NEW ONSET STATUS EPILEPTICUS AND MULTIFOCAL HAEMORRHAGE IN A YOUNG ADULT, A RARE CLINICAL PRESENTATION OF CNS VASCULITIS

Abstract

Primary central nervous system vasculitis (PCNSV) is a rare inflammatory disorder affecting the blood vessels of the brain and spinal cord, without systemic involvement or underlying connective tissue disease. It usually presents with a wide range of nonspecific symptoms in the form of focal neurological deficits, new onset seizures, severe headaches, and cognitive impairment. Diagnosis is usually made when unexplained neurological deficits with either an angiogram or CNS biopsy shows features of vasculitis with other causes ruled out. Few cases are being reported every year thus making the diagnosis of PCNSV difficult in emergency department. The patient discussed here is a 29-year-old male who presents as status epilepticus to our emergency department. MRI brain reveals multiple subacute intraparenchymal haemorrhage with punctate micro haemorrhages. CSF analysis shows pleocytosis with mildly elevated protein levels. A diagnosis of primary CNS vasculitis was made and patient rapidly improved after receiving intravenous Methylprednisolone for 7 days.