Clinical Reasoning: A young woman with rapid mental deterioration and leukoencephalopathy: A treatable cause

  • Biotti D
  • Esteban-Mader M
  • Diot E
 et al. 
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A 21-year-old woman was admitted due to rapid worsening of mental deterioration, which led to her becoming bedridden for over 3 months. She was born to consanguineous parents and had mild mental retardation and spastic paraparesis that impaired running. She became pregnant 4 months before admission. During the first weeks of pregnancy she developed deep vein thrombosis, which was treated with anticoagulant therapy. A medical abortion using misoprostol and mifepristone was performed. Since this event, mental changes progressed rapidly. She had a brain MRI showing multifocal T2 white matter signal changes (figure, A and B). A diagnosis of psychosis was considered.

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  • Damien Biotti

  • Maud Esteban-Mader

  • Eric Diot

  • Cécile Acquaviva

  • Nathalie Guffon

  • Caroline Tilikete

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