A 40-year-old woman presents with acute onset vertical diplopia, ataxia, and dysarthria. Vital signs: BP 128/82, HR 88, RR 16, Temp 37.2°C, SpO2 98%. Examination reveals vertical nystagmus and limb ataxia; cranial nerve examination is normal. MRI brain demonstrates T2-hyperintense lesions in brainstem and cerebellum. CSF analysis shows oligoclonal bands, mild pleocytosis (WBC 45/μL), and normal glucose. Which of the following is the most likely diagnosis?
- A)Cerebellar atrophy from alcohol
- B)Acute cerebellar inflammation from varicella
- C)Neuromyelitis optica spectrum disorderGABARITO
- D)Wernicke encephalopathy
- E)Multiple sclerosis
Explicação
Brainstem and cerebellar demyelinating lesions with oligoclonal bands and pleocytosis in CSF is characteristic of neuromyelitis optica spectrum disorder (NMOSD), which frequently presents with brainstem attacks causing diplopia, nystagmus, and ataxia rather th... Ver explicação completa e trilha adaptativa →