Neuro-Restore — Lombardo Palma, MD, MSPH

Disequilibrium-Ataxia 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 and underwent brain surgery. Craniectomy found a left fossa abscess due to infected tooth abscess extension. He received a 6 weeks course of triple intravenous antibiotics and physical therapy but ataxia persisted. Upon discharge, he came to my office, his exam showed ataxia. He received in-office high-dose dextromethorphan challenge—(DM CHALL) via oral Delsym 3 oz swallow that was positive with mild neuro improvement within 30 min. He was treated w/ high dose DM + Allopurinol + Memantine—[DM+AL+MEM] for 2 months. Videos show his gait before and 30’ after DM CHALL, and after 5 months at-home, with complete ataxia and left flank visual impairment resolution. Patient gave written consent to publish case his videos.

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