A 62 year old female
presented with fever and persistent difficulty in speaking.
Vitals : Temp.- 101 degrees F; Pulse- 86/ min; B.P.- 108/ 70
mm Hg
Neurological notes:
The patient was alert and oriented with respect to time but
unable to name objects properly. Dysarthria, occasional word
substitution and neologisms were noted. The patient followed
two but not three-step commands. Neurological exam: gait,
strength, and sensation were normal. A provisional diagnosis
of an aphasic temporal lobe lesion was made.
A CT scan showed a low
attenuation lesion involving the medial and posterior aspect
of the left temporal lobe and inferior basal
ganglia.
Differential
diagnosis:
- Infection
(encephalomyelitis)
- Demyelinating
disease
