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Johns Hopkins University School of Medicine Clinico-Pathological Conference

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Johns Hopkins University School of Medicine Clinico-Pathological Conference

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    1. Johns Hopkins University School of Medicine Clinico-Pathological Conference Benjamin M. Greenberg, M.D., M.H.S. Assistant Professor Department of Neurology Johns Hopkins School of Medicine

    3. Differential Diagnosis at This Point

    4. Differential Diagnosis at This Point

    5. Differential Diagnosis at This Point

    6. Differential Diagnosis at This Point

    7. Differential Diagnosis at This Point

    8. Differential Diagnosis at This Point

    9. Differential Diagnosis at This Point

    10. Differential Diagnosis at This Point

    11. Differential Diagnosis at This Point

    12. Differential Diagnosis at This Point

    13. Differential Diagnosis at This Point

    24. Subacute Central Nervous System Degeneration with Parkinsonism, Eye Movement Abnormalities and Frontal Love Dysfunction “Degenerative” Parkinson’s Disease Progressive Supranuclear Palsy Corticobasal Degeneration Diffuse lewy body disease Toxic/Metabolic Wilson’s Manganeese MPTP Infectious Whipple’s Prion Diseases Flaviviruses Mitochondrial Disorders Nutritional Deficiencies B12 Thiamine Medications/Drugs Dopamine Antagonists Immune Mediatied Paraneoplastic ADEM Multiple Sclerosis Neoplastic CNS lymphoma Intravascular lymphoma Glioma

    29. Subacute Central Nervous System Degeneration with Parkinsonism, Eye Movement Abnormalities and Frontal Love Dysfunction “Degenerative” Parkinson’s Disease Progressive Supranuclear Palsy Corticobasal Degeneration Diffuse lewy body disease Toxic/Metabolic Wilson’s Manganeese MPTP Infectious Whipple’s Prion Diseases Flaviviruses Mitochondrial Disorders Nutritional Deficiencies B12 Thiamine Medications/Drugs Dopamine Antagonists Immune Mediatied Paraneoplastic ADEM Multiple Sclerosis Neoplastic CNS lymphoma Intravascular lymphoma Glioma

    30. Whipple’s Disease First described in 1907 by George Hoyt Whipple, a JHH pathologist He developed recurring arthropathy, weight loss, and steatorrhoea, became worse, and died. At necropsy the intestine and mesenteric lymph glands were infiltrated by mononuclear cells and deposits of fat. Weakly gram positive rod, Actinomycetes Neurologically Cognitive decline Vertical Gaze difficulty Oculomasticatory myorhythmia Movement disorders

    31. Paraneoplastic Subacute presentations Opsoclonus small cell lung cancer Neuroblastoma Gynecologic malignancies Limbic Encephalitis small cell lung cancer (anti-Hu) Germ cell tumors can have brainstem encephalitis. Can precede malignancy by years

    33. Paraneoplastic Syndrome (Whipple’s is a close second)

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