Published online Jul 28, 2018. doi: 10.4329/wjr.v10.i7.78
Peer-review started: April 25, 2018
First decision: June 6, 2018
Revised: June 11, 2018
Accepted: June 27, 2018
Article in press: June 28, 2018
Published online: July 28, 2018
Spontaneous left arm weakness, objective vertigo, obesity.
Left arm downward drift associated with local joint pain.
Acute vasculopathy; neuropathies; joint affections.
Unremarkable laboratory examination.
A head NCCT revealed the presence of a left-sided hypodense peri-callosal curvilinear lesion; a CT Angiography ruled out vascular obstructions, while the thoracic scan showed two posterior extradural hypodense lesions at T1-T2. The MRI did not show diffusivity alterations: the curvilinear peri-callosal lesion appeared hyperintense in T1-W and hypointense at fat suppression sequences, without contrast enhancement, thus confirming the lipoma.
Rest and painkillers.
Envelopathies: defects of proteins making up the nuclear envelope.
A particular obesity pattern associated with cerebral-spinal lipomas may be related to the same gene defect in patients affected by the Emery-Dreifuss muscular dystrophy X-linked variant. In our case, lipomas may be considered incidental findings, whereas the patient’s symptoms could be related to an initial painful contracture, which is a typical hallmark of the disease.