Practical Neurology Podcast
Ptosis with paroxysmal cough, and ”just another kinase” - Case Reports
May 14, 2024
The podcast discusses intriguing case reports including a man with drooping eyelid and chronic cough, abnormal facial movements in a 70-yo man, and abnormal arm and leg movements in a 90-yo woman. The hosts, along with neurology professionals, analyze these cases step-by-step. The discussion touches on differential diagnoses, investigative processes, and the importance of thorough assessments in complex medical conditions.
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Quick takeaways
- Gustatory sweating can be a symptom of neuro-sarcoidosis, highlighting the importance of monitoring ACE levels for disease activity.
- Abnormal facial movements and limb chorea in the elderly may indicate underlying conditions like polycythemia vera, necessitating genetic testing for accurate diagnosis and treatment.
Deep dives
Case 1: Evaluation of Horner's Syndrome in a 62-year-old man with ptosis and sweating abnormalities
A 62-year-old man presented to neurology with left eye ptosis, later diagnosed with Horner's syndrome showing a constricted pupil and abnormal sweating. Further investigations revealed elevated serum ACE levels and reduced sympathetic skin response in the left arm. MR confirmed subepicardial sarcoidosis, leading to a diagnosis of probable neuro-sarcoid. Treatment with hydroxychloroquine and prednisolone showed improvement, but recurrence of skull-based lesions and cough was noted.
