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Abstract

A 58-year-old man with dizziness and unsteady gait had a 10-year history of behavioral change, impotence, and a progressive peripheral neuropathy. CT revealed low-density, contrast-enhancing lesions in the right pontine tegmentum and the right medial temporal lobe. Temporal lobe biopsy contained a collection of mature histiocytes, with PAS-positive rod-shaped inclusions. These inclusions, when studied by electronmicroscopy, were seen to be membrane-bound bacilliform bodies. Peroral jejunal biopsy contained no such inclusions. Despite treatment with antibiotics, the patient's neurologic illness progressed, and he succumbed to intercurrent sepsis. We believe this to be the first instance in which a lesion of Whipple disease has been identified within the CNS by CT scan, and the diagnosis made antemortem, in the absence of demonstrable systemic disease.

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Published In

Neurology®
Volume 32Number 6June 1982
Pages: 612
PubMed: 6178057

Publication History

Published online: June 1, 1982
Published in print: June 1982

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Authors

Affiliations & Disclosures

John J. Halperin, M.D.
Departments of Neurology (Drs. Halperin and Landis) and Patholgy (Dr. Kleinman), Massachusetts General Hospital, Boston, MA.
Dennis M.D. Landis, M.D.
Departments of Neurology (Drs. Halperin and Landis) and Patholgy (Dr. Kleinman), Massachusetts General Hospital, Boston, MA.
George M. Kleinman, M.D.
Departments of Neurology (Drs. Halperin and Landis) and Patholgy (Dr. Kleinman), Massachusetts General Hospital, Boston, MA.

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Cited By
  1. Isolated central nervous system Whipple disease, Surgical Neurology International, 13, (477), (2022).https://doi.org/10.25259/SNI_591_2022
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  2. Incontinence and Sexual Dysfunction, The Wiley Handbook on the Aging Mind and Brain, (389-416), (2018).https://doi.org/10.1002/9781118772034.ch19
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  3. Magnetic Resonance Imaging Features of Solitary Inflammatory Brain Masses, Journal of Neuroimaging, 8, 1, (8-14), (2016).https://doi.org/10.1111/jon1998818
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  4. A 47‐Year‐Old Man with Ophthalmoplegia and Dementia, Journal of Neuroimaging, 1, 3, (140-145), (2016).https://doi.org/10.1111/jon199113140
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  5. The Neurology of Whipple’s Disease, Neuro-Immuno-Gastroenterology, (327-337), (2016).https://doi.org/10.1007/978-3-319-28609-9_18
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  6. Isolated CNS W hipple disease with normal brain MRI and false‐positive CSF 14‐3‐3 protein: a case report and review of the literature , Brain and Behavior, 2, 6, (838-843), (2012).https://doi.org/10.1002/brb3.97
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  7. Progressive dementia associated with ataxia or obesity in patients with Tropheryma whipplei encephalitis, BMC Infectious Diseases, 11, 1, (2011).https://doi.org/10.1186/1471-2334-11-171
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  8. Persistent amnesic syndrome as long‐term outcome of cognitive function after Whipple's disease, European Journal of Neurology, 4, 6, (613-617), (2011).https://doi.org/10.1111/j.1468-1331.1997.tb00414.x
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  9. Isolated inctracranial Whipple's disease—Report of a rare case and review of the literature, Journal of the Neurological Sciences, 308, 1-2, (1-8), (2011).https://doi.org/10.1016/j.jns.2011.05.029
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  10. Nervous System, Integrating Therapeutic and Complementary Nutrition, (2010).https://doi.org/10.1201/9781420003413.ch10
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