19-year-old male, circumstantial marijuana and cocaine base paste.
Ovalle complained of persistent headache and development of motor deficit in the right limbs, vision impairment and gait imbalance.
She was admitted oriented, dysarthric, with right hemiparesis and bilateral cerebellar signs.
Cerebrospinal fluid and brain CT were normal and the patient was discharged undiagnosed.
Three weeks later, he was admitted to the Hospital del Salvador, affilial, without meningeal signs, impaired consciousness, with incomprehensible language and normal eye fundus.
The absence of responses to the threat made us suspect amaurosis.
Also with tetraparesis, exhaled reflexes, bilateral Babinski.
Occasional chroniasis of the right upper extremity.
Laboratory tests and cerebrospinal fluid are normal, C-reactive protein 0.5.
The serology of the immunodeficiency virus, Epstein-acquired herpes 1, 2 and HTLV-1 were non-reactive.
Brain MRI (T2 and FLAIR), hyperintensity of right fronto-posterior and parieto-occipital subcortical areas, hyperintensity of the protuberance greater to left.
Methylprednisolone bolus therapy was initiated for subacute demyelinating disease.
Two days later the patient developed respiratory distress, acute pulmonary symptoms, coma and died.
Medical-legal autopsy.
