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Volume 8
Journal of Gastrointestinal & Digestive System
GI Diseases 2018
July 11-12, 2018
July 11-12, 2018 Sydney, Australia
15
th
International Conference on
Digestive Disorders and Gastroenterology
Acute brainstem syndrome secondary to malnutrition from functional dyspepsia
Dhanoop Mohandas
Isle of Wight NHS Trust Hospital, UK
B
rain stem syndrome is a condition commonly characterized by limb weakness, ophthalmoplegia and gait disturbances. The
common causes of brain stem syndrome are ischemia, neoplasia, demyelination, infective and hamartomous lesions in the
brain. Imaging ideally with a MRI scan is usually diagnostic in most cases and possibly following other investigations to identify
systemic abnormality or CSF changes before appropriate therapy can be introduced. A 42 year old Caucasian lady presented
with non-specific symptoms like lethargy, malaise, was off food for a couple of months and had lost a considerable amount of
weight (4 stones=25.4 kg). She was admitted to the hospital with nausea and vomiting for a few weeks and complained of a
lump in her throat. Gastroscopy was unremarkable. She also complained of sudden onset of double vision for the last few days
and examination showed vertical Nystagmus. She also complained of unusual sensation in her feet and soreness in the bottom
of her feet when she stood up. There was no obvious limb ataxia, absent lower limb tendon jerks but flex or plantars and intact
objective peripheral senses. Gait was unsteady while walking with eyes open but was better with eyes closed. The patient was
lucid the whole time. During the course of the stay in the hospital the patient developed Oscillopsia. She underwent a MRI
scan which was unremarkable. She was investigated for autoimmune cause including GQ1b for Miller Fischer syndrome and
paraneoplastic screen to investigate the weight loss. Lumbar puncture which was performed which showed protein of 0.69 and
rest of the values are normal. She was transferred to a tertiary neurology centre. Based on her clinical examination finding and
MRI report she was diagnosed with brain stem syndrome secondary to malnutrition due to functional dyspepsia. She was seen
by the dieticians and NG feed was started.
dhanoop_m@yahoo.comJ Gastrointest Dig Syst 2018, Volume 8
DOI: 10.4172/2161-069X-C2-068