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Doc Navarrow@DocNavarrow·1h

@D82436Bmb Interesting case, thanks for sharing. It reinforces how bilateral basal ganglia patterns can be seen across different inflammatory and autoimmune conditions, including Neuropsychiatric Systemic Lupus Erythematosus.

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M.BIYAJIMA M.D.@D82436Bmb·12h

@DocNavarrow Very interesting case. We recently published a similar case, which may be of interest: link.springer.com/10.1007/s10072…

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Doc Navarrow@DocNavarrow·2d

👱‍♀️58F with 2 weeks of confusion, behavioral change, and seizures. Labs unremarkable, renal function normal. 🍴On MRI I see… a fork? 👀What do you see?

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@nirmalregency Fair point. This case is better called autoimmune encephalitis, not limbic encephalitis. No mesial temporal involvement on MRI. “Autoimmune” defines etiology. “Limbic” defines location. Using “autoimmune limbic encephalitis” as a blanket term is misleading.

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Nirmal Pandey MD DM Neurologist@nirmalregency·1d

Where is the “limbic” encephalitis as mentioned on the title of this case report?

💡Lentiform fork sign on MRI typically points to uremic encephalopathy… but not always. ✅Normal renal function should raise suspicion. In this case, CSF revealed anti-NMDA receptor antibodies → autoimmune encephalitis. doi.org/10.1016/j.radc…

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Doc Navarrow@DocNavarrow·1d

@nirmalregency Fair point. This case is better called autoimmune encephalitis, not limbic encephalitis. No mesial temporal involvement on MRI. “Autoimmune” defines etiology. “Limbic” defines location. Using “autoimmune limbic encephalitis” as a blanket term is misleading.

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Nirmal Pandey MD DM Neurologist@nirmalregency·1d

@DocNavarrow Where is the “limbic” encephalitis as mentioned on the title of this report?

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Doc Navarrow@DocNavarrow·1d

💡Lentiform fork sign on MRI typically points to uremic encephalopathy… but not always. ✅Normal renal function should raise suspicion. In this case, CSF revealed anti-NMDA receptor antibodies → autoimmune encephalitis. doi.org/10.1016/j.radc…

👱‍♀️58F with 2 weeks of confusion, behavioral change, and seizures. Labs unremarkable, renal function normal. 🍴On MRI I see… a fork? 👀What do you see?

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SERAM - Sociedad Española de Radiología Médica@SERAM_RX·1d

¡Tenemos buenas noticias! 👏 El curso #AIRPSERAM2026 está disponible en la plataforma online de #FormaciónSERAM 👉 Contenidos en correlación radiológico-patológica en mama, abdomen y genitourinario, con expertos del AIRP y enfoque directo a la práctica clínica Toda la información aquí 🔗 f.mtr.cool/fezficneoz

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Neurosurgery Cocktail@BipinChaurasia_·3d

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@OAndrePa Strong association, yes. But MS is likely multifactorial. EBV may be necessary, not sufficient.

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André@OAndrePa·2d

@DocNavarrow It is so strongly associated that a vaccine against EBV is being developed for decades to try to stop MS development.

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Dr. Brandon Beaber@Brandon_Beaber

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Doc Navarrow@DocNavarrow·2d

🦠Is Epstein-Barr virus really linked to multiple sclerosis? 🤔Interesting observation supporting a possible long preclinical phase. Makes you wonder how many “silent” biological signals precede MS by years.

A woman was diagnosed with MS in 2019. A cerebrospinal fluid sample (obtained from spinal anaesthesia in a research study) 15 years prior showed antibodies against Epstein-Barr virus (EBV). A case report from Spain pubmed.ncbi.nlm.nih.gov/41841779/

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@wAvydRR6z0niUMr Glad you found it useful. ありがとうございます！

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秋本和美@wAvydRR6z0niUMr·2d

@DocNavarrow この症例、勉強になりました。ありがとうございます。

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Doc Navarrow@DocNavarrow·2d

✅Intradural extramedullary capillary hemangioma of the cauda equina. 🩸Often mistaken for schwannoma or meningioma due to overlapping imaging features. Unfortunately, its higher vascularity carries an increased risk of intraoperative bleeding. doi.org/10.1055/s-0045…

👩‍💼25F with 1-year history of low back pain and progressive left-sided radiculopathy, no motor deficit, normal reflexes. Symptoms worsening despite conservative management. 🩺What’s your differential?

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音成"脳の内科医"@neshige_s·2d

2週間の経過での精神症状、発作血液検査に異常なし診断は？以前からいってますが両側対称性は中毒、代謝、薬剤、ウイルスが相場

👱‍♀️58F with 2 weeks of confusion, behavioral change, and seizures. Labs unremarkable, renal function normal. 🍴On MRI I see… a fork? 👀What do you see?

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@OGdukeneurosurg

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Oren Gottfried, MD@OGdukeneurosurg·2d

He survived a head injury most wouldn’t expect anyone to live through… and lived for decades. How is that even possible? #history #science #medicine #neuroscience #americanhistory

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@PeterItebimien @IhabFathiSulima @ChefKarim02 @esanum @TSM_Humanist @PJaseja @drsthanus @nirmalregency @daniel_gewolb @DrAkhilX @drkeithsiau @modernHealthMe @MEmwanta @rkalyes1 @Doctors__squad @BrownJHM @the_beardedsina 🐰The “inverted V” (rabbit ears) sign reflects symmetric T2 hyperintensity in the dorsal columns on axial MRI. Classic for subacute combined degeneration, but not just nutritional B12 deficiency.

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Itebimien Peter@PeterItebimien·2d

A 24yr♂️ with complaints of numbness and tingling of feet and hands,frequent falls.History👉heavy recreational use of substances.Diagnosis & what is this sign? Mgt? #MedTwitter #MedX #NeuroTwitter #GITwitter @IhabFathiSulima @ChefKarim02 @esanum @TSM_Humanist @PJaseja @drsthanus

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Doc Navarrow@DocNavarrow·2d

✅Intradural extramedullary capillary hemangioma of the cauda equina. 🩸Often mistaken for schwannoma or meningioma due to overlapping imaging features. Unfortunately, its higher vascularity carries an increased risk of intraoperative bleeding. doi.org/10.1055/s-0045…

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