PMC3037987_01
Motor nerve conduction study of the right median nerve and the right tibial nerve. a Right median nerve on the 12th hospital day. b Right tibial nerve on the 12th hospital day. These studies showed reduced motor nerve conduction velocities (MCV) with conduction block (median nerve 11.3 m/s, tibial nerve 36.6 m/s). The sizes of the compound muscle action potential of the right median nerve were 2.0 mV at the wrist and 0.33 mV at the elbow, and those of the right tibial nerve were 1.0 mV at the ankle and 0.57 mV at the popliteal fossa, respectively. c Motor nerve conduction study of the right median nerve on the 94th hospital day, showing improvement of the MCV (23.2 m/s) and severity of the conduction block (the sizes of the compound muscle action potential were 0.404 mV at the wrist and 0.225 mV at the elbow). MCV of right tibial nerve on the 94th day was not evoked.
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F1
On the day of transfer, nerve conduction studies showed reduced motor nerve conduction velocities (right median nerve: 11.3 m/s, normal value >55 m/s, right tibial nerve: 36.6 m/s, normal value >45 m/s) with conduction block (fig. 1), and sensory nerve action potentials could not be evoked in both nerves.
Brain MRI findings. a Images on the 42nd hospital day showed high-intensity lesions in the bilateral thalamus and bilateral medial temporal lobes. b Images on the 64th hospital day revealed improved abnormal high-intensity lesions in the bilateral thalamus but progressive atrophy of the bilateral medial temporal lobes.
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F2
Brain MRI showed high-intensity lesions in the bilateral thalamus and medial temporal lobes on diffusion and FLAIR images (fig. 2a), and the electroencephalogram showed diffuse spike and wave complexes. On the brain MRI on the 64th hospital day, the abnormal high-intensity lesions in the bilateral thalamus were reduced, while marked atrophy of the bilateral medial temporal lobes was seen (fig. 2b).