Table 1 Excerpt of clinical investigations and laboratory findings of presented cases
Investigations | Patient 1 | Patient 2 | |||
|---|---|---|---|---|---|
Initial visit | Month 2 | Month 5 | Initial visit | Reference range | |
Blood tests | |||||
CRP | 8.5 mg/l | – | 65 mg/l | 444.2 mg/l | < 5.0 mg/l |
IL-6 | – | – | – | 385 pg/ml | < 7.0 pg/ml |
sIL-2 receptor | – | – | – | 5611.0 U/ml | 158–623 U/ml |
Auto AB | Negative | – | – | Negative | Negative |
CSF analysis | |||||
Cell count | 1 cells/µl | – | – | 118 cells/µl | 0–5 cells/µl |
Protein | 347 mg/l | – | – | 964 mg/l | 150–400 mg/l |
Lactate | 1.6 mmol/l | – | – | 4.5 mmol/l | 1.2–2.1 mmol/l |
Glucose CSF/serum ratio | 58.7% | – | – | – | > 50% |
Virology | Negative | – | – | Negative | |
Microbiology | Negative | – | – | Negative | |
Cytology | – | – | – | 93% neutrophil granulocytes 1% eosinophil granulocytes 1% monocytes 6% lymphocytes | |
Neuro-pathology | No atypical cells | – | – | Signs of active inflammation, granulocytes dominating, no atypical cells | |
CT staging | Partial response | – | Progressive disease | Progressive Disease | |
Cerebral MRI | No evidence for leptomeningeal disease/CNS metastasis | No evidence for leptomeningeal disease or CNS metastasis | – | Diffuse contrast enhancement of the meninges | |
Neuro-graphy | |||||
Median nerve | |||||
Sen | No potential bilaterally | No potential bilaterally | No potential bilaterally | No potential | Amplitude > 5.0 mV |
Mot | No potential | Small amplitude (0.1 mV), reduced velocity (45.4 m/s); right arm | Small amplitude (0.3 mV/0.8 mV), reduced velocity (35.5/46.5 m/s); right/left arm | Normal | Velocity > 50.0 m/s |
Tibial nerve | No potential | No potential | No potential | Decreased motoric amplitude (4.5 mV); right leg | Amplitude > 5.0 mV |
Sural nerve | No potential | No potential | No potential | Decreased amplitude (3.1 µV); left leg | Amplitude > 3.8 µV |
NMUS findings | |||||
Median nerve | Almost continuous swelling (both sides, right > left) | Decrease of swelling (right) | No swelling (right), CTS (right) | Carpal-tunnel-syndrome (both sides) | |
Ulnar nerve | Discontinuous swelling (both sides) | Decrease of swelling (right) | No swelling (right) | Swelling (right) | |
Tibial nerve | n.a | Normal (left) | n.a | Tarsal-tunnel syndrome (both sides) | |
Fibular nerve | n.a | Normal (left) | n.a | Swelling (both sides) | |
Vagus nerve | Normal (both sides) | Normal (right) | n.a | Swelling (right) | |
C5 longitudinal | Normal (both sides) | Normal (right) | n.a | Swelling (left) | |
C6 longitudinal | Swelling (right) | Reduced swelling (right) | n.a | Swelling (left) | |
Sural nerve | n.a | Normal (left) | n.a | Normal (both sides) | |