I put together these medical challenges. The cases are hypothetical and do not necessarily represent actual or typical presentations of medical diseases. Disclaimer is at the bottom of this page.
Thursday, March 15, 2012
Always Put This On Your Differential
A 40 year old woman presents with a right facial droop, initially thought to be Bell's palsy until she develops a left sided one subsequently. She presents to her primary care doctor who does a review of systems and finds polyuria as well as disturbances in thirst, sleep, appetite, and libido. Not much is done, and she is told to follow up in a few months. In the meantime, she has a partial seizure and returns to the hospital. A contrast-enhanced MRI shows nonspecific meningeal enhancement and multiple white matter lesions. A lumbar puncture shows a mononuclear cell pleocystosis and elevated total protein. Glucose is normal. A CT of the chest is obtained due to an abnormal routine chest X-ray and is shown below.
Challenge: What's your diagnosis?
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