Description of Event or Problem · 1
JOURNAL REFERENCE: BANUELOS PA, TEMES R, LEE VH. NEUROGENIC STUNNED MYOCARDIUM ASSOCIATED WITH REVERSIBLE POSTERIOR LEUKOENCEPHALOPATHY SYNDROME. NEUROCRIT CARE. 2008;9(1):108-111. WE REPORT A CASE OF NEUROGENIC-STUNNED MYOCARDIUM AND REVERSIBLE POSTERIOR LEUKOENCEPHALOPATHY SYNDROME (RPLS) OCCURRING SIMULTANEOUSLY IN A PATIENT. THE TWO REVERSIBLE CLINICAL SYNDROMES THAT ARE HYPOTHESIZED TO BE A RESULT OF SYMPATHETIC DYSREGULATION. REPORTABLE EVENT: WE PRESENT A WOMAN WITH A HISTORY OF HYPERTENSION AND CHRONIC BACK PAIN STATUS POST SPINAL CORD STIMULATOR, WHO PRESENTED WITH SEVERE HEADACHE, SEIZURE, AND CONFUSION ASSOCIATED WITH ACUTE HYPERTENSION. MAGNETIC RESONANCE IMAGING (MRI) OF THE BRAIN REVEALED BILATERAL PATCHY T2 SIGNAL HYPERINTENSITY, CONSISTENT WITH RPLS. TRANSTHORACIC ECHOCARDIOGRAM (TTE) SHOWED REGIONAL-WALL MOTION ABNORMALITIES IN THE APICAL REGIONS, CONSISTENT WITH NEUROGENIC-STUNNED MYOCARDIUM. THE PATIENT'S TTE SHOWED NORMALIZATION AT 3 DAYS, WITH MENTAL STATUS RETURNING TO NORMAL BY DAY 5. MRI ABNORMALITIES WERE RESOLVED COMPLETELY AT 1 MONTH FOLLOW-UP STUDIES.