Abstract
27-year-old man was admitted with a severe occipital headache, acute in onset. He also complained of very severe bilateral leg and arm pain. Reflexes were increased and plantars negative. Cranial nerves and cerebellar functions were normal. Sphincters were normal. Rest of neurological examination was influenced by serious pain in all four extremities (showed on diagram), therefore patient was very difficult to examine. He had a dry cough. CRP was marginally increased (25). Hi temperature was increased (37.4 °C). During admission his pain became more prominent in arms and forearms, suggestive of radiculopathic pain.
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Further Reading
Eberhardt O, Küker W, Dichgans J, Weller M. HSV-2 sacral radiculitis (Elsberg syndrome). Neurology. 2004;63:758–9.
Ganzenmueller T, Karaguelle D, Schmitt C, Puppe W, Stachan-Kunstyr R, Bronzlik P, Sauerbrei A, Wegner F, Heim A. Prolonged detection of herpes simplex virus type 2 (HSV-2) DNA in cerebrospinal fluid despite antiviral therapy in a patient with HSV-2-associated radiculitis. Antivir Ther. 2012;17:125–8.
Nadgir R, Yousem DM. Neuroradiology: the requisites. Philadelphia: Elsevier Health Sciences; 2016.
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Dolezal, O. (2019). Painful and Weak Young Man. In: Clinical Cases in Neurology. In Clinical Practice. Springer, Cham. https://doi.org/10.1007/978-3-030-16628-1_18
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DOI: https://doi.org/10.1007/978-3-030-16628-1_18
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