Case 6-2009 -- A 37-Year-Old Woman with Vertigo, Facial Weakness, and a Generalized Seizure

doi:10.1056/NEJMcpc0807823

Volume 360:802-809		February 19, 2009		Number 8

Case 6-2009 — A 37-Year-Old Woman with Vertigo, Facial Weakness, and a Generalized Seizure

Didier Cros, M.D., R. Gilberto Gonzalez, M.D., Ph.D., and Eugene J. Mark, M.D.

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Presentation of Case

Dr. Sang-Woo (Steve) Han (Neurology): A 37-year-old woman wasseen in the emergency department of this hospital because ofa seizure. Four months earlier, episodes of vertigo began tooccur several times a week that lasted up to several hours andwere associated with nausea and vomiting. She was evaluatedin the emergency department of another hospital; meclizine wasprescribed, and she was instructed to follow up with her primarycare physician. During the next 3 months, she had episodes ofvertigo several times per week that were associated with tinnitus,diminished hearing, a sense of fullness in her right . . . [Full Text of this Article]

Differential Diagnosis

Neoplastic Disorders

Infectious Disorders

Inflammatory and Granulomatous Disorders

Neurosarcoidosis

Dr. Didier Cros's Diagnosis

Pathological Discussion

Anatomical Diagnosis

Source Information

From the Department of Neurology (D.C.); the Division of Neuroradiology, Department of Radiology (R.G.G.); and the Department of Pathology (E.J.M.), Massachusetts General Hospital; and the Departments of Neurology (D.C.), Radiology (R.G.G.), and Pathology (E.J.M.), Harvard Medical School.