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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 342:957-965 March 30, 2000 Number 13
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Case 10-2000— A 63-Year-Old Man with Changes in Behavior and Ataxia
Louis R. Caplan, and David N. Louis

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Presentation of Case

A 63-year-old man was admitted to the hospital in early July because of rapidly progressive changes in behavior and ataxia.

The patient had been well until 13 days earlier, when he began to have bifrontal headaches, with low-grade fever. Ibuprofen and acetaminophen were prescribed. Two days later, he was found to be disoriented and confused, with a stumbling gait, and was brought to another hospital. The white-cell count was 12,600 per cubic millimeter, with 88 percent neutrophils; the erythrocyte sedimentation rate was 55 mm per hour. The aspartate aminotransferase level was 91 U per liter, and the alanine aminotransferase level . . . [Full Text of this Article]

Differential Diagnosis

Clinical Diagnosis

Dr. Louis R. Caplan's Diagnoses

Pathological Discussion

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