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We report a Native American male in his 50s with a complex medical history including alcohol use disorder and seizure disorder who presented with complaints of generalized weakness and multiple falls. The patient was admitted for altered mental status, community acquired pneumonia, sepsis, and bacteremia. On hospital day 23, the patient reported a sudden onset of sensation of food stuck in his upper chest. Brain MRI confirmed osmotic demyelination syndrome (ODS) within the central pons. Further workup revealed this finding was likely due to malnutrition, alcoholism, hypoalbuminemia, and vitamin B6 deficiency. However, the patient presented with normonatremia throughout his entire hospital stay. After acute onset of ODS, the patient was transferred to the ICU where he continued to decline. After 68 days from initial presentation, the patient died in hospice care from myelinolysis complications. This case demonstrates a case of ODS of the central pons in a patient with normonatremia, hypoalbuminemia, and severe vitamin B6 deficiency. [ABSTRACT FROM AUTHOR]

A Caucasian male in his 60s presented with acute onset of dizziness, dysarthria, and gait ataxia. Upon extensive workup, positive findings were cerebrospinal fluid (CSF) showing lymphocytic pleocytosis with oligoclonal bands, positive celiac disease autoantibodies in blood, a duodenal biopsy indicating lymphocytic infiltration, and positive anti-mGluR1 antibody titers in CSF. The patient was started on a strict gluten-free diet and intravenous immunoglobulin therapy for 5 days and showed mild consecutive improvements each day of treatment. He was discharged after 22 days, and was encouraged to continue gluten adherence, physical and speech therapy, and follow up with neuroimmunology. This report demonstrates that autoimmune encephalitis due to anti-mGluR1antibodies and gluten ataxia are both immune-mediated disorders that should be considered in acute cerebellar ataxia cases. By broadening the differential diagnosis and a comprehensive CSF analysis, identification of gluten ataxia and autoimmune encephalitis were beneficial in the management of this particular patient. [ABSTRACT FROM AUTHOR]

Statins have grown to become an important class of medications in the primary and secondary prevention of cardiovascular diseases. While lowering low-density lipoprotein-C (LDL-C) levels, statins also have a role in stabilization and regression of atherosclerotic plaques. In the last two decades, there is a mounting body of evidence that suggests that statins and lowering serum lipid levels may be associated with an increased risk of developing intracerebral hemorrhage (ICH). This review article provides a concise summary of the most important studies performed to date and the pathophysiology behind the association between statins and ICH. [ABSTRACT FROM AUTHOR]

Pituitary adenomas are a common brain tumor that are frequently asymptomatic but may initially present with vision deficits or very rarely as meningitis thought to be due to cerebrospinal fluid leakage. In this case report we discuss the initial presentation of a pituitary macroadenoma as aseptic meningitis, particularly in the absence of an identifiable cerebrospinal fluid leak. We also discuss the workup and diagnostic challenges associated with this atypical presentation, including findings on imaging and pertinent laboratory results. [ABSTRACT FROM AUTHOR]