Case Challenge Part 2: A Woman with Ataxia and Abnormal Uterine Bleeding

A continuation of the case description and a diagnostic question.

The previously described 46-year-old woman presenting with headache, ataxic gait, and a history of abnormal uterine bleeding (NEJM JW Neurol Mar 29 2016; [e-pub]) had a normal complete blood count and comprehensive metabolic panel. Complement levels and serum protein electrophoresis were normal; antinuclear antibodies were mildly positive (1/80).

Cerebrospinal fluid (CSF) had 162 leukocytes/mm³ (with 95% of these being lymphocytes), and normal levels of proteins and glucose. The CSF-VDRL (venereal disease research laboratory) and serum FTA-ABS (fluorescent treponemal antibody absorption) tests were both nonreactive. CSF polymerase chain reaction for herpes simplex, herpes zoster, and cytomegalovirus were negative.

Contrast-enhanced magnetic r…

Authors

Jaime Toro, MD

Disclosures

Editorial BoardsMultiple Sclerosis and Related Disorders

Jaime Toro, MD

Disclosures

Editorial BoardsMultiple Sclerosis and Related Disorders

David Cuellar-Giraldo, MD

Saúl Reyes, MD

Lina Quintero, MD

Nicolas Lemus, MD

Maria I. Reyes-Mantilla, MD

Case Challenge Part 2: A Woman with Ataxia and Abnormal Uterine Bleeding

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