Speech

Re: Help needed in Puerto Rico

Re: Help needed in Puerto Rico



Posted by ccf neuro M.D.* on November 23, 1997 at 15:30:25:

In Reply to: Help needed in Puerto Rico posted by Antonio Gonzalez on November 11, 1997 at 18:31:44:


My relative, who lives in Puerto Rico, lived a normal life
until five months ago when all of a sudden she lost her speech
and her ability to function on her own. Her body constantly
shakes and the right side of her body is very weak. She is 45 years
of age and her mind however is intact. She has been seen by several
neurosurgeons who can't determine what is wrong. Laboratory tests, MRI,
CT scan, electroencephalogram and other tests all come out negative.
She and her family are very worried and feel the worse. Has anyone seen
a case like this before ? If so what is the diagnosis ?
Your help will be immensely appreciated.

Antonio
--------------------------------------------------------------------------------------------------------------------

Antonio,


To the best of my knowledge, there is no medical condition that could produce all of the symptoms you describe and have a totally normal EEG, MRI of the brain, and CT scan of the brain, with the very remote possible exception of Creutzfeld-Jakob disease, a rare degenerative disease caused by the accumulation of abnormal protein in the brain (this condition, by the way, is often associated with severe shaking spells), or a severely narrowed blood vessel in the neck or brain that is causing a lack of blood flow to the left side of the brain that is bad enough to stop that side of the brain from functioning properly without actually destroying it--- even if this were the case, however, the EEG should be very abnormal. If she's as bad off as you say, either the EEG or MRI should have shown something major wrong. If you're absolutely certain they were normal, serious consideration would have to be given to a rare stress-related problem known as conversion disorder. I would suggest that your relative see a neurologist as opposed to a neurosurgeon, to determine whether your relative may have Creutzfeld-Jakob disease, and if s/he cannot identify a neurologic explanation for her symptoms, the only remaining option would be a psychiatrist--- but only if all possible neurologic explanations were excluded.
Please remember that information provided in the forum is intended for general medical informational purposes only. The actual diagnosis and treatment of your relative's specific medical condition should be strictly in conjunction with her treating physician(s). Good Luck to you and her in finding an answer to her problem!!





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