Neuro-Restoration — Lombardo Palma, MD, MSPH

Disequilibrium case w/ video documentation. 69 y/o male Mexican roofer with history of disequilibrium for 3 months. After positive imaging showing left intracranial fossa mass he was hospitalised for brain surgery. He underwent craniectomy that found a left fossa abscess due to infected tooth cavity. He was discharged after a for 6 weeks course of triple intravenous antibiotics. Upon discharge, he came to my office. A neurological exam demonstrated ataxia. He was given  an in-office high-dose dextromethorphan challenge—(DM CHALL) in the form of Delsym 3 oz swallow that was positive with mild neurologic improvement within 30 min. He was treated w/ high dose Dextromethorphan + Allopurinol + Memantine—(MEM+AL+MEM) for 2 months. Videos show his gait before and after DM CHALL and 5 months later in at-home visit. The later shows complete ataxia resolution. Pt gave written consent to publish case his videos.