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An Unusual Form of Motor Neuron Disease Following a Cat Bite

Published online by Cambridge University Press:  18 September 2015

Arthur J. Hudson ,
Harry V. Vinters ,
R. Charles Povey ,
Leslie A. Hatch ,
Dean H. Percy ,
John H. Noseworthy  and
John C.E. Kaufmann
Arthur J. Hudson*
Affiliation:
Department of Clinical Neurological Sciences, University of Western Ontario, the University and St. Joseph's Hospitals, London, Ontario
Harry V. Vinters
Affiliation:
Department of Pathology, University of Western Ontario, University and St. Joseph's Hospitals, London, Ontario
R. Charles Povey
Affiliation:
Department of Clinical Studies, Ontario Veterinary College, University of Guelph, the University and St. Joseph's Hospitals, London, Ontario
Leslie A. Hatch
Affiliation:
Department of Microbiology and Immunology, University of Western Ontario, the University and St. Joseph's Hospitals, London, Ontario
Dean H. Percy
Affiliation:
Department of Pathology, Ontario Veterinary College, University of Guelph, the University and St. Joseph's Hospitals, London, Ontario
John H. Noseworthy
Affiliation:
Department of Clinical Neurological Sciences, University of Western Ontario, the University and St. Joseph's Hospitals, London, Ontario
John C.E. Kaufmann
Affiliation:
Department of Pathology, University of Western Ontario, University and St. Joseph's Hospitals, London, Ontario
*
Dept. of Clinical Neurological Sciences, University Hospital, London, Ontario, Canada N6A 5A5
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Abstract:

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A case of motor neuron disease with clinical and pathological resemblance to amyotrophic lateral sclerosis (ALS) in a woman who was severely bitten on the ankle by a cat is described. Weakness first appeared at the ankles and relentlessly advanced proximally, terminating in death from pulmonary failure in a year. A number of unusual features that are uncharacteristic of ALS were found that included a markedly elevated antinuclear antibody titre in the serum and the presence of prominent oligoclonal bands in the cerebrospinal fluid. The spinal cord showed loss of anterior horn cells and pyramidal degeneration that are characteristic of ALS, but an extraordinary finding was the presence of transmural granulomatous inflammation of numerous small and medium sized vessels, especially veins, in the subarachnoid space around the cord. There were also inflammatory changes in the brainstem and spinal cord consisting of microglial and astrocytic nodules and perivenous cuffing by mononuclear cells. Ill-defined hyaline eosinophilic cytoplasmic inclusions were seen in some remaining anterior horn cells. No viral particles were found by electron microscopy despite an extensive search. Virological studies were inconclusive but there is reason to believe that this patient's illness was caused by an as yet unidentified virus.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 13 , Issue 2 , May 1986 , pp. 111 - 116
Copyright
Copyright © Canadian Neurological Sciences Federation 1986

References

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