case_images: PMC8164334_01
case_images: Still picture of Supplementary Video S1 highlighting upper limb tremors and orofacial dyskinesias.
case_images: IMCRJ-14-343-g0001.jpg
case_images: PMC8164334_01_IMCRJ-14-343-g0001.jpg
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case_images: Scale (GCS) was 7/15, she had grimacing, tongue biting, bruxism, hyper-salivation and abnormal arm movements which were difficult to classify (Figure 1, Supplementary Video S1). She was intubated, mechanically ventilated and admitted to the intensive care unit (ICU).
case_images: Axial magnetic resonance imaging (MRI) slice images of the brain: On admission: (A) T1-weighted contrast-enhanced (T1+C) and (B) axial fluid-attenuated inversion recovery (FLAIR) sequences illustrating contrast enhancement (white arrow) with sulcal hyper-intensity (black arrow) respectively; Day 15: (C) T1+C and (D) FLAIR sequences illustrating resolution of MRI abnormalities.
case_images: IMCRJ-14-343-g0002.jpg
case_images: PMC8164334_01_IMCRJ-14-343-g0002.jpg
case_images: f0002
case_images: CSF on day 2). Contrast-enhanced MRI brain scan demonstrated leptomeningeal enhancement (Figure 2A) with corresponding sulcal hyperintensities (Figure 2B) and serial electroencephalography (EEG) showed non-specific diffuse slowing with no epileptiform discharges. At day 15 repeat MRI brain scan showed almost complete resolution of the meningeal enhancement (Figure 2C) and sulcal hyperintensities (Figure 2D) but her GCS remained persistently low at 8/15 and her unrelenting dyskinesias required higher sedation requirements.