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Elephant in the Room vs. Red Herring

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Clinical Cases in Neurology

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Abstract

67-year-old gentleman was referred to Neurology outpatient department for a 6 month history of gait difficulties, incontinence and occasional swallowing issues. He also reported a numb right side of his face (“like having local anaesthesia at the dentist”) and that his symptoms were gradually progressing. He was referred by his Haematologist as he had a history of Chronic Lymphocytic leukaemia (CLL) with lymphadenopathy, splenomegalia and leukocytosis. This diagnosis was known for more than 5 years (verified by bone marrow biopsy) and clinically he seemed stable from a haematology point of view.

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Further Reading

  • Benjamini O, Jain P, Schlette E, Sciffman JS, Estrov Z, Keating M. Chronic lymphocytic leukemia with central nervous system involvement: a high-risk disease? Clin Lymphoma Myeloma Leuk. 2013;13:338–41.

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  • Kasper DL, Fauci AS, Hauser S, Longo D, Larry Jameson J, Loscalzo J. Harrisons manual of medicine. 19th ed. New York: McGraw Hill Professional; 2016.

    Google Scholar 

  • Lindsay KW, Bone I, Fuller G. Neurology and neurosurgery illustrated e-book. St. Louis: Elsevier Health Sciences; 2010.

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  • Nadgir R, Yousem DM. Neuroradiology: the requisites. Philadelphia: Elsevier Health Sciences; 2016.

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  • Sanchez-Quintana A, Breña-Atienza J, Marrero-Santos C, Alvarez-Acosta L. Late relapse of progressive multifocal leucoencephalopathy postallogenic transplant in a young patient with CLL. BMJ Case Rep. 2013; https://doi.org/10.1136/bcr-2013-200213.

    Google Scholar 

  • Thompson AJ, Banwell BL, Barkhof F, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018;17:162–73.

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Dolezal, O. (2019). Elephant in the Room vs. Red Herring. In: Clinical Cases in Neurology. In Clinical Practice. Springer, Cham. https://doi.org/10.1007/978-3-030-16628-1_13

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  • DOI: https://doi.org/10.1007/978-3-030-16628-1_13

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-16627-4

  • Online ISBN: 978-3-030-16628-1

  • eBook Packages: MedicineMedicine (R0)

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