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Bilateral substantia nigra lesions on magnetic resonance imaging in a patient with encephalitis lethargica
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  1. H VERSCHUEREN
  1. Department of Neurology, Algemeen Ziekenhuis Monica, Campus OLV Middelares, Deurne, Belgium
  2. Department of Neurology, Algemeen Ziekenhuis Middelheim, Antwerpen, Belgium
    1. R CROLS
    1. Department of Neurology, Algemeen Ziekenhuis Monica, Campus OLV Middelares, Deurne, Belgium
    2. Department of Neurology, Algemeen Ziekenhuis Middelheim, Antwerpen, Belgium

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      A 21 year old man was admitted to hospital presenting with low grade fever (37.7°C), slight meningeal irritation, headache, visual hallucinations, dysarthria, insomnia, gait and limb ataxia, and a postural tremor.

      There was no relevant history except for a fall into a river after a fight 2 weeks before admission. There were only a few superficial skin lesions, no medical attention was sought. The patient denied the use of recreational drugs.

      Brain CT was normal. A lumbar puncture was performed showing 72 white blood cells/mm3 (84% monocytes and 16% polymorphic neutrophils), and …

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