Vertigo and left facial p...

A 29-year-old-woman was admitted to the hospital for treatment of vertigo and left facial palsy. General examination results obtained upon admission were normal. During a neurological examination, she was determined to have right rotatory nystagmus, left peripheral facial palsy, and diminished sensation on the left side of her face. Antithyroglobulin antibodies (1:1600, normal< 1:100), anti-microsomal antibodies (1:400, normal< 1:100), and a low titer of anticardiolipin antibodies (aCL) (19.7 U/mL, normal:< 10 U/mL) were detected by serological analysis. Using gadolinium enhancement, a brain MRI showed a lesion in the left middle peduncle (Figure A). She received IV methylprednisolone. Following treatment, her symptoms gradually got better. However, she has not opted for further treatment to prevent disease progression as she wants to get pregnant. After five years, she again visited the hospital. A new lesion was discovered on the left side of the medulla, and MRI confirmed the lesion in the left middle peduncle  (Figure B). It was repeatedly established that Lupus anticoagulant (L.A.) was present in her plasma.